CompanyChapter I: Introduction
Background
The causes of dementia are progressive neurodegeneration that leads to memory impairment, language comprehension and speech, executive function, and ability in activities of day-to-day living. There have been cognitive impairments such that most of the patients develop changes in personality and "behavioral and psychological symptoms of dementia (BPSD)" like psychotic symptoms (delusions and hallucinations), agitation and wandering, as well as purposeless activity or aggression in the older people. Dementia is caused by the range of underlying processes of neuropathology, which is the commonest form of the disease In recent decades, approximately 600,000 people in the UK have been affected with dementia, which is of people over 65 years old, but it has been estimated that by the end of 2026, the range will be approached to 840,000 while rising to more than 1.2 million by the end of 2050 (Dong 2010, p. 15). All over the world, prevalence figures are set to increase steeply. It is currently estimated that 24.3 million people all over the world suffer from dementia, but this number might be affected, and it will double every 20 years to approximately 81.1 million in the year 2040. However, it has been seen that the number of people who die due to dementia is increasing day by day (Esbensen 2010, p. 107). According to estimation from the project of UK MRC-CFAS, a huge multi-center study is looking towards the functionality of health and social care for approximately 13000 older people. Moreover, it suggests that people who died between the ages of 65 and 69 have a high risk of suffering from dementia, rising to approximately 58% of the people who died with dementia above the age of 9 years. In the United Kingdom, one in three people above the age of 65 will die while they are suffering from dementia (Friedman, Tanouye & Joseph 2011, p. 417). The current English National Dementia Strategy has been highly focused on the detection as well as treatment of dementia at early ages with cholinesterase inhibitors or social and psychological interventions. Hence, there has been no evidence that such types of interventions will prolong the lives of people suffering from dementia, and as per recent interest in how the palliative care approach will provide benefits to people with advanced dementia (French 2014, p. 618).
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The research questions are
What are the current practices of mental health services for dementia patients?
What are the problems faced by elderly patients in accessing mental health services in the UK?
Aims and Objectives
The study aims to critically analyze the main issues that have been faced by elderly people with dementia services. Moreover, the aim is to identify gaps in current mental health services in the UK for dementia treatment of elderly people. The study will provide existing mental health services provided to dementia patients.
The main objectives of the study are
- To explore the current practice of mental health services for dementia patients in older adults
- To identify existing mental health services provided related to dementia in the UK
- To identify issues related to healthcare and support by the caregivers to elderly people.
Significance of Research
The significance of research is that it will help to overcome issues faced by elderly people for using mental health services or treatment. There have been certain ongoing treatments that have been used to provide support to older adults suffering from dementia. This research helps to evaluate the effectiveness of services such as family care, robot therapy, and cognitive and psychological therapy that can be used for palliative care for dementia treatment. The research will increase the knowledge of caregivers in the treatment of dementia for elderly people.
Outline of Chapters
The dissertation is divided into five chapters that are based on intrinsic requirements for achieving the research objective. The content covered in these chapters is explained below:
Chapter 1: Introduction
The first chapter will be linked with the introduction, which defines the overall structure, aims, and objectives of the research. This will include the significance of the research, developing research questions, and the background of the research. This will help users to understand the importance of research that will be undertaken and it will highlight relevant issues within research. Moreover, the first chapter will include determining the appropriate direction within research that needs to be done.
Chapter 2: Literature Review
The second chapter will provide an extensive review of the past literature and appropriate and best-fit research studies that have been conducted previously related to the subject that is under consideration. This will help to develop comprehension of relevant theoretical and conceptual frameworks within the research study so that proper information can be provided to readers that aid in improving their knowledge.
Chapter 3: Research Methodology
The third chapter will go through the research methodology that will be undertaken with results and findings in the next chapter. The research methodology proposed for the completion of this study is performing a systematic review established through the PRISMA model. This will enable the assessment of relevant literature intrinsically associated with the overall aim and objectives of the study. Moreover, the systematic review will also enable the assessment of various qualitative as well as quantitative studies related to the subject. Hence, augmenting findings of the study through evaluation of empirical as well as qualitative data related to the notion has been performed under research. Hence, the selection of appropriate literature is mandatory for the development of effective and extensive research findings and the attainment of the overall research objectives. The third chapter will also include relevant ethical considerations of the study. The ethical considerations related to the study will be associated with moral and legal regulations along with the proper utilization of secondary research studies. In addition to the limitations of the study, they will also be enumerated to assert negative consequences that can be experienced throughout the study.
Chapter 4: Findings and Analysis
The fourth chapter will be related to the enumeration of findings and results of the study. In this section, all the information collected throughout the investigation of secondary sources will be evaluated and analyzed to extract the proper findings that can address or help the researcher accomplish its investigation objectives.
