1.1 Why is it important to recognise and respect an individual’s heritage? Because peoples heritage is part of their culture. The more you understand about it the more you understand the person and the reason they do some of the things they do. You have a heritage and it is why you were brought up with the beliefs and standards. You want people to respect that, so you should give the same respect. It’s also a part of history which has helped us evolve throughout this world. You may not like it or agree with it, but you should at least learn a bit about it before you make a decision and still respect it. 1.2 Compare the experience of dementia for an individual who has acquired it as an older person with the experience of an individual who has acquired it as a younger person.
Younger people with dementia may have different needs to people aged over 65 requiring a different type of service or a response appropriate to their age. In general, younger people with dementia are more likely to: Be in work at the time of diagnosis, have dependent children, have heavy financial commitments such as paying a mortgage, have a rarer form of dementia with which professionals are less familiar, find it difficult to rationalise losing skills at such a young age, find it more difficult to access appropriate information and support. Much of the support for people with dementia comes from family and friends, who provide unpaid care.
Younger people with dementia are more likely to have younger partners and family, who may be in work and/or education. This may mean that their friends and family are also less available to provide support for them. The specific needs of younger people with dementia have been recognised in the dementia strategies and plans in England (2009), Northern Ireland (2011) and Wales (2011). There is also reference made to younger people with dementia in the National Institute for Health and Clinical Excellence (NICE) guideline
1.3. How can the experience of dementia be different for individuals
a. who have a learning disability
Dementia generally affects people with learning disabilities in similar ways to people without a learning disability, but there are some important differences. People with a learning disability are at greater risk of developing dementia at a younger age – particularly those with Down’s syndrome: often show different symptoms in the early stages of dementia are less likely to receive a correct or early diagnosis of dementia, and may not be able to understand the diagnosis may experience a more rapid progression of dementia. May already be in a supported living environment, where they are given help to allow them to live independently. May have already learned different ways to communicate (e.g. more non-verbal communication if their disability affects speech) will require specific support to understand the changes they are experiencing, and to access appropriate services after diagnosis and as dementia progresses.
b. who are from different ethnic backgrounds
The first issue to be aware of is that we are all influenced by our cultural background? What we have learned when growing up. In other words, culture is relevant not just to people from other cultures but to all of us. A second issue is that a person is more than their cultural background. Individuals from one cultural background are not all the same as each other. A person’s identity is also shaped by, among other things, their own personality, education, family experience, socioeconomic status and life experience. While we should always be aware of and sensitive to a person’s cultural background, it is important not to make assumptions about the person just because they are a member of a particular CALD community (The Cultural and Linguistically Diverse).
When looking at the field of dementia, one way of incorporating a person’s cultural background is through the concept of person-centred care. When you take this approach, you treat each person as an individual and consider all aspects of that person’s background. You also try to understand what the person is going through from their own perspective as much as possible. In terms of how culture and language may impact on the dementia experience, important issues include: varying cultural notions about dementia; difficulties in accessing health and community support services; the effect of dementia on language; difficulties with diagnosis; and social isolation.
c. who are at the end of life
As they reach the end of life, people suffering from conditions like Alzheimer’s disease or Parkinson’s disease can present special problems for caregivers. People live with these diseases for years, becoming increasingly disabled. Because they do not die soon after they are diagnosed, it can be hard to think of these as terminal diseases. But they do contribute to death. Illnesses like Alzheimer’s disease make it difficult for those who want to provide supportive care at the end of life to know what is needed. Because people with advanced dementia can no longer communicate, they cannot share their concerns. Is Uncle Bert refusing food because he is not hungry or because he’s confused? Why does Grandma Ruth seem agitated, is she in pain and needs medication to relieve it, but can’t tell you.
As these conditions progress, they also obstruct efforts to provide emotional or spiritual comfort. How can you let Grandpa know how much his life has meant to you? How do you make peace with your mother if she no longer knows who you are? Someone who has severe memory loss might not take spiritual comfort from sharing family memories or understand when others express what an important part of their life this person has been. Palliative care or hospice can be helpful in many ways to families of people with dementia.
Sensory connections, targeting someone’s senses, like hearing, touch, or sight, can bring comfort to people with Alzheimer’s disease. Being touched or massaged and listening to music, “white” noise, (White noise is a type of noise that is produced by combining sounds of all different frequencies together. If you took all of the imaginable tones that a human can hear and combined them together, you would have white noise), or sounds from nature seem to soothe some people and lessen their agitation.
