Nursing Management of Dementia

Sreeja V, RN, RPN*, Jyoti Beck, RN, RPN**

* staff Nurse, Central Institute of Psychiatry, Ranchi, India

** Dep. Nur. Superintendent. Central Institute of Psychiatry, Ranchi, India

	Introduction
	Prevalence & Epidemiology
	Etiology
	Signs & Symptoms
	Types of dementia
	Assessment & Management
	Nursing management
	Nursing care plan
	Problems of the carer
	Conclusion
	Bibliography

X. PROBLEMS OF THE CARER

The carer, if a spouse is likely to also be elderly and possibly with poor physical health. If the carer is a child they may have family responsibilities such as dependent children, producing divided loyalties and some times marital conflict. The carer may live a distance away and suffer financial problems from travel expenses. There may be embarrassment caused by the reversal of roles, especially if caring for the personnel hygiene of a parent of the opposite sex. Lack of insight and knowledge of the progress of dementia, which symptoms can be modified and how to obtain help, can all be remedied by introducing the carer to a support group such as Age concern and the Alzheimer’s Disease society. 

Help of Carer

Carer giving is hard work and is usually considered a professional activity. Amateur careers are untrained so it is not surprising they makes mistakes such as using restrain to prevent behaviour (e.g.: locked doors or request for sedation) rather than environmental or Psychological management Brodaty (1992) Suggests that, training should be comprehensive, tailored to Individual needs, and continuing through the different phases of the illness. A joint report by the RCP (1989 suggests that for the massive issue of Dementia, the emphasis should be on support of carer. Attention should be given to “Those aspects which wear careers down such as restlessness, aggression, disturbed nights and in continence “together with complicating problems such as depression in patient of career. The report describes the role of the community Psychiatric Nurse as monitoring and support, counseling, helping with practical, financial and emotional difficulties and advocacy on behalf of the patient and families. How ever one must beware the tendency for paternalistic control. Where a patient is in capable of consent, relatives should be consulted closely at every stage of treatment. But when a patient is capable of making certain decisions. It is both unnecessary and stigmatizing to wish to confirm the decision with a relative (Murphy 1986).

1). In the Home: - The home help service can reduce the amount of work necessary in the house, leaving the carer more time to spent with the patient. Some district run schemes where paid or voluntary carers come to the house and stay with the demented patient while the carer with the demented patient while the career goes out, or take the patient out for some hours giving the career since alone in the home. 

2). Outings: - Many voluntary and statutory groups are able to arrange outings, either day trips or even holidays, for the carer and patient, to give interest and stimulation to them both. 

3). Day Care: - Social service department and voluntary service run day care scheme in all areas. It is usually possible for transport to collect and return the patient, although sometimes a carer may do this, if there are major problems with physically dependency or behaviour such as aggression day care may be provided by the psycho geriatric day hospital, which has a higher number of staff, including nurses to deal with such problems.