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Students in Health and Social Care Management and Policy Programme will need to focus on a health and social issue and policy

Structure One
Outline of the Policy Report (Please note that this is not an essay, it has to be written in a report format see below)

Begin with an executive summary/abstract giving an overview of the report

Contents Page
List section titles with their commencing page number

Section 1
Introduction
Background / Context / Aim of the report / Rationale of the report (What is the significance of this report) / Who is the audience?

Section 2
Give an overview of the country
Clarify and discuss:
An issue (offer social, economic, political context - illustrate with relevant and recent data)
A policy framework (policy addressing this issue – include the chronology around policy development, context? Drivers? Resistance? Actors? Key stakeholders? Policy changes?

Section 3
Critically discuss the policy (scrutinise the policy triangle: policy content, policy process, and actors) Critically discuss the implementation stage of the policy (Was the policy successful in addressing the issue?)

Section 4: Theoretical connection - connect what you have discussed with relevant theory
For instance, If you are focusing on a specific policy and the changes it has gone through over time you may want to employ incrementalism etc
You do not need to include this section on the theory, instead weave theory into every section. However, you do it, it is important to engage with relevant theories

Section 5
Recommendations for the policy?
Recommendations for the implementation stage?

Section 1

Introduction 

In March 2012, a major improvement in dementia care was a challenge for England. This was one of the biggest challenges that were identified as there was high-level population that was suffering from dementia which cannot be ignored through a mere approach. These issues can be tackled through several approaches that can be drawn in areas of healthcare.  

Background 

The report consists of a three-year program on Dementia care that would address a challenge and celebrate the success of the country. The aim of the report is to present the National Dementia Strategy in order to build a nation that serves the best research on dementia care. There is a combined force that is real and focuses on to sustain and progress towards supporting people suffering from Dementia and improve their quality of life (Fleming 2011).

The aim of the report is to present the findings of the main issue in England and to focus on the National Dementia Strategy. A real and positive change is given to people with dementia to support them and provide care with high quality at their home or in a care home. The key issues are been recognized by the government and urgent actions are taken in order to have a formal diagnosis for people who needed care and support. Driving improvement in health care was the prime objective of the government of England. NHS has set several standards to improve the diagnosis rate of dementia and support individuals.     

The report consist the overview of the country, issue in terms of economic, political and social issues in context with recent data. A policy framework is addressed with the issue recognition and it includes the chronology that has developed around policy development and drivers of the policy. The key stakeholders are mentioned in the report with reference to the National Dementia Strategy and government policy introduced in the year 2012 by the Prime Minister of England.  The audience in the report is people of England who are suffering from Dementia.

Overview of the country 

Dementia is a growing challenge in England. The population ages and lives longer, because there are several actions taken by health care services. This is the growing issue that the world is facing. In England, the rate of Dementia is high that considers 676,000 people are suffering from dementia as per the report 2012. The number of people suffering from dementia in the UK is estimated to be 900,000. It affects older people at large, after the age of 65 people develop dementia. Some people may suffer from dementia at an early age due to the issues that an individual is facing in family and career. There are as such 540,000 carers in England who treat dementia on a large scale. The total population from one in three people suffer from dementia in England. The working hours are cut down due to dementia and its consequences. In England, there are more than 100.000 people who have cut work due to dementia and have left their work and career. The economic cost of the country is higher as per the report. The disease estimated a huge cost with 23 pound billion a year. This can triple in the next 10 years. The cost of cancer is less and the heart disease is less as compared to dementia in England. Dementia is a key issue and this is resolved by NHS England. In 2012 March, Prime minister has launched a challenge on dementia for 2020 that has set out to build an achievement with the aim to provide support and care for the people suffering from dementia. In 2014, Alzheimer’s society produced a report that studied the economic and social impact of dementia in England and the UK. The cost is estimated to be higher each year which seems to be a more than expected cost by the government.

Aim of the report

Dementia is a set of symptoms that include loss of concentration and problems in remembering things. There is a change in the behavior and mood while a person feels difficult to communicate. The brain gets damaged in this situation and there is a certain disease that may certainly harm in future as per the neurological condition of a person. Parkinson’s and according to Chaudhury (2013), Alzheimer’s disease is observed in a person with the condition in which there are series of small strokes that a person may suffer in such condition. It is the major problem in England and the UK that the government has observed. Thereby there are several policies and laws that have helped people in the UK in getting support from NHS and other organizations such as Alzheimer’s society and NHS health.

