Unit standard 23920
Task 1:
1.1:

Dementia

Normal ageing

loss of nerve cells

As regards with dementia brain ,the reason which is contributing to the death of nerve cell and disrupt the messages in the brain are plaques and tangles
Plaques and tangles are the reason of the dead of nerve cells

In normal ageing brain the loss of nerve cells can lead to the lower number of functioning synaptic nerve impulses to and from the brain and the processing information is quite slow because of losing small amounts of nerve cells.
Searching still can find small amount of plaques and tangles in normal ageing brain and also

slow reactions and decisions

In dementia brain ,the processing to figure out the information quite slow because of plaques and tangles ,therefore it can lead to slowly reaction and decision in ADLS
The people have dementia cannot understand some of the instruction and cannot make a decision for themselves, therefore they need someone else can make the decision for them.

In normal ageing, some of nerve cells are lost therefore their reaction are quite slow but they still can make their decision for their life.
The reaction of elderly person is quite slow and unstable therefore they can easily to get a fall.

memory changes

Because of losing nerve cells and plaques and tangles in the brain, the dementia resident can easily to forgetful memory and people even those are very closer with them.

The dementia resident cannot remember their own living style of them before so they can not follow the instruction and their routine well, they need a support of the careers.

The old people the still can remember clearly all their memory in their life and very happy to share it with people.

Elderly people normally want to keep everything they did as the routine and never forget to do follow the routine instruction

plaques and tangles

There are a lot’s of plaques and tangles in the brain and nerve cells of dementia resident brain. Most of nerve cells are dead.
Plaques and tangles is the protein.

There is still have small amounts of plaques and tangles in the brain of elderly people
Most of plaques and tangles are not affecting anything in lifestyle and thinking of old people.

1.2:
A, Dementia and delirium:

Dementia

Delirium

Onset

Becoming dementia can be over several years and it is usually gradually appear not suddenly.

to become delirium can be acute or sub acute

Duration/ causes

Dementia can follow person for a months or a years and progressive

usually brief/ hours to days

Emotion

The emotion of dementia client every unstable up and down every time, can be shallow ,apathetic, labile, irritable and careless

The resident who has delirium can immediate memory impaired, attention and concentration impaired.

B, Dementia and Depression:

Dementia

Depression

Memory and cognition

Dementia resident can not remember their memory and feeling hard to cognitive deficits.

The depression person can easily get some memory loss and have a poor attention

Sleep

Often a disturbed 24hrs clock mechanism, later in the disease process.

Early morning walking or intermittent sleep patterns

Thoughts

the dementia find difficulty making logical connection and processing

The thinking of depression people is quite slow may be preoccupied with sadness and hopelessness. Always have a negative thought about them, do not have any interested.

1.3:
A, Alzheimer’s disease:

In the brain of client who has Alzheimer’s disease have large amount of plaques and tangles in the brain and nerve cells. Most of nerve cells are death
The person who has Alzheimer’s disease get every easy to lost of memory, and also the way to think logically is reduced therefore they can not make a decision for themselves.
From day to days the way to expressed behaviors of person who has Alzheimer’s disease are changed.
Some client has Alzheimer’s disease regularly going to loss of language skill.

From the beginning of Alzheimer’s disease until the end the personality of the client are changing very quickly and their emotion is unstable, up and down all the time.

B, Vascular dementia:

The person who has vascular dementia normally has a number of small stroke and the stroke damage the brain associated with learning, memory and language, and also in the brain of client regularly appear amounts of plaques and tangles.
The communicated between the brain and another part of the body is not well anymore therefore the client may get very slowly and lethargy; sometime it can lead to lack of bladder control.
Some clients may get depression and their emotion changing very quick.
They always get confused and get problem with remember the memory; short term memory.
Most of client who has vascular dementia feel very hard to walking because of unsteady and unstable.

C, One type of dementia: Parkinson’s disease:

The brain of person who has Parkinson’s disease appear amounts of plaques and tangles inside the brain and the nerve cells also, therefore can lead to loss of nerve cells.
The patient have a slowly thinking process and in daily living activities also.
The client has Parkinson’s disease can feel quite difficult to concentrate in something.
The client with Parkinson’s disease has poor judgments therefore they cannot make their own decision.
The client has a poor motivation.

