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Dementia is the general name for a decline in cognitive abilities that impacts a person's ability to do everyday activities. This typically involves problems with memory,thinking,and behavior. Aside from memory impairment and a disruption in thought patterns,the most common symptoms include emotional problems,difficulties with language,and decreased motivation. The symptoms may be described as occurring in a continuum over several stages. Dementia ultimately has a significant effect on the individual,caregivers,and on social relationships in general. A diagnosis of dementia requires the observation of a change from a person's usual mental functioning and a greater cognitive decline than what is caused by normal aging.
A feeding tube is a medical device used to provide nutrition to people who cannot obtain nutrition by mouth,are unable to swallow safely,or need nutritional supplementation. The state of being fed by a feeding tube is called gavage,enteral feeding or tube feeding. Placement may be temporary for the treatment of acute conditions or lifelong in the case of chronic disabilities. A variety of feeding tubes are used in medical practice. They are usually made of polyurethane or silicone. The diameter of a feeding tube is measured in French units. They are classified by the site of insertion and intended use.
Polypharmacy (polypragmasia) is an umbrella term to describe the simultaneous use of multiple medicines by a patient for their conditions. Most commonly it is defined as regularly taking five or more medicines but definitions vary in where they draw the line for the minimum number of drugs. Polypharmacy is often the consequence of having multiple long-term conditions,also known as multimorbidity. An excessive number of medications is worrisome,especially for older patients with many chronic health conditions,because this increases the risk of an adverse event in those patients.
Ian John Deary OBE,FBA,FRSE,FMedSci is a Scottish psychiatrist known for work in the fields of intelligence,cognitive ageing,cognitive epidemiology,and personality.
The Clinical Dementia Rating or CDR is a numeric scale used to quantify the severity of symptoms of dementia.
A caregiver,carer or support worker is a paid or unpaid member of a person's social network who helps them with activities of daily living. Since they have no specific professional training,they are often described as informal caregivers. Caregivers most commonly assist with impairments related to old age,disability,a disease,or a mental disorder.
The prevention of dementia involves reducing the number of risk factors for the development of dementia,and is a global health priority needing a global response. Initiatives include the establishment of the International Research Network on Dementia Prevention (IRNDP) which aims to link researchers in this field globally,and the establishment of the Global Dementia Observatory a web-based data knowledge and exchange platform,which will collate and disseminate key dementia data from members states. Although there is no cure for dementia,it is well established that modifiable risk factors influence both the likelihood of developing dementia and the age at which it is developed. Dementia can be prevented by reducing the risk factors for vascular disease such as diabetes,high blood pressure,obesity,smoking,physical inactivity and depression. A study concluded that more than a third of dementia cases are theoretically preventable. Among older adults both an unfavorable lifestyle and high genetic risk are independently associated with higher dementia risk. A favorable lifestyle is associated with a lower dementia risk,regardless of genetic risk. In 2020,a study identified 12 modifiable lifestyle factors,and the early treatment of acquired hearing loss was estimated as the most significant of these factors,potentially preventing up to 9% of dementia cases.
As populations age,caring for people with dementia has become more common. Elderly caregiving may consist of formal care and informal care. Formal care involves the services of community and medical partners,while informal care involves the support of family,friends,and local communities. In most mild-to-medium cases of dementia,the caregiver is a spouse or an adult child. Over the period of time,more professional care in the form of nursing and other supportive care may be required medically,whether at home or in a long-term care facility. There are evidences to show that case management can improve care for individuals with dementia and the experience of their caregivers. Furthermore,case management may reduce overall cost and institutional care in the medium term. Millions of people living in the United States take care of a friend or family member with Alzheimer’s disease or a related dementia.
Alzheimer's disease (AD) is a neurodegenerative disease that usually starts slowly and progressively worsens,and is the cause of 60–70% of cases of dementia. The most common early symptom is difficulty in remembering recent events. As the disease advances,symptoms can include problems with language,disorientation,mood swings,loss of motivation,self-neglect,and behavioral issues. As a person's condition declines,they often withdraw from family and society. Gradually,bodily functions are lost,ultimately leading to death. Although the speed of progression can vary,the typical life expectancy following diagnosis is three to nine years.