Chapter 5: Conclusion
The final fifth chapter will assert conclusive remarks related to findings of dementia patient services that have been developed in the previous chapter and assert relevant recommendations about the findings. In addition to this, it also includes limitations that have been found by the researcher throughout the investigation, along with the quality of the study that has been reviewed by the investigator.
Chapter II: Literature Review
Mental Health Problems With Elderly People
Dementia is said to be an umbrella that usually defines the syndromes and organic disorders where the changes to the physical structure of the brain are the main causes of illness, which includes the death of brain cells or damage in the brain parts that will deal with thought processes. This will lead to a decline in mental ability, which might affect memory, problem-solving, thinking, perception, and concentration (Friedman, Tanouye & Joseph, 2011, p. 422).
According to Wall and Duffy (2010), older people suffering from dementia started to forget about their daily activities as well as personal hygiene, and they face difficulty in coping with the problems associated with their daily lives (p. 108). Mental health problems are said to be common in older people as compared to younger adults, and they are associated with suicide, individual suffering, use of health and social care services, as well as poorer outcomes or results from physical illness. Though symptoms of mental health in elderly people are more or less to be volunteered, identified, or treated. Specifically, very few studies such as Prince et al. (2013) have been presented that show complaints regarding dementia issues by elderly people, as it is said to be a common issue of memory loss due to age factor (p. 63). The presentation of mental illness is related to physical illness as compared to emotional symptoms.
According to Sampson et al. (2010), dementia decreases the mental ability of a person and causes mental disorders, functional or cognitive impairments, and intellectual deficits that represent actual diseases that occur in older patients, for which most doctors, families, and the entire society must have the knowledge and compassion so they can take care of patients effectively (p. 159).
Many people used to lead a long and prosperous life without any issues related to mental health, and despite all the relevant images of elderly people being slow and forgetful, dementia is not an inevitable development in the current age where there is a need for new developments in interventions (Dong 2010, p. 15).
There are many reasons why mental health issues are increasing in rate along with age, whereas it is from biological changes that can interfere with the ability of the brain to provide processed information to social changes like children leaving the place or retirement, which can lead to feelings of isolation or worthlessness (Esbensen 2010, p. 107). There have been many underlying diseases like stroke or Parkinson's that are most commonly developed, and it is often considered important for the contributory factors. Many mental health problems can have a serious impact on the ability of older people to carry out the basic and day-to-day activities of living. The impact of mental health problems on the lives of people, even if there are only a few minor symptoms, is needed to get it checked so that it will not be changed into a huge problem in the future (Collins et al. 2011, p. 27).
Some problems will go untreated and undiagnosed as per low mood that might be ended as the unavoidable outcome of decline from the chronic diseases that might often develop in late years, while odd behavior might be the attribute that has been seen frequently to eccentricity. Many older people are struggling without any help, or they don't need any other help from anyone (Friedman, Tanouye & Joseph, 2011, p. 417).
Understanding the needs of dementia patients as to why psychiatric illnesses have been developed and the way elderly people get affected is said to be vital in providing help to people for managing problems as easily and effectively as possible, and it helps to reduce the risk, which can have serious harm to the people (Esbensen, 2010, p. 126).
The experience of the person who is suffering from dementia is said to be unique. Early-onset dementia is referred to as a term that can be used for a dementia patient whose diagnosis has been received just before the person is 65 years old. It has been estimated that approximately 40,000 people have been diagnosed with dementia all over the United Kingdom. Subtyping dementia is said to be important for guidance regarding the treatment and prescription of the decisions. Alzheimer's disease is said to be the most common type of dementia that has been diagnosed among 60% of degenerative people, and the causes of Alzheimer's are still unknown (Friedman, Tanouye & Joseph, 2011, p. 417).
Issues with Existing Services for Dementia
Currently, there is no uniform model of mental health services for dementia patients across England. The majority of the people that are suffering from dementia are looked after more in primary care as compared to the old-age psychiatry services given to the patient at the time of their mental health issues (Schoenmakers, Buntinx & DeLepeleire, 2010, pp. 44-45). The reason behind this is that most people diagnosed with dementia have been provided with care at home, and it is supported by families, neighbors, and mainstream services. In the year 2011, a World Alzheimer Report was presented that showed the need for early intervention within dementia, and it has been suggested collaborative care as the available means for improving the quality of care and cost-effectiveness within community care. Collaborative care comprises the care of the case manager, who will coordinate the care between the professionals that lie between secondary and primary care and utilize the pathways of evidence-based care to address the psychosocial and physical needs of people. It has been found that it is said to be effective in such conditions as a person in depression. While the earlier trials of interventions have found there are many benefits for people suffering from dementia and family caregivers. According to recent year systematic reviews, it has been found that little clinical, as well as cost-effective evidence, has been used to support the widespread implementation of case management beyond the benefits of quality of life (French, 2014
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