End of Life & Dementia Care Essay

1.1 Dementia is a progressive disease where an singles brain functions deteriorate and affects their mental capabilities. This disease is incurable which is analogous to a nonher terminal illness much(prenominal) as erectcer. Symptoms of insanity go away affect an item-by-items memory leading to leaving and confusing, speech/ communication, belowstanding and judgement. Medication freighter be prescribed to suffice dim d knowledge the progression of symptoms. Within the more advanced stages the soulfulness depart commonly suffer from incontinence, hold in mobility and limited communication usu eithery the case-by-caseistic leave not be able to use sentences just limited words. Other symptoms that worsen similar to those with a terminal illness are aspiration, difficulty with breathing, pressure sores from neglect of mobility, unrecognisable symptoms of fuss (whitethorn not be able to communicate) this could lead to the someone not macrocosm treated for wo(e) .1.2 The blockade of feeling experience whitethorn protestentiate amid those who project to madness to those who singulars without. An unmarried whitethorn lack understanding surrounding the diagnosing being do, they whitethorn scram had symptoms for a longer period of time onwards a diagnosis had been made. This burn lead to confusion as to why they are having symptoms and the way they are feeling. An individuals communication may be limited, so they may not be able to announce their feelings, changes in symptoms and hassle. This can lead to depression/ anxiety which impacts on the individuals behavior I.e. verb eithery aggressive, changes in appetite. Lack of communication regarding wound in the ass could impact on the quality of rush and aesculapian treatment, as finagle givers are the primary source of recognising an individuals ail through and through sounds rather than speech and non verbal communication. Whereas someone who doesnt carry dementia may be able understand a diagnosis and plunge fully on how this can affect their wellness through an illness progressing.1.3 Person bosomd finagle has come under Health and social fearfulness act which states that state should energize choices well-nigh their lives and they should be at the centre of all planning. Is it heavy having the person at the centre of all assist throughout the time of caring for someone and when termination of liveliness-time is approaching. The do provided to an individual deep down this should be based around their choices, beliefs, set and decisions which may have been made in advance. Working as a disturbancer these should be respected. For causa knowing the individuals likes/ dislikes surrounding food, drinks, clothing, to have permission to give medication when the individual is unable to verbally consent.1.4 In the earlier stages of dementia it is authorized that the carer works alongside and includes the individual and their family to mak e plans to reflect the individuals wishes to be cared for at the oddity of life, to begin with the dementia progresses and leaves the individual unable to communicate their wishes. Otherwise an appointed person would need to make decisions for the individual which could leave them feel di tonic and unhappy. provision and assessing allows time to plan for the care over the few days of life including later nete. These advanced care plans reflect the individuals values, beliefs and choices I.e. lifestyle, finances, medication, DNARs, funeral plans, after death care, appointed person for as/when the individual lacks capacity under the rational health act to make ruff interest decisions on their behalf.2.1 Pain in individuals with dementia is poorly recognised and undertreated can be due to lack of communication. This is estimateent on what stage the individual is at within their dementia and how well the care givers know the individual. Some people maybe able to verbally commun icate to carers if they are in pain by using single words and using non verbal methods I.e. pointing to what hurts that as this diseases progresses the individuals ability to express themselves will worsen. If pain is going unrecognised, then there would be no medical intervention, which could fare more pain and will impact on the individuals health and behaviours.2.2 In the earlier stages individuals may be able to express pain through verbal and non verbal communication, in concert the carer could recognise that they are in pain and a rough subject of where this is coming from. This will enable carers to be able to provide medical intervention if needed I.e. Administering PRN paracetamol or seeking medical attendance from a nurse/doctor when required. Care givers should use clear questions when talk to someone with dementia as it may take them a forgetful longer to process what is being asked. As the dementia progresses the individual could be unable to communicate, but they may be able to express pain through noise I.e. screams, but these could be easily misinterpreted by care providers as a normal behaviour if these are steady occurrences.2.3 When pain has been recognised by care providers, communication with the individual is important where accomplishable dependant of their ability to be verbal and how much capacity the individual has to understand their pain. Care givers will continuously manage and observe the individual for changes in needs and record these within the daily care notes within the care plan. Dependant on the type of pain will depend on what medical intervention will be crush for the individual through advice from early(a) health professionals.Health professionals offer support to care providers to work as a multi-disciplinary team to promote the well-being of the individual to observe, monitor symptoms as well as the care stave. Care lag can give over the counter medications as per care plan, or the doctor/ nurses can prescr ibe stronger pain rilievo and controlled drugs. As end of life gets nearer palliative nurse would be shoot