There are certain factors that cause dementia. Dementia is caused due to damage in brain cells. The brain cells are not able to communicate with each other and this disturbs the brain cell life cycle. Due to ineffective communication, communication with other people is not as normal as other people communicate. Moreover, there is a change in normal thinking and change in behavior and mood of a person. Cheng, Hu and Ou-Yang (2013) stated that, there are several distinct regions that the brain does not function well for people suffering from dementia. There are high levels and different types of dementia that affect a person such as a high level of protein that makes a person unable to communicate with each other that is Alzheimer’s disease. Memory loss is one of the major symptoms that is observed among patients of Alzheimer’s disease (Lee, Boltz and Algase 2017).

Policy implementation 

The Prime Minister Challenge on Dementia care contains commitments that the government will put together to reach at a level to inspire the country for support and care for dementia patients. People suffering from dementia need support and care where the dementia programs and research practices are conducted by the government of England. There are 50 commitments that are spread in order to focus on the social action and awareness of dementia care policy. This meets the demand of the country to focus on the joint efforts by several organizations to reach towards an armed length body that protects the people of England. According to Calkins (2005), the NHS and the local authorities have planned together in order to work on the voluntary sector and consider the underlying effects of the plan. There are several actions that are taken in order to complete the policy with several ongoing measures taken for people suffering from dementia. The full implementation plan has to be developed in the year 2020, while the current policy of 2015 has a wide range of activities that support the program.

Dementia policy

There are two clear plans that contain the two phases such as policy up to 2018 and policy 2018-2010. A concrete plan includes the two phases of policy implementation that covers the immediate actions that are taken by NHS and the government organizations to deliver support for the organizations dealing to improve dementia care services and awareness about the disease. According to Brawley (2001), the organizations work together in order to focus on the implementation of the plan that describes the detail about the actions taken for dementia care. For the second phase, the long-term actions are included while implementing the plan for the year 2018-2020. The phase indicates success that can be achieved with altered care and the future years in order to account the funding allocations and planned research. The best practices are achieved in terms of social and clinical care provided to people suffering from dementia.

Rationale of the report

Dementia policy is implemented in order to ensure stakeholders to engage within the plan and comprehensively consider the approach that has roundtable sessions. As such attendees were considerably asked to focus on the commitments and respective work to be undertaken in order to seek out the standardized approach. As such there are responses from the program that has been implemented towards the collated approach considered the different activities and actions for the implementation plan.

The policy is implemented with an agreed approach to consider the support and care for dementia patients. However, it is important that the partners need to focus on the process that includes extensive research and clinical care. In partnership with Alzheimer’s society and Dementia UK, the networks are built with policy implementation. There is a different format that considers this session as the statement developed by the dementia care partners. The policy focuses on the engagement sessions of partners on the research for dementia care. The patient's care was the key priority that was the major challenge for the plan that was implemented for 2020. The program board implementation plan engages several organizations to ensure the minority ethnic groups people to focus on the onset dementia care program. There are several priorities that are identified and this in terms supports the people in considering diagnosis for the people in England, people can live in their home with their freedom that is independent, waiting times are improved, continuity of care is provided and the organization gives an opportunity to plan for advanced care treatment to the patients. The policy implementation includes the tangible process that leads to dementia care which still needs an improvement plan that is considered with the personal experience and care for the people. The National Dementia Declaration is announced while implementing the policy that recognizes the effective progress for people suffering from dementia.

Dementia Intelligence plan is considered with a network that provides the key domains for people in an entirely new pathway. The data majorly covers prevalence, prevention, diagnosis, living well, supporting well and dying well. The policy considers the driving improvements that consider a challenge in several aspects such as timely diagnosis, high-quality service and care in hospitals, high-quality compassionate care provided in the community and adequate care provided in care homes. The improvement plan is included in dementia policy that considers the major and a central role for people.

Policy actors and evidence 

It is important to note that the policy alone cannot make the wide range of decisions, in fact, it is critical to understand that the government should consider several different organizations help in order to focus towards achieving the objective of care and support to the people. The policy actors are the organizations and association that works towards achieving required objective. While considering the system, social care, and health perspective, the local government focuses on the independent sector for improving the quality and makes a major difference to overcome with the number of challenges that people face in their family and public. Lee, Chaudhury and Hung (2016) argues that improved timely diagnosis is considered to be the major improvement plan while implementing the policy for the next phase. Moreover, 42% of people in England are suffering from dementia which is a serious issue. As such the government should take formal diagnosis for the people in order to give them the care and treatment that they need. The services and care provided to people while diagnosing the patient vary from area to area and in a different way. The high quality of care in hospital, community and care homes should be provided that estimates the problem to be solved adequately with sufficient training as a person-centered approach applied by an organization. People living with dementia cannot access social care services which should be majorly focused as an issue. There is intermediate care that is provided to the people with at most care and intelligence.  

