CFP 208 A1 Nursing Challenges in Care
Imagine waking up in the morning and no knowing your partner or spouse lying next to you in the bed. Imagine waking up and not knowing your own name, how old you are or when your birthday is. Imagine having to look at your children, grandchildren, brothers and sisters and asking who they are. Imagine seeing the one you devoted your life to and them not remembering you. Imagine going to visit them every day and every time having to explain to them who you are and how you were a huge part of their life. Well due to the average life expectancy of the population of not only Scotland but the world increasing, the number of individuals experiencing this and progressing to receiving a diagnosis of dementia has considerably risen to astonishing levels. The aim of this essay is to demonstrate an understanding of the aetiology and pathophysiology of a chosen cognitive impairment, which for the purpose of this essay will be vascular dementia. A brief explanation in relation to patient confidentiality will be included at the start of the essay followed by the essay being broken into two main section within the main body which will include firstly the pathophysiology and aetiology, secondly focus on three separate nursing challenges faced by the writer in the care of the individual with vascular dementia and what care the writer provided for the individual in relation to improving quality of life, relieving of symptoms and improving patient safety. Lastly within the conclusion one recommendation for future nursing practice will be included. Examples from clinical practice will be used throughout this essay as well as relevant, up-to-date literature and theories. For the purpose of this essay and to ensure that the identity of the individual was protected the individual will be referred to as ‘Mr X’, this is due to nursing staff having a legal, professional and ethical obligation to protect all the information they have regarding patients. (Data Protection Act 1998). Vascular dementia is caused by a lack of supply of blood to the brain. This is caused when a blockage or narrowing of the arteries occur. One of the most common ways that these narrowing’s or blockages happen are as a result of the same process in which heart disease occurs. Therefore, the factors which are associated with heart disease are also associated with vascular dementia. Many people who go on to receive a diagnosis of vascular dementia do so as a result of a stroke (infarct) or a series of ministrokes. Due to the stroke part of the brain dies which is what causes the dementia to develop. Vascular dementia commonly develops as a result of the stroke happening on the left side of the brain or when it involves the hippocampus or memory centre. Other forms of vascular dementia may occur such as subcortical dementia (Binswanger Diseases) as a result of high blood pressure. Other causes of vascular dementia include those caused by conditions which reduce the blood supply to the brain, including autoimmune diseases, genetic diseases, and infections of the heart, brain haemorrhage and profoundly low blood pressure (Dorsey,J et al) The patient who will be discussed throughout this essay was an elderly gentleman in his late seventies who lived at home with his wife and eldest son and his family prior to admission into a long term, sixteen bedded care facility. The patient presents with a shuffling gait and relied a lot on his family for a majority of his day to day care before admission. This patient is generally a very private individual who required a lot of encouragement to discuss any issues that he has regarding his diagnosis of vascular dementia. The patients’ main support network has always been his family and a few close family friends. The patients’ rapid decline came to the attention of staff as a result of a focal seizure. Individuals with dementia may display a vast range of challenging behaviours such as screaming and...
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