1.4:

The most significant risk factor of dementia is age. The number of person who is over sixty-five is quite high, according to National Institute on Age information.
The second risk factor is lifestyle specially the smoking and has alcohol intake person, researching shown that the people who has smoke and have much of alcohol intake are very easy to get atherosclerosis- one cause lead to dementia.
The third one is cholesterol. In blood of human if have high levels of cholesterol can easier to get vascular dementia.

1.5:
Cognitive effects

at early dementia changes, the clients has difficulty with the short term memory. Therefore in daily living the client feel quite hard to following the conversation with others and regularly they feel lonely and depression, isolation.
some of residents can feel quite hard to planning, organizing and making decision in their life. Therefore the client can feel confused because some of them cannot work of even make a decision for their life .They can feel lost and isolated.

Functional effects :

Some of client might have trouble with certain skills such as dressing, toileting, showering
Because the communicated between the brain and some part of body is not good anymore therefore people become slower, some of clients may feel uselessness and worthlessness.

Behavioral effects :

The way to communicated and express of dementia client is quite strange therefore sometime the careers cannot understand of misunderstanding.
The way of thinking of dementia client is also up normal, they just want to do the things they think it right, therefore sometime they can make other people feel embarrassed.

Psychological effects:

The person who has dementia can easily to anger and frustration, sometime they become over emotional, laughing and crying at the same time, therefore can make other people confused , misunderstanding.
The client can easy to be depression, isolation with others, therefore in the daily living are quite hard to cooperate with the careers.

Task 2:
2.1:
Relationship:

All of family members and friends should be encouraged to participate and share in leisure and social experiences.
The relationship between staff, the family members and the person with dementia need to be developed and trusting, therefore its can bring some of benefit for dementia client such as the social, spiritual and emotional well being.
With dementia client the environment around them are quite important, therefore some of social interaction between people with dementia and others resident can helpful.

Communication:

The way of communication of dementia resident is quite different from normal; therefore with the dementia client the best way to communicated is starting talking right in front of the client, not too close, using eye-contact and some of face expression.
Otherwise , the speech and tone must be slow and gentle when talking with dementia client, do not shouting or screaming
Dementia resident still can talk but the speech of talking is quite slow therefore the health care assistance need to be very patient and allow them to talk, give them the choice and independent.

Individual:

All of family members and health care assistance should treat the dementia resident with the individual and give them the respect.
Dementia resident need to be encouraging and respect with the choice in their life.
Some of dementia resident still can do some things independent such as washing face, eating, drinking, therefore the careers need to understand and give them independent as much as they can do.

Feeling:

The emotion of dementia client is always up and down, unstable anymore, therefore they can easier be sad and isolation. With this situation, the health care assistance need to spent time, be patient and encourage them to talk make them feeling better.
The careers need to patient, encouraged the dementia talking and be listening , understanding and give them the advise with the respectful.

Abilities retained:

The careers always give the opportunities for people with dementia to respond appropriately and utilize their abilities.
The careers need to known about care plan of the resident therefore they can know what sort of activities the clients love to do in the past and give them suggest some of the activities similar with their interested in the past.

Needs of the person with dementia:

Psychological need: the dementia resident need a person to understand and listening to them, therefore the careers need to have some knowledge about dementia resident and give some advice for them.
Physical need: some of dementia resident’s motilities are quite week there for they need a support of motilities aids such as walking frame or hip protector. Moreover, others dementia client have a problem with the communication therefore they need some communication aid to support them communicated with other people.

2.2:

Relationship: the relationship between the family, friends and the healthcare assistance with dementia resident is very important with dementia client. All the careers can be the stronger supporter for the dementia client.
Feeling: The feeling is also very important with dementia resident. The careers always need to know how can make the resident feeling better and also make sure that they have knowledge their feeling.
Needs: all the needs seem to be one of the significant important things with the dementia resident, its can make dementia resident feeling more securities and safe, more confident and happier.

2.3:
The meaningful activities are quite important with dementia resident. Some of them may not doing these activities anymore because of some weakness side in the body but they still can remember the feeling when they was played this game and it is can make them feel better . In some how it can remind the client to the happy memories in the past with the games. Moreover the meaningful activities can make the dementia feeling happier when join activities with others resident therefore they will be more confident and their communication skill will be better.
Task 3:
3.1:
1, Verbal communication:

The way of communication of dementia resident is quite difficult to understand because dementia process can lead to the decrease of communication.
When they talking might not make sense therefore can make other people confused.
The speech of communicated also quite slow and might be stuck to finding some words or sentences.