Section 2

There are several ontological theories that are put forward in order to consider the phenomenological perspectives. The literature considers the experiential theories and the focus is towards understanding the nature of dementia. The theories of dementia classify several elements such as dementia is a brain disease, it is a normal aging process, it is a psycho-neurological condition, it is a mental health issue and is a social construction. Moreover, it fairly describes the cognitive theory in considering the conceptualization of the phenomenon. There are closely related symptoms and behaviors that have a major focus on variability and diversity symptoms. Apparently, the arbitrary manner is related in which the disease reflects the condition of the brain and dysfunctional cells that briefly considers the theory. The disease is becoming common and there is a connection to mental disability that is reflected in the social model with disability and cognitive impairment. Thereby the cognitive approach is reflected with the impairments and the adaption of environments and social conditions. There is a clear distinction between the theories and the concepts that are reflected in the study while it considers the explanatory theory that explains the semantic distinction and critical condition in dementia. The realm leads to a constraint about individual experience and conceptions with an interaction of relations focusing on the intervention programs for social care. Dementia policy is collective research and a focus towards supports individuals suffering from dementia and considering a cognitive approach towards the theory (Lee, Chaudhury and Hung 2016).  There are aligning theories that are presented with several subordinate programs and interventions.

There are many types and forms of dementia that are observed in people. There are different symptoms and causes for each one of them. Dementia is a collection of symptoms that affect the brains with its dysfunctional type and disorders. Alzheimer is a kind of dementia disease that is mainly observed in older citizens. It is a type of dementia that affects the level of thinking, ability to perform and the behavior of a person in day to day tasks. The brain function is majorly affected by this disease and it may affect a person and interfere in working life. Dementia is considered as a normal disease that is a part of aging but not necessary that all the older people are affected by dementia. Karim, Verity and McManus (2012) state that Dementia is a disease commonly found in old people but anyone can get is after the 40s or 50s. The study on dementia care has been influenced institution and organizations to commonly work towards a better approach for life.

Alzheimer’s is a common disease that is caused by the dysfunctional type of brain cells. Dementia is caused by brain cells that damage the function of the brain. Dementia costs the society and economy with 26billion pounds that is more than heart disease and cancer. There is an estimated cost that would increase the cost in 2020 to more than 2%. The impact of dementia leads to a dramatic situation in the future. However, it is growing in the economy with one of the most important issues observed in the UK. The growing dementia issue has estimated to be increased in the year 2030 with 44 million people in the world. Dementia can even start before the age of 60 while there is a series of growth that leads to various studies and real data for Clinical commissioning group that indicates several areas and ranges of dementia that affect the population. Fleming and Purandare (2010) considers from the theoretical approach, it is important to know that dementia reflects with cognitive and affective theory. Theory of mind mainly refers to the attribute that affects the mental state and feelings. Thoughts are related to cognitive component whereas feelings are related with the effective component. The functions of the brain relate with the neurodegenerative disease which is moreover considered and appreciated with the investigation in dementia care. There are several mechanisms that are reflected towards the age-related disease and thus include apoptosis, neuroendocrine, autoimmune and oxidative stress theories. Apparently, the age-related damage is higher that produces the dysfunctional approach towards neuronal cytoskeleton. There are diminishing neuronal energy that reflects the damage to mitochondria while it intends to destroy neuronal energy that a person relates and has a thought process. The human genome should mainly consider the apoptosis that works under self-destruction with an intended program that determines the age and choice of environment. The present human life approach expectancy is 75 and the future life expectancy has increased up to 100. According to Calkins (2003), the best practice that works towards the wellness program is been considered by old people. The accelerated brain aging and senile plaque lead to a pathological hallmark that appears to be around 25% among individual within the age group of 50-60.

