The Causes Dementia in Older Adults

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Table of Contents

Executive Summary
Introduction
Concepts of Mental Health and their Implications in Care Management
Use of Local and National Data to Improve Health Policies
Theories and Ethical Principles Relating to Health Promotion
Conclusion and Recommendations
Reference List

Executive Summary

The purpose of this report is to investigate the causes of dementia and explore the role of a mental health nurse in helping patients to manage the condition. In this document, dementia is presented as a public health concern in the United Kingdom because it is a poorly understood cognitive condition and the population at risk, which is mostly comprised of elderly people, is increasing as people live longer in the United Kingdom. Therefore, dementia is a public health concern because of its surging prevalence and low levels of community awareness regarding its impact on patients, families, and society. From a background of a high prevalence of dementia in the United Kingdom, due to a growing aging population, this report suggests that early diagnosis of dementia should be improved and its occurrence minimized through behavioral changes. The theory of reasoned action and the health belief model are presented in this document as supportive frameworks for implementing the aforementioned objectives. The role of community healthcare nurses is pivotal in accomplishing these goals because they are important caregivers. This report recommends that their services should be complemented by the provision of home-based care, which may be provided by well-resourced family members. Lastly, it is advised that local and national health data should be used to track progress in health promotion and in identifying new requirements in disease management.

Introduction

Dementia is a mental health condition characterized by a decline in cognitive reasoning, loss of memory, and poor judgment. The World Health Organization (2019) posits that mental health condition is among the leading causes of disability among older patients throughout the world. Based on the importance of cognitive functions to human life, dementia causes significant disruptions to a person’s daily activities and, by extension, their quality of life through a manifestation of the aforementioned symptoms (Honig et al., 2018; Clarkson et al., 2017). Its effects on patients are dire because the condition has physical, psychological, and economic costs to their wellbeing and that of their families.

Dementia commonly affects older persons because of their declined cognitive functioning. Global estimates suggest that 50 million people suffer from the disease and 10 million new cases are reported annually (World Health Organization, 2019). In the United Kingdom (UK), about one in every 14 people, aged over 65 years, suffer from the disease (Alzheimer’s Society, 2020). This ratio is expected to increase as the population of elderly people increases (Dementia UK, 2020; Wauters and Van Broeckhoven, 2019; Olney, Spina, and Miller, 2017)). Therefore, the rising cases of dementia in the UK pose a serious public health risk. Consequently, it is important to understand its causes and management. To this end, key issues that will be covered in this report include an appraisal of key mental health concepts relating to dementia, the use of local and national health data to formulate appropriate health policies, and a critical evaluation of theories and policies to develop effective health programs aimed at increasing people’s awareness of the disease. The findings of this report will help to improve the efficacy of collaborative public health interventions for addressing dementia in the UK and promote the use of evidence-based practices in its management.

Concepts of Mental Health and their Implications in Care Management

Reasons for High Prevalence of Dementia

As highlighted in the introduction section of this report, dementia is a cluster of several types of diseases that cause a decline in cognitive functioning. There are many causes of the disease but Alzheimer’s is leading because it accounts for up to 70% of all cases diagnosed (Schols and Kardol, 2017; Marie, Hannigan and Jones, 2017). In most cases, the disease is associated with age, childhood trauma, and the presence of a head injury (Honig et al., 2018). A history of unskilled work and alcohol abuse are also other risk factors contributing to the high incidence of the disease (Farina et al., 2017; McShane et al., 2019). Smokers and patients who suffer from high blood pressure have the highest exposure to dementia because of their poor health. Early symptoms might consist of hallucinations and difficulty in measuring distances (Mueller et al., 2017; McKeith et al., 2017; Kane et al., 2018; Jellinger, 2017). Broadly, the reasons for the high rates of dementia are genetic and socioeconomic.

Role of Community Mental Health Nurse

Although almost all forms of dementia are treatable, it is difficult to reverse the mental health decline caused by the disease. Therefore, community mental health nurses have a role in helping patients to take medication that would alleviate symptoms (Stokes, 2017). In this regard, post-diagnostic care and support is important component of care management. In the UK, this type of intervention has been spearheaded by the National Health Service (NHS) through the “Well Pathway for Dementia,” program, which encourages nurses to help patients prevent dementia and live well with it (NHS England, 2020). These initiatives highlight the importance of community mental health nurses in providing post-diagnostic care.

Use of Local and National Data to Improve Health Policies

The effective management of dementia as a public health concern depends on the use of reliable data to formulate effective health policies and programs to manage it. Particularly, data obtained from different levels of healthcare management, such as local and national data in the UK could be instrumental in developing collaborative public health interventions (Woods et al., 2018; Wu et al., 2017). The goal is to create synergy across various levels of healthcare management. Such data, if well aggregated, could be used to develop health guidelines and proposals that would improve the prevention of the disease (Nordström and Nordström, 2018; Langa et al., 2017). The use of epidemiological data relating to dementia in the UK could also be relevant in predicting healthcare needs and resources needed to manage the condition in specific communities.