2, Vocalization:

Some of dementia resident who cannot talk may expressed their communication through noisy behavior such as screaming, moaning, singing.
Some of them might repetitive speech, make some stranger noise, these mean they might need your attention.

3, Gestures:

Some of dementia client might not have problem with vision and communication, they might using some of signal like tapping ,waving , pointing, shrugging, .etc to communicated.
Some of them might try to touch you to get your attention.
With different client have different culture may have some different gestures and have some different meaning.

4, Communication aids:

With different client might using different communication aids like with person cannot talk, they can using communication card or picture book to communicated.
Some of dementia resident might using talking mats to communicate or through music to express the communication

3.2:
1, Sensory losses:

With the older ageing, some of the client may have a problem with the hearing but they did not have the hearing aid on therefore they cannot listen clearly or might misunderstanding when communicated.
Some of them have a poor vision but they did not wear glasses so they cannot see the body languages of others people who want to communicated with them.
Some of dementia resident cannot say properly and cannot listen properly also can be the barrier for them when communicated.

2, Communication partner:

Some of dementia resident cannot talking therefore they need the communication partner to help them to express what they want, the communication partner may be their family, their friends, but sometime they are not available to communicated.

3, Heath status:

Some of dementia resident have a short term memory or have memory loss therefore it is seemed to be quite hard to communicate.
With some of dementia client who can have stroke or illness cannot have abilities to communicate with others. Some of disease can lead to a barrier in communicated of dementia client is UTI, depression and Parkinson.

4, Environment:

The noisy, large environment might make the communicated of dementia resident become harder like they cannot speak louder or cannot hearing properly.
Sometime the person who is communicated with the dementia resident may speaking too fast that will make dementia resident confused and misunderstands.

5, Culture:

Some of resident who can speak other languages when they have dementia they might come back and speak in their own languages therefore the healthcare assistance cannot understand what they want to say.

6, Age:

It is seem quite difficult when the dementia resident talking with younger person. Some of younger they speak quite fast or speak in younger expression therefore the dementia resident cannot understand what they want to say.
Because of the orderly process, the dementia may feel quite difficult to find the words and their speech when speaking is quite slow.

7, Gender:

There are a different in communicated between male resident and female resident. Normally the male resident may not likely to share the emotion or thinking to others than female.
The way of expression in male resident might stronger and they might use different words than female resident.

8, Reverting to original languages:
Some of resident they are from another country, they used to speak in another language but they have not using it for a long time. And then when they get dement, they might come back to speak in their own languages, these can made the careers and others be confused and misunderstanding.
9, Expressive and receptive communication problems:

Some of client with dementia they cannot communicate and express their needs because they have a trouble to finding the words and sentences.
Sometime the dementia client might not able to understand how to communicate in verbal or non-verbal. They might not able to understand the word form, reading and writing also.

3.3:
1, Communication partner:

Some of the dementia client might get confused with the communication partner therefore you need to make sure the partner is introduced clearly to the client.
Always make sure that the client is feeling comfortable with the communication partner.
The communication partner and the ways of communication, the expression of the client need to be recorded.

2, Environment:

The environment of communication need to be sure that the client can hearing properly and feeling comfortable during communicated.
The familiar environment is recommendation to against the confusing and scaring during communication period.

3, Verbal and Non-verbal:

The communicated person need to make sure that talking clearly, slowly, easy to understand. They can using the eye-contact and remember give them a time to understand and communicated.
With non- verbally, they can using a body languages, touching in the hand and shoulder, using some picture to communicated.

4, Singing:

The careers can using the song which one the client love to hear can make the client feeling better, happier. Moreover it is can help client remember the happy memory make them feeling more relaxed.
The singing can be one of the ways of communication and also can help the client feeling happier.

5, Music:

The careers may use the music to encourage communicated with dementia resident.
The music might be a solution to make the dementia resident calm down and relaxed.

6, Activities:

The activities might help dementia resident to communicate with others people to increase confident.
Also the activities can help dementia resident more relaxation, made them more opened with others.

7, Communication aids:

Some of the communication aids might help dementia resident who are not able to talk can communicated with others via picture book, picture, board, etc.
Communication aids can make the resident more confidence to talking with others.

Vijay Kumar