Unit 17 Task 1
1
Caring for individuals with Dementia
Introduction
Dementia is an umbrella term for progressive, degenerative brain disorder which affect memory, thinking,
behaviour and emotion, which affects a person’s ability to perform normal daily activities. Dementia is caused by
damage of brain cells, which interferes with the ability of brain cells to communicate with each other, affecting
thinking, behaviour and feelings. Alzheimer’s disease is the most common type of dementia. Dementia mainly
affects older people and it can affect men and women. In the UK, there are 850,000 people with dementia,
however, over 40,000 people with dementia are under the age of 65. (Alzheimer’s Society, 2020)
Acute Confusion states, sometimes known as delirium, is a period of reversible confusion, not being able to think
clearly or quickly, not paying attention, not being able to make decisions or even remember things, with sudden
onset, often associated with illness or post-operative state, often in unfamiliar surroundings, and often affecting
the elderly. It occurs in between 10-20% of all hospital admissions. (Brain Skills, 2012) there are many causes of
Acute Confusion such as virtual or physical disease and any drug. The most common causes are urine or chest
infections, head injury, metabolism abnormalities which means that chemicals or hormones in the blood are out
of balance, alcohol drug or medication withdrawal, liver or kidney failure or dehydration. Acute Confusion is
reversible, GP or medical staff must find the cause from medical assessment and treat it, for example if it was
caused by an infection then the GP should treat it with antibiotics. (Brain Skills, 2012)
Depression is a more persistent condition in which a number of feelings, such as sadness, hopelessness or lack of
energy, dominate a person's life and make it difficult for them to cope. It is a mood disorder, which can develop
quickly, and it can happen to anyone at any point of their life. it is a serious condition and it very common. At
least one in five people in the UK will experience depression at some time in their lives. Depression is also
common among people at all stages of dementia. Once an individual is depressed, they experience symptoms
like hopelessness or irritability most of the time. Also, they may have an increased anxiety, feelings of isolation
and of being cut off from other people, sleep disturbance. They may also have a loss of interest or pleasure in
activities that were once enjoyed, and have problems with remembering, concentrating or making simple
decisions. Therefore, some of these symptoms are similar to those experienced by people with dementia.
(Alzheimer’s Society, 2019)
This report will focus on Alzheimer's, Vascular and Frontotemporal lobe dementia, whilst each type of dementia
has similar causes such as ageing, there are different causes for each. For example, frontotemporal lobe
dementia is associated with familial tendency and genetics as well as Alzheimer’s. On the other hand,
Alzheimer's is associated with ageing, health problems like diabetes, stroke and high cholesterol and, some
lifestyle factors such as excessive drinking of alcohol, unhealthy diet and smoking. Vascular has a strong
association with lifestyle factors and ageing, for example, having a stroke, diabetes or heart disease increases
the likelihood of developing vascular dementia. (Alzheimer’s Society, 2020)
Learning Aim A: Causes of Three Types of Dementia and Symptoms
Alzheimer's disease is caused by the formation of abnormal deposits of tangles and plaque which are made from
two proteins, amyloid and tau. They are present in healthy nerve cells however, in Alzheimer’s, they function
abnormally. This means that, amyloid forms plaques outside the nerve cell and tau forms tangles inside the cell.
This abnormal formation of plaques and tangles damage the nerve cells causing them to die, which cause the
brain to shrink and diminish. This process accelerates with age. The hippocampus, which has a vital role of
,Unit 17 Task 1
2
forming memories, is one of the first areas that are affected, which is why a person with early stage of
Alzheimer’s may have trouble in forming new memories, which means that they have a loss of short-term
memories than long term memories. For example, a person will remember memories from childhood but may
not remember what they have done earlier that day. Later, the amygdala is affected, and it has a vital role in
emotions. Therefore, a person with Alzheimer’s recalls feelings or emotions about an event, even if they cannot
recall the facts of the situation. (Alzheimer’s Society, 2017) individuals with Alzheimer’s disease may be prone to
mood swings and, can also become paranoid and angry with people close to them. They may forget things
constantly and need things repeated many times. They also get lost, even if they are in an environment that they
are familiar with, for example, at their children’s house.
Applying this to the case study of Anjeela Johal Kaur, a 68-year-old who has Alzheimer’s disease, she was found
in her previous home looking for her husband who had died a year ago and, has become lost in familiar places.