1.4 How can the experience of an individual’s dementia may impact on carers.
Caring for someone with dementia can be stressful because of the complex, unpredictable and progressive nature of the illness. This may have a profound social, emotional, physical and financial impact on carers, including increased risk of stress related illness such as depression. Many carers feel that their views and needs are overlooked by health and social care professionals and that their right to support as partners in the provision of care is not well recognised. It is important that the needs of carers are recognised in supporting people living with dementia, at all stages of the illness and in all settings.
2.1 Describe how current legislation, government policy and agreed ways of working support inclusive practice for dementia care and support
This resource provides easy access to the policy documents, reports and briefings that are raising the profile of issues around the support of older people and the implications of an ageing population. The initiatives and documents are listed chronologically with the most recent at the top. After thirteen years of a Labour government, a new coalition government of Conservatives and Liberal Democrats was formed in May 2010.
The coalition issued a ‘Programme for Government’ that combined the two parties? ‘Best ideas and attitudes’ to provide a blueprint for action on public services and set out the underlying ethos of the coalition. The Bills included in the Queen’s Speech (25 May 2010) with the potential to improve the lives of older people included the Health Bill, the Pensions and Savings Bill, the Energy Bill, the Welfare Reform Bill and the Decentralisation and Localism Bill. ]
2.2 Give examples of how an individual with dementia may be subjected to discrimination and oppression
The impairment in mental capacity caused by dementia can make people with dementia particularly vulnerable to discrimination and infringements of their rights. For example, they may be excluded from discussions about their care because their views and preferences are not seen to be valid or perceived to be a result of their condition, rather than a legitimate preference. When this occurs, the person with dementia may also be less able to object, or to challenge decisions that have been made on their behalf. Under the Mental Capacity Act a person must be presumed to be able to make their own decisions “unless all practical steps to help him (or her) to make a decision have been taken without success”. This must become a reality for people with dementia.
Examples are: Ageism: research shows that older people are denied access to the full range of mental health services that are available to younger adults. This particularly disadvantages people with dementia who are often over 65 and in need of mental health support. There are also widespread, mistaken assumptions that dementia is merely “getting old”, rather than a serious disease. This has led to unequal treatment for people with dementia, including poor rates of diagnosis and a lack of appropriate services. Abuse: Abuse is a serious infringement of the Human Rights Act and has a severe impact on quality of life. People with dementia are particularly vulnerable to abuse. Impaired mental capacity increases the risk of abuse and a person’s dementia can make it harder to detect when abuse is occurring.
Abuse can occur across all care settings, including by care workers and professionals in formal; care settings and by unpaid carers, family members, neighbours and strangers in informal care settings. It can take the form of psychological, financial, emotional, sexual or physical abuse. The Society believes that poor quality care must also be recognised as a form of abuse. The over-prescription of anti-psychotic drugs: The widespread over-prescription of anti-psychotic drugs to treat the behavioural symptoms of dementia is a serious breach of rights.
Antipsychotic drugs have serious risks for people with dementia including excessive sedation, accelerate cognitive decline and increased mortality. The failure of the health and social care system to respond safely and effectively to dementia is a major barrier to people with dementia and their carers accessing safe and effective interventions. Anti-psychotics should always be a last resort, used only at times of severe distress or critical need. Alzheimer’s Society supports the Dementia Action Alliance’s call to action to ensure that anyone with dementia who is receiving antipsychotic drugs receives a clinical review
2.3 Give example of how an individual with dementia can be subject to discrimination and oppression
2.4 How can diversity, equality and inclusion be addressed in dementia care and support. Fundamental to a person centred approach are the concepts of equality, diversity and inclusion. It is important to understand that each person’s experience of dementia is unique. It is essential to recognise and respect a person’s individual history, in particular: the experience of dementia for a younger person may be very different to the experience of an older person the experience of dementia may be different for individuals, who have a learning disability; who are from a Black or minority ethnic background; who are lesbian, gay, bisexual or transgendered; who are approaching the end of their life.
4.3 How can you challenge discrimination and oppressive practice of others when working with an individual with dementia?
Challenging discriminatory behaviour means not letting this behaviour happen without taking some sort of action against it. Remember, there are many ways that people can be discriminated against. They include verbal or physical abuse, exclusion, labelling or stereotyping . It is important to challenge discriminatory behaviour because it can cause distress, ill health, isolation and stress to a resident.
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