Caring for people with Dementia

NICE 2010 quality standards

What is Dementia and associated symptoms?
Dementia is a progressive brain disease characterised by a gradual loss of mental awareness, loss of memory, personality change and deteriorating functional capacity. It is characterised by varying mental health and physical symptoms and often requires complex care.

What are causes?

For most people the cause is unknown but there are some known causes or risk factors such as:

  •  Diseases and infections that affect the brain e.g. Alzheimer‟s disease or meningitis;
  •  Pressure on the brain e.g. brain tumor;
  •  Lack of blood and oxygen supply to the brain e.g. stroke and head injuries;
  •  Cardio-vascular insufficiencies.

What are different Types of Dementia?

  • Alzheimer’s disease accounts for majority of dementias in England. It changes the chemistry and structure of the brain, causing brain cells to die.
  • Vascular dementia is caused by problems with the supply of oxygen to the brain following a stroke or small blood vessel disease. Vascular dementia along with those mixed vascular with Alzheimer’s dementias; make up around 30 per cent of the total.
  • Dementia with Lewy Bodies is caused by protein deposits that develop inside nerve cells in the brain and interrupt its normal functioning. It shares symptoms with Parkinson‟s disease, including slowness of movement.
  • Fronto-temporal dementia is a rare form of dementia, It often affects the under 65s, with dramatic effects on behaviour and personality, rather than memory, in the early stages.

Challenges of caring with dementia

The symptoms of dementia vary but the frustrations and confusion associated with these can lead to challenging and aggressive behaviours, even in people who previously never exhibited such behaviours. This can make caring for people with dementia very challenging as can the manifestation of co-morbid conditions including mental health illnesses such as depression, psychosis and delirium as well as physical illness such as heart disease, diabetes and chronic renal failure.

Importance early diagnosis

There is evidence that the earlier the dementia is diagnosed the better the outcomes, it will also help with decision making and preparing the individual and their family for choices they will need to make in the future. Evidence also exists to support the use of memory stimulating exercises and social interaction to delay the development of the disease. It is important to ensure that individuals with suspected dementia are professionally assessed and receive a full diagnosis and supporting information

There is no evidence that dementia can be prevented specifically, however risks can be reduced by improved lifestyles such as weight loss, limited intake of alcohol, health checks and heart MOTs; what is “good for the heart is good for the brain”.

Importance of Staff Training

All our staff have Dementia training which provides them with an understanding of Dementia, and how to deal with the different behaviours and the importance of understanding residents living with Dementia.

Local services and Information sources

  • The Alzheimer’s Society provide a wealth of information especially at a community level, working with a network of statutory and non statutory organisations such as Age Concern and lunch clubs.
  • There are Dementia Advisors who provide support with post diagnosis care planning. This is critical role in navigating the system for service users and carers as early as possible.

Further Information

NICE Dementia Quality Standard 1 June 2010