This explains that, her hippocampus is affected and have caused her to have a loss of short-term memories than
long-term memories, as she remembers she had a husband but cannot remember he died a year ago. These
memories may cause her to develop mood swings where she varies from happy to angry, as she is not in control
of her feelings and emotions.
Age is the strongest knows risk factor of dementia. A person’s risk of developing Alzheimer’s disease doubles
roughly every 5 years after the of 65. This is because of the risk factors associated with ageing, for example, high
blood pressure, changes to nerve cells, DNA, loss of sex hormones and changes in immune system. Another risk
factor is gender, where women are more likely to develop Alzheimer’s disease than men. Although, reasons are
still unclear, it is said that when women go through menopause, there is the lack of hormones like oestrogen
after menopause. Additionally, inheriting certain versions of genes increases a person’s risk of developing
Alzheimer’s disease. For example, have a close relative like a parent of sibling with Alzheimer’s disease increase
an individual’s own chances of developing it very slightly compared to someone with no family history.
Therefore, genetics is another risk factor however, it is also possible to inherit genes that directly cause
Alzheimer’s disease. For example, if a person has the faulty gene then each of their children has 50% chance of
inheriting it. Finally, medical conditions and diseases are another risk factor in Alzheimer’s disease. For example,
the cardiovascular risk factors and diseases should be considered, like diabetes and high mid-life cholesterol,
which are knows for Alzheimer’s disease. In the case of Anjeela, she has type 2 diabetes, which must have been
an increased risk factor that caused her to develop Alzheimer’s disease. A person who smokes or drinks above
the NHS recommended levels of alcohol has a significant increase risk of developing Alzheimer’s disease. This is
because, smoking has an extremely harmful effect on the heart, lungs and blood vessels in the brain. Therefore,
conditions and lifestyle factors can be risk factors to Alzheimer’s disease. (Alzheimer’s Society, 2016) People with
Down’s syndrome are born with an extra piece of DNA. This means they also have an extra copy of the APP gene
which leads to the amyloid build-up associated with Alzheimer’s disease. While not everyone with Down’s
syndrome will go on to develop symptoms of Alzheimer’s, the risk is much higher. Around 1 in 10 of those with
Down’s syndrome develop Alzheimer’s between the ages of 40-49 years. This increases to over half of people
aged 60-69 years. (Alzheimer’s Research UK, 2019)
Vascular dementia is caused by the impairment of blood supply to the brain (Such as a clot or burst of arteries)
causes neuronal dysfunction, leading to loss of memory and other cognitive abilities. It is the second most
common type of dementia, after Alzheimer’s. Therefore, vascular dementia may develop after a stroke, either
ischemic or haemorrhagic, or a series of mini strokes. This can result from high blood pressures, overusing
blood-thinners drugs, or abnormal formations of blood vessels for example, aneurysms. When the blood cannot
, Unit 17 Task 1
3
reach the brain cells they will eventually die, causing problems with memory, thinking or reasoning. A person’s
symptoms can be constant following a stroke like a multi-infarct dementia, and/or if they have another stroke
like a post-stroke dementia, there can be a sudden worsening of symptoms, known as a ‘step like’ progression.
(Alila Medical Media, 2018) Additionally, vascular dementia is also caused by small vessel disease, the most
common cause, where there is a narrowing of vessels deep in the brain. This will lead the person to experience
gradual loss of abilities like slowing of think and problem solving. For example, a person may take longer to think
of a word and write if down. These symptoms may increase as the person will continue to have an unhealthy
diet, smoking and not regular exercise. It is said that there is no cure for vascular dementia. (Alzheimer’s Society,
2020) The symptoms of vascular dementia vary greatly. Memory loss and general forgetfulness is common, they
may find difficult to perform tasks as they lose ability to stay focused. Also, there will often be problems with
decision making, being or staying organised and following sequenced instructions. Processing information
becomes slower that previously, and concentration will become poor with sudden, brief periods of confusion.
They may have mood swings, more irritable or tearful, or happier than usual.
Applying to the case study of Dr. Raymond Boston, who is 76 years old and has vascular dementia. Because the
blood cannot reach his brain cells and die, he shows general forgetfulness such as turning on the gas rings on his
cooker and forgetting to light them, or may forget to take his medication, which is why the staff have to ensure
that he takes the medication. His blood vessels may have narrowed making it harder for the blood to flow easily,
causing him to have gradual loss of abilities like slowing of think and problem solving. This is shown by his
inability to manage his money when going out to buy things from the local shop, which is why the staff member
helps him to count it out. He also shows to have delusions as he accused the Admiral Nurses of being intruders
and, he also becomes confused about money, declaring that he was penniless, which is not true.