the breezeing to monitor the individual and advise staff on how best to care for the individual and what symptoms to look for in the last few days of life I.e. changes in skin colour, increase of secretions. Medications maybe increased I.e. syringe drivers, which will help ease the pain and to make the individual more comfortable.Advice from colleagues and other health professionals will support care givers to the highest degree non medicated techniques, these can be how best to position the individual, how often they should be repositioned to prevent pressure sores, skin care reinforcement the skin clear of sores, afflicting to keep the mouth peachy as there would be increased secretions from the mouth, advice on fluid intake, methods how to try and encourage fluid intake i.e. spooning drinks, changes in food I.e soft. The individual should have an advanced care plan wh ich care givers would be using to pit the individuals needs and wishes for example if they have a DNAR in place, then cardiopulmonary resuscitation would not be given.3.1 Carers may feel guilt and stress and the end of life of an individual with dementia because they may have felt ostracize emotions towards the individual throughout the stages of dementia. At diagnosis the carer may not have reliable the diagnosis and treated the individual normally which could have caused licking between the individual/ carer or they could have been in denial of the diagnosis and treated the individual normally, so the needs of the individual may not have been met fully. This could of impacted on the behaviour of the individual to stick agitated or withdrawn if they feel they are a burden.The carer may not fully understand the symptoms of dementia especially challenging behaviour I.e. shouting out/ aggression. The carer may have felt negative emotions such as embarrassment and may have lost t heir temper or felt like hurting the individual and they are frustrated with the ceaseless needs of support the individual has. When dementia has progressed and the carer may have been stressed from taking on the responsibility of caring if they have not had regular breaks. But on the other hand the carer may feel guilty for taking breaks and leaving them for other services to look after them. The carer may have had to make difficult decisions regarding accommodation for the individual such as going into residential care as they feel they can no longer cope with the responsibility of looking after them. After death the carer may feel they have let the individual down and not cared for them well enough based on their own expectations of themselves, they may to a fault regret certain decisions I.e. residential care.3.2 Carers can be supported by other professionals to understand how the end of life process may differ for individuals with dementia. Any health professional involved wi th the individuals care can provide support and advice I.e. GPs, nurses, palliative nurses and social workers. They can also suggest informative services offered to carers as support where they can go and discuss the process with trained professionals and other carers. Communication between family, carers, health professionals is vital with end of life care as this can provide reassurance that the individual is being cared for is comfortable as possible, also to keep informed of all changes in the individuals health I.e. refusal/ lack of ability to drink.A familymember may have been chosen to be the individuals power of attorney in the advanced care plan once capacity has been lost. This would have been documented under the Mental Health Act. This chosen person would need to be involved in decisions alongside doctors. All the people involved with the care of the individual will support each other, answer any questions, and work alongside any advanced plans which should have been pu t in place. As towards end of life the individual wont be able to make their own decisions so someone else will have to do this in the best interest of the individual.3.3 Anyone supporting an individual with dementia will feel loss and grief at the end of his or her life. Some people may experience loss and grief at the time of diagnosis or once the dementia has progressed further as there will be a lack of recognition between family and the individual as they may feel the dementia has taken over. People may feel all different kinds of emotions through loss and grief. Some may have accepted the diagnosis/ changes of the individual and feel sadness. Others may find this a relief that the individual has passed and no longer having to carry on with progressing symptoms causing them pain and a poor quality of life.3.4 Carers can have support from health professionals to make decisions and some of these decisions have to be made with health professionals, for example for a Do Not Attempt Resuscitation decision has to be made by a GP has to sign this document off in order to meet their best interests. Other decisions may need to be made if an advanced plan hasnt been made such as where the individual will reside at home or within a residential placement.3.5 At the final stages of end of life it is important to have good communication between all relevant parties (carers, family and colleagues). This is important so relatives are kept informed about how the individuals health is, any changes in medications as towards end of life as it is common to be prescribed a higher dosage of pain relief I.e. morphine syringe drivers, as changes as in the final stages changes can happen quickly. Relatives may also want to know about the individuals health as they may want to visit to say their last words or even be position at the time of death. Good communication is also important between carers as inresidential placements there will be staff change overs which they will need t o know the individuals health state, information about medication, to read end of life care plans, if anyone relatives need calling, any other info I.e. visits from nurses/ GPs.