Caregiver syndrome or caregiver stress is a condition that strongly manifests exhaustion,anger,rage,or guilt resulting from unrelieved caring for a chronically ill patient. This condition is not listed in the United States' Diagnostic and Statistical Manual of Mental Disorders, although the term is often used by many healthcare professionals in that country. The equivalent used in many other countries,the ICD-11,does include the condition.
Deprescribing is described as a patient-centred process to taper or stop medications with the intention to achieve improved health outcomes by reducing exposure to medications that are potentially either harmful or no longer required. Deprescribing is important to consider with changing health and care goals over time,as well as polypharmacy and adverse effects. Deprescribing can improve adherence,cost,and health outcomes but may have adverse drug withdrawal effects. More specifically,deprescribing is the planned and supervised process of intentionally stopping a medication or reducing its dose to improve the person's health or reduce the risk of adverse side effects. Deprescribing is usually done because the drug may be causing harm,may no longer be helping the patient,or may be inappropriate for the individual patient's current situation. Deprescribing can help correct polypharmacy and prescription cascade.
Roger Watson is a British academic. He is Academic Dean in the School of Nursing,Southwest Medical University,China and Professor of Nursing,Caritas Institute of Higher Education,Hong Kong. Until 2022 was the Professor of Nursing at the University of Hull. He is the editor-in-chief of Nurse Education in Practice and an Editorial Board Member of the WikiJournal of Medicine. Watson was the Founding Chair of the Lancet Commission on Nursing,and a founding member of the Global Advisory Group for the Future of Nursing. Watson was elected Vice President of the National Conference of University Professors in 2020 and became President in 2022 until 2024.
David John Webb,is a British physician,scientist and clinical pharmacologist,who currently holds the Christison Chair of Therapeutics and Clinical Pharmacology at the University of Edinburgh.
Jiska Cohen-Mansfield is the Igor Orenstein Chair for the Study of Geriatrics at Tel Aviv University Medical School and a professor at the Department of Health Promotion at the School of Public Health in the Sackler Medical Faculty at Tel Aviv University. She is the director of the Minerva Center for Interdisciplinary Study of End of Life at Tel-Aviv University.
Majda Pajnkihar is former Dean of the Faculty of Health Sciences at the University of Maribor,Slovenia. She is one of the founding members of Udine-C Network,an international research group with the main interest in nursing careers.
Heather Clare Whalley is a Scottish scientist. She is a senior research fellow in Neuroimaging at the Centre for Clinical Brain Sciences,University of Edinburgh.,and is an affiliate member of the Centre for Genomic and Experimental Medicine at the University of Edinburgh. Her main focus of research is on the mechanisms underlying the development of major psychiatric disorders using the latest genomic and neuroimaging approaches.
Pam Smith is a Professor of Nursing in the School of Health in Social Science at the University of Edinburgh. Her research relates to emotions and care within the nursing profession.
Tonks Fawcett is a Professor of Student Learning in Nursing Studies at the University of Edinburgh and a Principal Fellow of the Higher Education Academy. Her research focuses on mainly around clinical support of learner nurses and clinical decision making.
The Edinburgh Feeding Evaluation in Dementia (EdFED) Scale is a psychometric screening tool to assess difficulty with self-feeding in older people with dementia. It was developed at The University of Edinburgh by Roger Watson and Ian Deary.
The 4 'A's Test (4AT) is a bedside medical scale used to help determine if a person has positive signs for delirium. The 4AT also includes cognitive test items,making it suitable also for use as a rapid test for cognitive impairment.
References
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- ↑ Keyes, S. E.; Clarke, C. L.; Gibb, C. E. (2018). "Living with dementia, interdependence and citizenship: narratives of everyday decision-making" (PDF). Disability & Society. 34 (2): 296–319. doi:10.1080/09687599.2018.1528970. hdl: 20.500.11820/f7345ff4-7997-46e0-aad1-306ea1bfe1bb . S2CID 150196683.