Similar to Alzheimer’s disease, ageing is a strong risk factor of vascular dementia. For example, factors that
associate with ageing like high blood pressure, increased risk of cardiovascular diseases such as heart disease
and stroke, the weakening of natural repair systems. Additionally, for vascular dementia, men are actually at
slightly higher risk than women. This is because men are more prone to stroke and heart disease, which can
cause vascular dementia. In the case of Raymond, he is a man who is 76 years old, which shows by his ageing, his
symptoms have increased, which is why he moved from his house to a residential accommodation. Another risk
factor can be ethnicity. For example, South Asian people seem to develop, particularly, vascular dementia more
often than white Europeans. This is because South Asians are well known to be at a higher risk of stroke, heart
disease and diabetes as they have their cultural dishes which have unhealthy oils and excess sugar. Moreover,
vascular dementia has medical conditions and diseases as factors. for example, cardiovascular factors damage
the heart, arteries or blood circulation, which all affect a person’s change of developing vascular dementia such
as, type 2 diabetes, high blood pressure, high total blood cholesteric levels and obesity. These conditions are
avoidable risk factors for dementia and also for cardiovascular diseases as having cardiovascular disease or type
2 diabetes increases a person’s risk of developing vascular dementia by up to two times. This is because vascular
dementia is caused by problems with blood supply to the brain. Finally, lifestyle factors can cause developing
vascular dementia. For example, having excessive alcohol consumption increases the risk of developing vascular
dementia. Therefore, if a person does not take control of their health, they cannot reduce their risk of vascular
dementia. (Alzheimer’s Society, 2016)
Frontotemporal Lobe dementia (FTD) is caused by the damage of cells in the frontal and temporal lobes. These
two lobes control behavior such as depression, emotional responses and language. If mainly affects younger
people under the age of 65 and it is less common. Once considered a rare disease, FTD may account for 20-50%
1
Caring for individuals with Dementia
Introduction
Dementia is an umbrella term for progressive, degenerative brain disorder which affect memory, thinking,
behaviour and emotion, which affects a person’s ability to perform normal daily activities. Dementia is caused by
damage of brain cells, which interferes with the ability of brain cells to communicate with each other, affecting
thinking, behaviour and feelings. Alzheimer’s disease is the most common type of dementia. Dementia mainly
affects older people and it can affect men and women. In the UK, there are 850,000 people with dementia,
however, over 40,000 people with dementia are under the age of 65. (Alzheimer’s Society, 2020)
Acute Confusion states, sometimes known as delirium, is a period of reversible confusion, not being able to think
clearly or quickly, not paying attention, not being able to make decisions or even remember things, with sudden
onset, often associated with illness or post-operative state, often in unfamiliar surroundings, and often affecting
the elderly. It occurs in between 10-20% of all hospital admissions. (Brain Skills, 2012) there are many causes of
Acute Confusion such as virtual or physical disease and any drug. The most common causes are urine or chest
infections, head injury, metabolism abnormalities which means that chemicals or hormones in the blood are out
of balance, alcohol drug or medication withdrawal, liver or kidney failure or dehydration. Acute Confusion is
reversible, GP or medical staff must find the cause from medical assessment and treat it, for example if it was
caused by an infection then the GP should treat it with antibiotics. (Brain Skills, 2012)
Depression is a more persistent condition in which a number of feelings, such as sadness, hopelessness or lack of
energy, dominate a person's life and make it difficult for them to cope. It is a mood disorder, which can develop
quickly, and it can happen to anyone at any point of their life. it is a serious condition and it very common. At
least one in five people in the UK will experience depression at some time in their lives. Depression is also
common among people at all stages of dementia. Once an individual is depressed, they experience symptoms
like hopelessness or irritability most of the time. Also, they may have an increased anxiety, feelings of isolation
and of being cut off from other people, sleep disturbance. They may also have a loss of interest or pleasure in
activities that were once enjoyed, and have problems with remembering, concentrating or making simple
decisions. Therefore, some of these symptoms are similar to those experienced by people with dementia.