Issue

The four types as measured include Alzheimer’s, vascular, alcohol-induced and Lewy body disease. These reflect the four types of dementia that may occur in an individual after a certain period. There are reduced risk factors that generate the care level taken by carers. The medical conditions should be accommodated to older people. Even people suffering from mild dementia should address the wellness interventions program that helps in mental and physical functioning. While there are lifelong attempts that are made to mitigate the risk of dementia and compress the disability. Patients who have normal blood pressure or homocysteine are encouraged to have a clinical test that would let a person know about the intervened program if necessary. Dementia screening and intervention programs consider several medications and programs that are related to compensatory mechanisms. Algase, Beattie and Antonakos (2010) state that there is a cognitive decline that works often while considering the cognitive impairment and isolated amnesia. Apparently, individuals with normal screening focus towards a benefit towards cognitive wellness medication and program.

There is a retrospective identification of risk elements that are caused due to dementia and process that these factors may at times lead to a prevention of disease. The dementia prevention program and the prevention strategy leads to a major change in the research while performing on several programs and events that intervene with the judgments and proposed actions for safe and beneficial actions.   

The Department of Health has majorly considered several recommendations that can be made in 2020 report. This will help to integrate the development of the economy that makes attempts to forward the Alzheimer’s Research UK. Bictket (2010) state that there are several regulators that are engaged in an ambition to achieve alignment for current regulatory policies. Dementia Discovery Fund needs to be raised by SV Life Sciences so as to identify the potential and streamlined process as coordinated support to individuals. Furthermore, a good relationship can be accelerated towards an exemplary on speeding up the patients care with the latest technologies and tools that work towards attracting the environment and life sciences approach. Improved support for people suffering from dementia needs to be recommended with a change in the development and evidence-based research. There should be direct care providers for people living in nursing homes and assisted living. According to Chaudhury, Cooke and Cowie (2017), the level of care and support should ensure the incorporation of several programs with quality assurance systems where federal and state policymakers are working along with the NHS and PHE.

To encourage quality care programs, training and education programs should be assisted with the level of care and assistance for nursing homes is recommended. It is important that an informed decision should be empowered to people with dementia and their caregivers. The interactive guide helps to consider and recognize the best options in order to advocate the quality and assistance with Alzheimer’s disease. The Alzheimer’s association chose to work towards believing in an intervention that works on the significant difference for quality of life. The area represents the strategies to be improved in the programs supported for people. Due to inadequate fluid and food consumption, people may suffer from some of the other diseases. This will decline the health and well-being policy, so it is recommended that nutritional care preventive systems should be adopted by the associations in order to work towards a better program and assure nutrition and hydration for old age people. Moreover, it is important that pleasant and enjoyable time should be spent with residents, it gives them an opportunity to enjoy life and observe good things around them. Moreover, working towards providing support and care for people, pain management is the best therapy. Aeisel (2013) explains that pain is generally not recognized and is mainly untreated among people suffering from dementia. Individuals have difficult times to communicate with the people as a matter of this, there is poor management and behavioral symptoms are mainly generalized with unnecessary attempts for care. It is important to serve people with psychotropic medications that will help with improving the goals of an organization. There is ease made to distress people with dementia so that people can enjoy the quality of life. Treating pain is a systematic and formal way to ensure the quality of life. According to Hung, Chaudhury and Rust (2016), a person-centered focus is to be focused with person-centered care, assessment and care planning should be provided, detection and diagnosis should be carried out, information and support to an individual should be provided, medical management and ongoing care for people suffering from dementia. These are the recommendations that will help to improve quality care for people. There are supportive services that are transitions and coordinated for providing a therapeutic service to people.

Drivers of the policy

Several fundamentals of person-centered care should be applied; nonphysician care will help to increases detection of cognitive services, a person-centered assessment with proper care planning by institutions should be adopted as a major medical management health care system.

Prime Minister Challenge 2020 is the vision that will be realized in the near future. Dementia policy will ensure a better living for people with dementia as it will help to improve the support and care to be given in terms of investing and spending a particular portion for people with dementia. There are improved programs and associations that will help to engage people and transform society with better community care and coordination. This challenge has set the standards for working out towards aspirations with the help of NHS and associated partners in bringing up the economy while delivering support and care. Bictket (2010) says that the UK government has taken several steps to encourage the associations towards a next approach that will help in spending the review and considering strict actions to be associated with the government rules while fulfilling the reality version and considering a global leadership on dementia care. Better measures are taken for policy frameworks that will help to understand and work towards a genetic risk with environmental triggers to consider progress in providing care and support. Identifying research and working towards better care with advanced information technologies is the best way to help people suffering from dementia and Alzheimer’s disease.

