Dementia Resources

The population is ageing and so we are seeing an increase in the prevalence and incidence of age-related conditions, such as frailty and dementia. These two conditions can often go ‘hand in hand’, making it important to ensure appropriate recognition, assessment and then management of each when experienced together. This paper uses a case study approach to illustrate and discuss the issues as relating to community nurse practice.

Dementia is an umbrella term used to describe a group of symptoms characterised by behavioural changes, loss of cognitive and social functioning brought about by progressive neurological disorders. It is estimated that around one million people live with a dementia in the UK, with that figure set to rise to 1.2 million by the year 2040. We are learning more about the risk factors for developing dementia over the life course. This paper discusses the non-modifiable and modifiable risk factors for dementia and considers health promotion and health education activities that can be used by community nurses.

Due to its progressive nature, dementia is now the leading cause of death in England and Wales, so a palliative approach to care is beneficial because of its emphasis on supportive care. Many people with dementia also have other comorbid health conditions common
in older age, that in themselves may induce pain. However, people with dementia may have difficulty in understanding what they are feeling and in describing and locating the pain due to having issues with communicating their needs as their dementia progresses. This paper considers the recognition, assessment, treatment and management of pain in older people with dementia. It introduces the learner to what is known about the subject  and why it is important to know the person’s past history and previous ways of self-managing pain and discomfort using information gained from their family, carers and friends.

Storytelling is the act of telling or writing stories, or narratives. Typically, stories are told for entertainment, for informational or educational purposes. Telling stories and storymaking is integral to our human consciousness and lived experience

It is estimated that there are currently 944,000 older people living with dementia in the UK, and that 593,200 of those people are living with advanced symptoms. People living with advanced dementia have a significantly higher prevalence of pressure ulcers (PUs), compared to those living without dementia with similar comorbidities. The care and support required to prevent pressure ulcers in people living with dementia needs to be individualised, following a holistic and person-centred assessment of the person and their unique circumstances. An improved understanding of the increased risk and causal factors of developing pressure ulcers in high risk groups, such as people living with advanced dementia, can support practitioners to conduct a more through and person-centred risk assessment and management plan, including choosing the most appropriate products to meet a person’s needs.

Over the past decade, the author believes that society has begun to awaken to the
transformative power music can have both for those living with dementia, and those who care for them. There have been a number of viral news stories which have really captured the nation’s hearts and brought us all to tears — think of Paul Harvey with his beautiful Four Notes improvisation and Marta C Gonzalez, a forma prima ballerina living with Alzheimer’s who became animated listening to Swan Lake.

The number of people with dementia is expected to increase with a consequential effect on the wellbeing of families and increasing pressure on an already over-burdened health and social care system. Risk factors for dementia, both modifiable and non-modifiable,
if appropriately understood and identified are amenable to management and amelioration. Community and primary care nurses are in an ideal position to support the reduction and management of risk pre and post dementia diagnosis. Using a case study, this paper highlights some of the issues in identifying, assessing and managing risk in a person with an existing diagnosis of dementia and their family/carer. The potential for dementia-related risks to escalate can have a much wider impact on a family unit if not appropriately identified, managed and mitigated against. 

There are many challenges in providing palliative and end-of-life care to people with dementia; some of which may be reduced through advance care planning (ACP) to support the person with the diagnosis to have a greater influence on their care at end-of-life.
Advance care planning has been defined as a process of discussing and recording wishes, values, and preferences for future care and treatment held between an individual, family members and their care provider(s) that takes effect when the person loses capacity. This
paper considers some of the barriers and enablers to lead to better support of ACP in families affected by dementia.

Globally, there are more than 800 million people aged over 60, which equates to approximately 12% of the world’s population. This figure is expected to grow rapidly, with studies estimating that by 2050 numbers of older people will reach two billion (United Nations [UN], 2015). The UK has a higher than the global average older population.

The population of the UK, as with other developed nations, is ageing. Estimates show that in 50 years’ time, there are likely to be an additional 8.6 million people aged 65 years and over living in the UK (Office for National Statistics [ONS], 2018a). The increased ageing and morbidity of our population is driven by several factors.