28
May
Below is an outline of research suggested to provide information for critical analysis in the development of a holistic care plan.
Again, as in post An Exercise in Developing a Holostic Care Plan: Fill in the Gaps 
the coumns are numbered to (try!) and provide a flow to the outline. The word limit for each section is an approximation, with more emphasis placed on outocmes and evaluation of the plan and achievemnt of outcomes.
A Holistic Care Plan (1500w/6 pages)
|
Cognitive
issues |
1.
- Alzheimer’s disease is a physical disease which attacks the brain resulting in impaired memory, thinking and behaviour. The disease is named for the German physician, Alois Alzheimer who, in 1907, first described it26.
- As brain cells die, the substance of the brain shrinks. Abnormal material builds up as “tangles” in the centre of the brain cells and “plaques” outside the brain cells, disrupting messages within the brain, damaging connections between brain cells. This leads to the eventual death of the brain cells and prevents the recall of information26
- Memory of recent events is the first to be affected, but as the disease progresses, long-term memory is also lost. The disease also affects many of the brain’s other functions and consequently, many other aspects of behaviour are disturbed26
Sporadic Alzheimer’s disease
The disease can affect adults at any age, but usually occurs after age 65
Sporadic Alzheimer’s disease is by far the most common form of Alzheimer’s disease
It affects people who may or may not have a family history of the disease
Familial Alzheimer’s disease
The disease runs in a few families and is very rare
If a parent has a mutated gene, each child has a 50% chance of inheriting it
The presence of the gene means that the person will eventually develop Alzheimer’s disease, usually in their 40′s or 50′s
Familial Alzheimer’s disease affects a very small number of people
- [Identify which form of AD The patient suffers from]
(167w) |
| Client-focused |
evaluation; providing guidance for management and intervention20
- TIA strokes similar in sign to that of an actual stroke 2
- The patient may be using cholinterase inhibitors as part of his AD treatment to keep acetylcholine in the brain; excess acetylcholine linked to incontinence19
(67w) |
|
Goals for the patient
(Care Plan) |
- To keep the patient as comfortable as possible
- Lower risks of TIA stroke4
- Educate The patient to recognise triggers of TIA1
- Educate The patient in strategies to make lifestyle changes to lower his risk of TIA4
- Educate family and other supports (e.g., multidisciplinary team) as to The patient’s unique needs7
- Maintain regular bowel and urine continence.
- Use support systems and develop adequate coping behaviors.
- Oriented to time, person, place, and situation to the fullest possible extend.
- Perform dressing and grooming needs within the confines of the disease.
- Consume daily calorie requirements and show no signs of malnutrition.
- Communicate needs verbally or by using an alternative type of
communication.
- Perform toileting needs within the confines of the disease.
- Save him from embarrassment17
- Aesthetic and hygienic habits for carers17
- Be sure he is not hiding evidence of incontinence so that his hygiene can be maintained 17
- Decrease humiliation and enhance carer postiveness in the situation ;17
Approaching the problem with understanding, matter-of-factness and humour can improve the situation for everyone concerned.
- If someone has an accident, the three most important things that a carer can do are to:
try to overcome any embarrassment or distaste they may feel
avoid being angry or appearing upset
remember that it’s not the person’s fault.
However, this may not always be as easy as it sounds.
- If a carer finds their feelings about incontinence difficult to handle, it’s a good idea talk things through with a community nurse or continence adviser.
- It is important not to let dealing with incontinence get in the way of the relationship with the person being cared for 17
(367w)
|
| 2
|
3 |
- There are more than 200,000 Australians living with dementia including about one in four people aged 85 years and over. This is expected to double in the next 20 years as Australia’s population ages27
- In 2005 AD was one of the 10 leading causes of death among women and men; however it is the 3rd leading cause of death in women and the 10th in men22
- Deaths from AD have doubled in the past 10 years, from 2.6% to 5.3% of all deaths23
- The median age at death due to Alzheimer’s Disease is 86.7 years24
- In 2003, 167,000 people aged 60 years and over lived in cared accommodation. The main health condition of almost a third of these people was Alzheimer’s disease or other dementia25
(100w) |
- Dementia – one of the biggest health problems facing Australia28
- In 2020, the number of people with dementia will exceed 330 000, a 50% increase since 2007. In 2050, there are projected to be over
175,000 new cases every year, more than the total number of people with dementia in Australia in 200028
- Dementia is a key issue for Public Health policy, a potential target for preventive health approaches and a major cause of chronic disability and carer burden for Australians. Australia has a world class Health and Aged Care system, which is not sustainable unless reforms including additional funding for dementia are
put in place in the next 3 years28
- Minister for Ageing, Mrs Justine Elliot today welcomed Australian research assisting with the detection of early stage Alzheimer’s disease27
- Mrs Elliot also expressed her support for dementia research, funding and support, saying the Australian Government is investing $320 million over five years for dementia research and support27
- Rudd Government’s record funding of more than $28.6 the patiention for residential aged care over the next four years27
- AIBL Flagship Study of Ageing is an initiative of CSIRO, University of Melbourne, Edith Cowan University – Western Australia, Neurosciences Australia and the Mental Health Research Institute of Victoria.
- The study is the largest of its type in the world, having now tested more than 1000 people with and without Alzheimer’s disease27
- Mrs Elliot said: “The AIBL Flagship Study of Ageing aims to improve the understanding of the causes and diagnosis of Alzheimer’s disease, examine lifestyle and diet factors that may influence its onset, and help develop preventive strategies.”
“This discovery offers new hope in reducing the disabling impact of Alzheimer’s on individuals and our community,” Mrs Elliot said27
- Dementia Initiative – Making Dementia a National Health Priority
| The overall objective of the National Evaluation is to provide information to the Australian Government Department of Health and Ageing and other stakeholders that will enable them to assess: |
|
|
What effect the Dementia Initiative has hadconsumers; that is, people with dementia and their carers |
|
What added value has been given to current dementia care in Australia as a result of the activities funded by the Dementia Initiative29
(300w) |
|
- Assessment of The patient’s transition to nursing care; quality of life surveys for the patient and his carers11.
- Evaluate the practices of the residential facility13.
- Ongoing efforts should also include periodic monitoring (a minimum of every 6
months) of the development and evolution of cognitive and non-cognitive symptoms and their response to intervention (American Psychiatric Association, 1997 as cited in 14).
- Severe Impairment Battery (SIB), Alzheimer’s Disease Cooperative Study-activities of daily living scale (ADCS-ADL), Mini-Mental State Examination, Neuropsychiatric Inventory (NPI) or Clinical Global Impression of Improvement. Three composite measures were defined by combining the individual response criteria on these outcomes. The impact of baseline disease severity and of concomitant use of psychotropic drugs was also analysed18
(167w) |
[You need to refer to your lecture notes; what theories/models have been covered in class?]
(167w) |
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Start with a set of pre-surveys given to The patient on his presentation at the Residential facility; this will provide baseline data for comparing ongoing data collection
(67w) |
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