- "Prof. Charlotte Clarke - The Experience of Living With Dementia". YouTube. University of Edinburgh. 2 May 2013. Retrieved 26 May 2019. - ↑ Clarke, C. L. (2008). "Risk and long‐term conditions: the global challenge". Journal of Clinical Nursing. 17 (5a): 1–3. doi:10.1111/j.1365-2702.2007.02257.x. PMID 18298751. S2CID 116084255.
- Clarke, C. L. (2009). "Risk and long-term conditions: The contradictions of self in society". Health, Risk & Society. 11 (4): 297–302. doi:10.1080/13698570903045427. S2CID 146187091. - ↑ Roberts, K.; Clarke, C. (2009). "Future disorientation following gynaecological cancer: Women's conceptualisation of risk after a life threatening illness". Health, Risk & Society. 11 (4): 353–366. doi:10.1080/13698570903013623. S2CID 73876646.
- Clarke, C. L.; Gibb, C. E.; Keady, J.; Luce, A.; Wilkinson, H.; Williams, L.; Cook, A. (2009). "Risk management dilemmas in dementia care: an organizational survey in three UK countries" (PDF). International Journal of Older People Nursing. 4 (2): 89–96. doi:10.1111/j.1748-3743.2008.00149.x. PMID 20925808.
- Clarke, C. (2010). "Risk and long-term conditions-society, services and resilience". Journal of Nursing and Healthcare of Chronic Illness. 2 (2): 85–87. doi: 10.1111/j.1752-9824.2010.01060.x . - ↑ Clarke, C. L.; Keady, J.; Wilkinson, H.; Gibb, C. E.; Luce, A.; Cook, A.; Williams, L. (2010). "Dementia and risk: Contested territories of everyday life". Journal of Nursing and Healthcare of Chronic Illness. 2 (2): 102–112. doi: 10.1111/j.1752-9824.2010.01040.x .
- Botsford, J.; Clarke, C. L.; Gibb, C. E. (2011). "Research and dementia, caring and ethnicity: a review of the literature". Journal of Research in Nursing. 16 (5): 437–449. doi:10.1177/1744987111414531. S2CID 57883032.
- Clarke, C. L.; Alexjuk, J.; Gibb, C. E. (2011). "Information in dementia care: sense making and a public health direction for the UK?". International Journal of Older People Nursing. 6 (3): 237–243. doi:10.1111/j.1748-3743.2011.00288.x. PMID 21884489. - ↑ "A celebratory evening at the 2012 BMA Medical Book & Patient Information Awards". Jessica Kingsley Publishers. 14 September 2012. Retrieved 29 March 2023.
- Clarke C.L.; Wilkinson H.; Keady J.; Gibb C.E. (2011). Risk Assessment and Management for Living Well with Dementia. London: Jessica Kingsley. ISBN 9781849050050. - ↑ Clarke, C. L.; Bailey, C. (2016). "Narrative citizenship, resilience and inclusion with dementia: On the inside or on the outside of physical and social places" (PDF). Dementia. 15 (3): 434–452. doi:10.1177/1471301216639736. PMID 27170591. S2CID 206732814.
- Clarke, C.; Mantle, R. (2016). "Using risk management to promote person-centred dementia care" (PDF). Nursing Standard. 30 (28): 41–46. doi:10.7748/ns.30.28.41.s47. hdl: 20.500.11820/879b0763-1e20-496f-bf02-a8b2d745d778 . PMID 26959471. - ↑ Lee, J. J.; Clarke, C. L. (2015). "Nursing students' attitudes towards information and communication technology: An exploratory and confirmatory factor analytic approach". Journal of Advanced Nursing. 71 (5): 1181–1193. doi:10.1111/jan.12611. hdl: 1842/20455 . PMID 25586107. S2CID 52971841.
- Lee, J. J.; Clarke, C. L.; Carson, M. N. (2018). "Nursing students' learning dynamics and influencing factors in clinical contexts" (PDF). Nurse Education in Practice. 29: 103–109. doi:10.1016/j.nepr.2017.12.003. hdl: 20.500.11820/593b3748-0520-41bc-b3d0-12ccaaed87f1 . PMID 29245029.