(Alzheimer’s Society, 2019)
This report will focus on Alzheimer's, Vascular and Frontotemporal lobe dementia, whilst each type of dementia
has similar causes such as ageing, there are different causes for each. For example, frontotemporal lobe
dementia is associated with familial tendency and genetics as well as Alzheimer’s. On the other hand,
Alzheimer's is associated with ageing, health problems like diabetes, stroke and high cholesterol and, some
lifestyle factors such as excessive drinking of alcohol, unhealthy diet and smoking. Vascular has a strong
association with lifestyle factors and ageing, for example, having a stroke, diabetes or heart disease increases
the likelihood of developing vascular dementia. (Alzheimer’s Society, 2020)
Learning Aim A: Causes of Three Types of Dementia and Symptoms
Alzheimer's disease is caused by the formation of abnormal deposits of tangles and plaque which are made from
two proteins, amyloid and tau. They are present in healthy nerve cells however, in Alzheimer’s, they function
abnormally. This means that, amyloid forms plaques outside the nerve cell and tau forms tangles inside the cell.
This abnormal formation of plaques and tangles damage the nerve cells causing them to die, which cause the
brain to shrink and diminish. This process accelerates with age. The hippocampus, which has a vital role of
,Unit 17 Task 1
2
forming memories, is one of the first areas that are affected, which is why a person with early stage of
Alzheimer’s may have trouble in forming new memories, which means that they have a loss of short-term
memories than long term memories. For example, a person will remember memories from childhood but may
not remember what they have done earlier that day. Later, the amygdala is affected, and it has a vital role in
emotions. Therefore, a person with Alzheimer’s recalls feelings or emotions about an event, even if they cannot
recall the facts of the situation. (Alzheimer’s Society, 2017) individuals with Alzheimer’s disease may be prone to
mood swings and, can also become paranoid and angry with people close to them. They may forget things
constantly and need things repeated many times. They also get lost, even if they are in an environment that they
are familiar with, for example, at their children’s house.
Applying this to the case study of Anjeela Johal Kaur, a 68-year-old who has Alzheimer’s disease, she was found
in her previous home looking for her husband who had died a year ago and, has become lost in familiar places.
This explains that, her hippocampus is affected and have caused her to have a loss of short-term memories than
long-term memories, as she remembers she had a husband but cannot remember he died a year ago. These
memories may cause her to develop mood swings where she varies from happy to angry, as she is not in control
of her feelings and emotions.
Age is the strongest knows risk factor of dementia. A person’s risk of developing Alzheimer’s disease doubles
roughly every 5 years after the of 65. This is because of the risk factors associated with ageing, for example, high
blood pressure, changes to nerve cells, DNA, loss of sex hormones and changes in immune system. Another risk
factor is gender, where women are more likely to develop Alzheimer’s disease than men. Although, reasons are
still unclear, it is said that when women go through menopause, there is the lack of hormones like oestrogen
after menopause. Additionally, inheriting certain versions of genes increases a person’s risk of developing
Alzheimer’s disease. For example, have a close relative like a parent of sibling with Alzheimer’s disease increase
an individual’s own chances of developing it very slightly compared to someone with no family history.
Therefore, genetics is another risk factor however, it is also possible to inherit genes that directly cause
Alzheimer’s disease. For example, if a person has the faulty gene then each of their children has 50% chance of
inheriting it. Finally, medical conditions and diseases are another risk factor in Alzheimer’s disease. For example,
the cardiovascular risk factors and diseases should be considered, like diabetes and high mid-life cholesterol,
which are knows for Alzheimer’s disease. In the case of Anjeela, she has type 2 diabetes, which must have been
an increased risk factor that caused her to develop Alzheimer’s disease. A person who smokes or drinks above
the NHS recommended levels of alcohol has a significant increase risk of developing Alzheimer’s disease. This is
because, smoking has an extremely harmful effect on the heart, lungs and blood vessels in the brain. Therefore,
conditions and lifestyle factors can be risk factors to Alzheimer’s disease. (Alzheimer’s Society, 2016) People with
Down’s syndrome are born with an extra piece of DNA. This means they also have an extra copy of the APP gene
which leads to the amyloid build-up associated with Alzheimer’s disease. While not everyone with Down’s
syndrome will go on to develop symptoms of Alzheimer’s, the risk is much higher. Around 1 in 10 of those with
Down’s syndrome develop Alzheimer’s between the ages of 40-49 years. This increases to over half of people
aged 60-69 years. (Alzheimer’s Research UK, 2019)
Vascular dementia is caused by the impairment of blood supply to the brain (Such as a clot or burst of arteries)
causes neuronal dysfunction, leading to loss of memory and other cognitive abilities. It is the second most
common type of dementia, after Alzheimer’s. Therefore, vascular dementia may develop after a stroke, either
ischemic or haemorrhagic, or a series of mini strokes. This can result from high blood pressures, overusing
blood-thinners drugs, or abnormal formations of blood vessels for example, aneurysms. When the blood cannot
, Unit 17 Task 1
3
reach the brain cells they will eventually die, causing problems with memory, thinking or reasoning. A person’s
symptoms can be constant following a stroke like a multi-infarct dementia, and/or if they have another stroke
like a post-stroke dementia, there can be a sudden worsening of symptoms, known as a ‘step like’ progression.
