Exploring the relationship between physical health and mental health for the person with dementia.
“Dementia results in a progressive decline in multiple areas of functioning, including memory, reasoning, communication skills and the skills to carry out daily activities. Alongside this decline, individuals may develop behavioural and psychological symptoms such as depression, psychosis, aggression and wandering, which complicate care and can occur at any stage of the illness. Family carers of people with dementia are often old and frail themselves with high levels of depression and physical illness” (DOH 2009)
The following Essay will consider the relationship and impact between physical health and a diagnosis of dementia, for the person with dementia and their family carers. The importance of having a focus on both physical health and healthy living will be discussed, and reflections of this being an area which is often neglected by health care professionals and the wider population as a whole will be made. Finally, a rationale for supporting a more holistic approach to the care and support of the person with a diagnosis of dementia will be presented and an overview of how this has been included within my own practice area will be given.
It is believed that nationally, there are currently 821,884 people in the UK who are living with a diagnosis of dementia, with 163,000 new cases of dementia being diagnosed in England and Wales every year. However, until only relatively recently, dementia has suffered from poor awareness and understanding of the diagnosis and its disease trajectory. This may also have been made worse by the stigmas which are often attached to both mental health problems and old age. It has now been widely recognised that a diagnosis of dementia is considered to be one of the main causes of disability in older adults. The World Health Organisation (2003) in their global burden of disease report estimated that dementia contributed 11.2% of all years which were lived with a disability among older adults aged over 60 years of age. This was more than stroke (9.5%), musculoskeletal disorders (8.9%), cardiovascular disease (5%) and all types of cancer (2.4%).
Dementia can result in a range of difficulties: memory; thinking and planning; orientation to time, place and person; communication; learning; judgement; emotion; motivation, perception. These can all have an impact on mobility, for example: remembering where to go, understanding instructions or having something pleasurable to move for (Oddy, 2003). People with a diagnosis of dementia and their family carers may therefore be vulnerable to poor physical health and are often unlikely to have access to opportunities to participate in activities that will maintain good physical health, for example, appropriate physical activity, improved dietary advice etc. From an experiential perspective, activities which lead to improved physical health can have a positive impact on the ability to maintain levels of and behaviours which challenge others amongst people with dementia, in conjunction with reducing some of the symptoms of ill health and age related cognitive decline.
For some time, voluntary organisations have been proactive in raising concerns regarding the both the quality of and the appropriateness of the health and social care which is currently provided for the person with dementia and their family carer’s. These concerns were reinforced in The Audit Commission’s Forget me not report (2002) which observed that some GPs may treat the diagnosis and treatment of dementia with less urgency than other long term conditions such as cancer and COPD. in 2005 “Everybody’s business” was published which offered Clear policy guidance on how health and social care should commission and provide specialist services for older people with mental health problems...
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