Treating Dementia

Dementia can be understood as a category of symptoms due to disorders affecting the brain (www.alz.org, 2017). The typical symptoms are loss of memory, difficulties in the thought process, in language or problem solving abilities. This greatly affects the ability of the individual to conduct day to day activities. Dementia can also cause changes in behaviour, mood and personality. This is generally caused due to a decline of the normal mental functioning due to the Detoriation of the brain caused by aging. Several different disease can cause dementia, like Alzhimer’s disease, Lewy Body Disease, vascular dementia, fronto-temporal dementia, head trauma, Parkinson’s disease, Creutzfeldt-Jakob disease and Huntington’s disease. An individual with dementia, can be suffering from more than one of these diseases. Treating dementia depends on its causality, however progressive forms of dementia (like Alzhimer’s) have no treatment or cure to slow or stop the progression of the disease (Rizzi, Rosset & Roriz-Cruz, 2014). However there are few medicines that can help to manage the symptoms of advanced dementia. Cholinesterase inhibitors can also be used to manage the symptoms of mild or moderate dementia (Hahn & Paik, 2015).  However, improvement in their conditions and quality of life can be done by proper care giving, providing emotional support, and education and conducting programs of regular exercises (Forbes et al., 2013). Interventions (cognitive and behavioral) can also be used to help the patients (Huntley et al., 2015).

In the movie Age Old Friends (1989), a retirement home was shown where the protagonists of the movie were residents. The home had strict rules for its residents, and the surrounding was all strictly ordered. This deprived the residents of a sense of freedom, and self dignity. This was a major problem of approach in the treatment of dementia. Since the condition is mostly untreatable in advanced stages, it becomes necessary to allow the patients to try to lead a normal life, providing all the help they need to perform their daily activities. The strict ordering however also had its positive effect of timely administration of medicines, and participation in group activities. The spontaneity of the staff allowed timely action whenever needed, and prevented negligence due to complacency.

Taking into considerations the complicated nature of dementia symptoms, and the lack of treatment for its advanced stages, care must be taken to ensure the patients have a decent quality of life, with a sense of normalcy. Generally treatment in restricted nursing homes can be very restrictive, and can therefore be stressful for the residents. The conventional facilities, even though properly equipped medically to deal with any medical/clinical symptoms, are however not as well equipped to deal with the psychological difficulties associated with dementia. The purpose of this article is to construct a design for a treatment facility for dementia that will ensure a life with meaning and quality for the patients suffering from dementia.

The primary objective of the facility will be to extend help and support to patients with advanced form of dementia. This is mostly because at advanced stage, the condition becomes untreatable, and the patients require round the clock assistance. This can be a hurdle in regular nursing homes, or homecare facilities, and be a major challenge to deal with for the family members (Holden & Stokes, 2017). The proposed facility will be a housing community for the patients of advanced dementia, and employ round the clock staffs (medical practitioners, advisors for healthy living, and social workers). The design of the facility will be based upon the Hogeweyk Village for dementia patients in Amsterdam, and will involve creating a living environment for the patients (Paola, 2017). The environment will act as a community, consisting of the patient and the care givers, and the complex can be set up as a small village with general stores, pubs, café-restaurant, movie theatres, salon, supermarket, town square, and recreation centers (Glass, 2014).

The aim of the facility to provide a normal mode of life for the suffering people, and to take away the feeling of a restrictive environment associated with traditional facilities. The doctors and caregivers will be trained to make the experience as realistic as possible, residents can go out for shopping when they want, prepare food as they would staying home. The facility will try to provide a new home for these people, instead of just a treatment facility. It should be kept in mind that many of these patients will never be cured, and hence will live the rest of his/her life in the facility. Hence, utmost care will be taken to ensure they can have a meaningful life and that of quality. The caregivers will no longer be wearing the regular clinical outfits, reminding the patients of closed clinics. Instead they will wear regular cloths, and live next doors to the patients as neighbors. The doors will not need any locking system, while still ensuring security to the residents. Additional facilities like automated elevators can ensure that a patient would not need to remember or interact to operate the lift. If the residents are allowed the freedom to move, go shopping, walk in the sun and involve in group activities, they would feel less restricted, and the adverse effects of the disease on their psychology and mood can be greatly alleviated. Similar setups in Hogeweyk have shown positive results, with the patient eating better and living longer than patients living in traditional setups. The residents can also get involved in musical activities, or learn musical instruments, which can be helpful in stimulating the mind (Sapiro, Farrant & Pavlicevic, 2017).

One very common symptom of dementia is problems with short term memories, following instructions, or remembering them (Adams, Deokar, Anderson & Edwards, 2013). This can cause serious impedance in the daily activities. Ensuring freedom of movement to the patients can ensure the feeling of freedom, at the same time¸ being in close proximity of caregivers all the time, can ensure they receive help urgently. Being able to go out and travel through the village on their own, the patients can develop a sense of normalcy, in their rapidly detiorating mental health, and live in a stress free, helpful environment, that can be their home (Aubrecht & Keefe, 2016). Although, comparison can be drawn on such “artificially” created/projected sense of normalcy, as was in the case in the movie The Tuman Show (1998), it can be stated that for patients who are already losing their grip on reality, a fabricated reality can still keep them connected to this life, and prevent a sense of abandonment and alienation

References:

Adams, M. L., Deokar, A. J., Anderson, L. A., & Edwards, V. J. (2013). Self-Reported Increased Confusion or Memory Loss and Associated Functional Difficulties Among Adults Aged≥ 60 Years. Morbidity & Mortality Weekly Report, 62(18), 347-350.

Aubrecht, K., & Keefe, J. (2016). The Becoming Subject of Dementia. Review of Disability Studies: An International Journal, 12(2 & 3).

Forbes, D., Thiessen, E. J., Blake, C. M., Forbes, S. C., & Forbes, S. (2013). Exercise programs for people with dementia. Cochrane Database Syst Rev, 12, 0.

Glass, A. P. (2014). Innovative Seniors Housing and Care Models: What We Can Learn from the Netherlands. Seniors Housing & Care Journal, 74.

Hahn, S. J., & Paik, N. J. (2015). Pharmacological Treatment of Dementia. Brain & Neurorehabilitation, 8(1), 19-23.

Holden, U., & Stokes, G. (2017). The ‘dementias’. The Essential Dementia Care Handbook: A Good Practice Guide, 11.

Huntley, J. D., Gould, R. L., Liu, K., Smith, M., & Howard, R. J. (2015). Do cognitive interventions improve general cognition in dementia? A meta-analysis and meta-regression. BMJ open, 5(4), e005247.

Paola, S. (2017). Dementia village: A new model for living with dementia. AJP: The Australian Journal of Pharmacy, 98(1165), 16.

Rizzi, L., Rosset, I., & Roriz-Cruz, M. (2014). Global epidemiology of dementia: Alzheimer’s and vascular types. BioMed research international, 2014.

Spiro, N., Farrant, C. L., & Pavlicevic, M. (2017). Between practice, policy and politics: Music therapy and the Dementia Strategy, 2009. Dementia, 16(3), 259-281.

www.alz.org. (2017). What Is Dementia?. Alzhimer's Association. Retrieved 7 November 2017, from https://www.alz.org/what-is-dementia.asp