(Alila Medical Media, 2018) Additionally, vascular dementia is also caused by small vessel disease, the most
common cause, where there is a narrowing of vessels deep in the brain. This will lead the person to experience
gradual loss of abilities like slowing of think and problem solving. For example, a person may take longer to think
of a word and write if down. These symptoms may increase as the person will continue to have an unhealthy
diet, smoking and not regular exercise. It is said that there is no cure for vascular dementia. (Alzheimer’s Society,
2020) The symptoms of vascular dementia vary greatly. Memory loss and general forgetfulness is common, they
may find difficult to perform tasks as they lose ability to stay focused. Also, there will often be problems with
decision making, being or staying organised and following sequenced instructions. Processing information
becomes slower that previously, and concentration will become poor with sudden, brief periods of confusion.
They may have mood swings, more irritable or tearful, or happier than usual.
Applying to the case study of Dr. Raymond Boston, who is 76 years old and has vascular dementia. Because the
blood cannot reach his brain cells and die, he shows general forgetfulness such as turning on the gas rings on his
cooker and forgetting to light them, or may forget to take his medication, which is why the staff have to ensure
that he takes the medication. His blood vessels may have narrowed making it harder for the blood to flow easily,
causing him to have gradual loss of abilities like slowing of think and problem solving. This is shown by his
inability to manage his money when going out to buy things from the local shop, which is why the staff member
helps him to count it out. He also shows to have delusions as he accused the Admiral Nurses of being intruders
and, he also becomes confused about money, declaring that he was penniless, which is not true.
Similar to Alzheimer’s disease, ageing is a strong risk factor of vascular dementia. For example, factors that
associate with ageing like high blood pressure, increased risk of cardiovascular diseases such as heart disease
and stroke, the weakening of natural repair systems. Additionally, for vascular dementia, men are actually at
slightly higher risk than women. This is because men are more prone to stroke and heart disease, which can
cause vascular dementia. In the case of Raymond, he is a man who is 76 years old, which shows by his ageing, his
symptoms have increased, which is why he moved from his house to a residential accommodation. Another risk
factor can be ethnicity. For example, South Asian people seem to develop, particularly, vascular dementia more
often than white Europeans. This is because South Asians are well known to be at a higher risk of stroke, heart
disease and diabetes as they have their cultural dishes which have unhealthy oils and excess sugar. Moreover,
vascular dementia has medical conditions and diseases as factors. for example, cardiovascular factors damage
the heart, arteries or blood circulation, which all affect a person’s change of developing vascular dementia such
as, type 2 diabetes, high blood pressure, high total blood cholesteric levels and obesity. These conditions are
avoidable risk factors for dementia and also for cardiovascular diseases as having cardiovascular disease or type
2 diabetes increases a person’s risk of developing vascular dementia by up to two times. This is because vascular
dementia is caused by problems with blood supply to the brain. Finally, lifestyle factors can cause developing
vascular dementia. For example, having excessive alcohol consumption increases the risk of developing vascular
dementia. Therefore, if a person does not take control of their health, they cannot reduce their risk of vascular
dementia. (Alzheimer’s Society, 2016)
Frontotemporal Lobe dementia (FTD) is caused by the damage of cells in the frontal and temporal lobes. These
two lobes control behavior such as depression, emotional responses and language. If mainly affects younger
people under the age of 65 and it is less common. Once considered a rare disease, FTD may account for 20-50%