Theories and Ethical Principles Relating to Health Promotion

Addressing the healthcare needs of dementia patients requires the use of effective theoretical frameworks for designing public health interventions. To this end, the theory of reasoned action could be used to formulate public health programs for managing dementia because it highlights the link between people’s behaviors and health outcomes (He, Wan, and Luo, 2019). The “behavioral” component is integral to this analysis because the management of dementia is largely a product of people’s actions aimed at preventing, diagnosing, and managing the condition (Schols and Kardol, 2017). Particularly, since patients lose their cognitive abilities and depend on receiving care from family members or healthcare providers, it would be possible to use the theory to predict behaviors that would improve or worsen the quality of care provided. From this analysis, the theory of reasoned action largely suggests that people’s health behaviors are products of their behavioral intentions (He, Wan, and Luo, 2019). Therefore, the aforementioned theory portends several positive outcomes in the management of dementia because it helps healthcare workers to predict people’s behaviors that would ultimately affect the quality of their health outcomes.

Based on the need to undertake collaborative programs to increase people’s awareness of dementia, the health belief model could also be used to design effective interventions and health promotion programs for preventing or managing the disease. The theory presupposes that people’s health outcomes are products of their belief systems (McLean et al., 2019). Therefore, its proponents suggest that it is difficult to realize positive health outcomes if no strong belief supports them (McLean et al., 2019). This theory highlights the need to develop health interventions and programs that are centered on aligning positive health behaviors for preventing dementia with people’s beliefs. The opposite is also true because health behaviors that are inconsistent with people’s beliefs in the UK may fail to achieve their objectives.

Lastly, it is important to observe strict ethical guidelines when implementing health programs in the UK aimed at preventing or managing dementia among older adults. For example, there should be a keen emphasis on protecting the privacy of patients and families involved in care management to prevent social stigma (Kontos, Miller, and Kontos, 2017). Similarly, participants of healthcare programs should give their consent to partake in such initiatives. The goal of observing these ethical guidelines is to maintain the integrity of proposed health interventions.

Conclusion and Recommendations

This report has highlighted key concepts in mental health care relating to the management of dementia among older adults in the UK. The analysis has included a review of the use of local and national health data to formulate appropriate healthcare policies and develop synergy across different levels of healthcare management to provide the best possible care for patients. Lastly, a critical evaluation of health-based theories and policies has been provided to provide enough data for developing health promotion programs aimed at increasing people’s awareness of dementia. Broadly, the insights provided in this review could improve the quality of health interventions formulated at primary, secondary, and tertiary levels of care.

At a primary level, there is a need to evaluate the main causes of dementia, such as Alzheimer’s, and prevent their occurrence through early diagnosis and treatment. This means that more sensitization should be done within the community to increase people’s awareness of the disease-causing factors and encourage them to report suspected incidences. At a secondary level, families should be equipped with sufficient information on how to care for elderly patients suffering from dementia in their homes. The goal is to augment the primary healthcare plan provided at healthcare facilities with home-based care. This intervention should improve the synergy in care delivery between nursing professionals in the primary healthcare setting and family members in the secondary setting. Lastly, at a tertiary level, local and national data should be utilized to develop effective interventions using epidemiological and statistical data to determine the most affected demographics and the kind of resource requirements needed to manage the disease.

Reference List

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He, J., Wan, L. and Luo, B. (2019) ‘Intentions and influencing factors regarding natural childbirth among urban pregnant women in China, based on the theory of reasoned action and structural equation modeling’, Journal of International Medical Research, 7(2), pp. 4482-4491.

Honig, L. S. et al. (2018) ‘Trial of Solanezumab for mild dementia due to Alzheimer’s disease’, New England Journal of Medicine, 378(4), pp. 321-330.

Jellinger, K. A. (2017) ‘Dementia with Lewy bodies and Parkinson’s disease-dementia: current concepts and controversies’, Journal of Neural Transmission, 125(4), pp. 615-650.

Kane, J. P. M. et al. (2018) ‘Clinical prevalence of Lewy body dementia’, Alzheimer’s Research and Therapy, 10(1), pp. 112-119.

Kontos, P., Miller, K. L. and Kontos, A. P. (2017) ‘Relational citizenship: supporting embodied selfhood and relationality in dementia care’, Sociology of Health and Illness, 39(2), pp. 182-198.

Langa K., et al. (2017) ‘A comparison of the prevalence of dementia in the United States in 2000 and 2012’, JAMA International Medicine, 4(1), pp. 51-58.

Marie, M., Hannigan, B. and Jones, A. (2017) ‘Resilience of nurses who work in community mental health workplaces in Palestine’, International Journal of Mental Health Nursing, 26(4), pp. 344-354.

McKeith, I. G. et al. (2017) ‘Diagnosis and management of dementia with Lewy bodies’, Neurology, 89(1), pp. 88-100.

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NHS England (2020)NHS England’s role in mental health. Web.

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Schols, J. and Kardol, T. (2017) ‘Dementia care in nursing homes requires a multidisciplinary approach’, Dementia in Nursing Homes, 8(3), pp. 203-217.

Stokes, G. (2017) Challenging behaviour in dementia: a person-centred approach. London: Routledge.

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