The report concludes with the policy framework study, discussion of dementia care policy in the UK and the theoretical discussion with its relevant findings from the study. There are effective service models that are provided in order to enable the pathway of growth and implement health and social policy. There are care sectors that encourage people with participating in the research for better diagnosis and consideration in the global dementia care policy. Effective ways are introduced in the report to cure the disease and to modify several tracks that are accelerated by the government. There are international frameworks that are introduced by the government in order to consider collaboration and cooperation among researchers for coherent databases and services. The public fund is accessed by the government that has encouraged the policy frameworks and considers participating in the research.

References

Aeisel, J. 2013, ‘Improving person-centered care through effective design.’ Generations. Fall 2013; vol. 37(3), pp/ 45-52. Retrieved from https://www.ingentaconnect.com/contentone/asag/gen/2013/00000037/00000003/art00008 

Algase, DL; Beattie, ER & Antonakos, C. 2010, ‘Wandering and the physical environment.’ American Journal of Alzheimer’s Disease and Other Dementias. Jun 2010; vol. 25(4), pp. 340-346. Retrieved from  https://www.ncbi.nlm.nih.gov/pubmed/20378834

Bicket, MC. 2010, ‘The physical environment influences neuropsychiatric symptoms and other outcomes in assisted living residents.’ International Journal of Geriatric Psychiatry. Oct 2010; vol. 25(10), pp. 1044-1054. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/20077498

Brawley, EC. 2001, ‘Environmental design for Alzheimer's disease: a quality of life issue.’ Aging and Mental Health. May 2001; vol. 5(suppl. 1), pp. S79-S83. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/11513503

Calkins, MP. 2005, ‘Designing bathing rooms that comfort.’ Nursing Homes and Long Term Care Management. Jan 2005; vol. 54(1), pp. 54-55. Retrieved from: https://www.ideasconsultinginc.com/pages/BathingRooms.asp

Calkins, MP. 2003. ‘Lighting for older eyes.’ Nursing Homes and Long Term Care Management. Nov 2003; vol. 52(11), pp. 68-69. Retrieved from: https://www.ltlmagazine.com/article/lighting-older-eyes

Chaudhury, H. 2013, ‘The role of physical environment in supporting person-centered dining in long-term care: a review of the literature.’ American Journal of Alzheimer’s Disease and Other Dementias. Aug. 2013; vol. 28(5), pp. 491-500. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23687182

Chaudhury, H; Cooke, HA & Cowie, H. 2017, ‘The influence of the physical environment on residents with dementia in long-term care settings: a review of the empirical literature.’ Gerontologist. Mar 10, 2017. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/28329827

Cheng, WY; Hu, CJ & Ou-Yang, 2013, ‘Experience of cognitively intact residents cohabitating with residents with dementia in long-term care facilities.’ Journal of Gerontological Nursing. Sep 2013; vol. 39(9), pp. 34-41. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23786180

Fleming, R. 2011, ‘An environmental audit tool suitable for use in homelike facilities for people with dementia.’ Australasian Journal on Ageing. Sep 2011; vol. 30(3), pp. 108-112. Retrieved from: https://onlinelibrary.wiley.com

Fleming, R & Purandare, N. 2010, ‘Long-term care for people with dementia: environmental design guidelines.’ International Psychogeriatrics. Nov. 2010; vol. 22(7), pp. 1084-1096. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/20478095

Hung, L; Chaudhury, H & Rust, T. 2016, ‘The effect of dining room physical environmental renovations on person-centered care practice and residents’ dining experience on long-term care facilities.’ Journal of Applied Gerontology. Dec 2016; 35(12), pp. 1279-1301. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/25724947

Karim, H; Verity, F & McManus, M. 2012, ‘Designing dementia nursing and residential care homes.’ Journal of Integrated Care. 2012; vol. 20(5), pp. 322-340. Retrieved from: https://www.emeraldinsight.com/journals.htm?articleid=17055046

Lee, KH; Boltz, M & Algase, DL. 2017, ‘Is an engaging or soothing environment associated with the psychological well-being of people with dementia in long-term care?’ Journal of Nursing Scholarship. Mar 2017; 49(2), pp. 135-142. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/23786180

Lee, SY; Chaudhury, H & Hung, L. 2016, ‘Exploring staff perceptions on the role of physical environment in dementia care setting.’ Dementia. Jul 2016; vol. 15(4), pp. 743-755. Retrieved from: https://www.ncbi.nlm.nih.gov/pubmed/24864321

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