CONCEPT of SELF as affected by DEMENTIA

Sense of Self, continuity, security, apprehension, uncertainty, frustration, fear, foreboding, denial, seeking reassurance, preservation of pride, independence. Depression. Self-expression, communication, verbal - non-verbal, creativity. 'Letting go'. Acceptance, adjustment. Philosophies of care. Life history work. Videos. Grief reaction? Depression. Loss of cognitive functioning. No recognition of family, environment. Disintegration of personality. Aggression. Agitation. Orientation: Ability to drive. Disturbed sleep. Wandering. (Agent dependent Training). Visual cues in the environment. Copy of care plans for patient. Personal motivation. Activism as a advocate for self and others.

Aetiology. Genetics. Genetic guidance - counselling. Recommended sources of information. Pathological changes, investigations. Disease processes. Infection. Screening. Differential diagnosis - toxic confusional state. New drugs and treatment regimes. Side effects of drugs. Constipation. Continence. Weight loss. Appetite changes. Motor co-ordination. FALLS. STROKE (National Standards Framework) Dexterity. Ability to self care - dressing, hygiene, personal safety, eating and drinking. ‘Compliance’ if living alone. Pain - assessment! Evidence based interventions. Physical environment. Design of buildings - care facilities - Colour - Space - ability to see into other communal spaces. Public mental health - epidemiology - prevalence rates. Imaging facilities.

Knowledge and Coping strategies of others. Carers needs to be assessed. Knowledge About Dementia Inventory (KADI). Psychosocial dynamics effects of stress, high expressed emotion. Attitudes of care staff. ' Coming to terms with'. Early dementia. Loss of roles for patient and carer. Grief - 'loss' of a loved one - roles: husband / wife; lover; friend. Fear of 'losing' home, managing financially. Family support of patient and their carer be that husband/wife, partner. Responses of 'friends'. Fear of family children - understanding: hereditary? Use of Telecare to support - client's family & carers. Family member as first point of contact. Copy of care plans for patient. Public involvement in research. Self-help groups.

Information to patient, collaboration, concordance, mutuality, consent, carers - diagnosis, services. Access to services - memory clinics. Provision of respite care. Maintenance of personal autonomy, choices. Legal advice - capacity legislation. Vulnerability to exploitation/abuse: policy. Risk assessment & management - balance independence. Welfare benefits provision. Costs of drug regimes - NICE. Service transition. Maturity of services, ability to provide support for early dementia. Person-centered care provision. Capacity for service change. Continence services. Therapy: CBT (early dementia); Memory Group; Carers support; Psychosocial Intervention; Sensory environments; ‘Active’ day care. Service boundaries, aids, requirements, assessment. Decision and action if client is unsafe to drive. Services for carers. Carers as clients. Advocacy. Information strategy: patients - families, staff, management. Boundary mental health responsibilities between primary and secondary care. Thresholds for referral. Living wills. Inspection process of care facilities. Budgets - diet, activities, therapies. Patient-Centred Professionalism