Free Nursing Dissertations - This Paper Will Consider The Effectiveness Of Psychological Activities, Such
This paper will consider the effectiveness of psychological activities, such as reality orientation therapy, in the treatment and support of patients with dementia. Dementia is a progressive and debilitating neurological disorder associated with a decline in cognitive functioning, impaired memory, change in personality, self neglect, depression, confusion in thought, language and behaviour, including disorientation. Psychiatric aspects of the disorder that maybe treated through psychological therapies include depression/ anxiety symptoms, behavioural and personality disturbances and hallucinations/ delusions (Kasl-Godfrey and Gatz, 2000). However, although the functional and cognitive impairments associated with progressive dementia are well understood, less is known about the subjective experience of living with dementia from the perspective of the patient and their care-giver(s). The lack of knowledge may lead to avoidable affective aspects of the disorder being undiagnosed, and the patients existing personal abilities and psychological potential underutilised, and coping methods not fully explored (Kasl-Godley and Gatz, 2000).
It is more likely in the elderly and in the United Kingdom an estimated 600,000 people have dementia. This represents 5% of all persons over the age of 65, and 20% of all persons over the age of 80 (Bates, Boote and Beverley, 2004). As life expectancy increases in the population, it is predicted that the number of people that will develop dementia will also rise to 1.2 million by the year 2050 (Department of Health, 2001). In the absence of effective pharmacological treatments for dementia, it is necessary to consider the role of psychotherapeutic interventions in remediating the difficult and distressing symptoms of dementia amongst patients. At present, pharmacological treatments would only appear to be effective in delaying the onset of severe Alzheimer’s disease and there are individual differences in patient response to treatment. Furthermore, pharmacological treatment is not tolerated by some patients because of the side effects such as nausea and vomiting. In view of the limitations of pharmacological treatment, it is necessary to consider the effectiveness of psychological therapies such as the reality orientation method. At present, little is understood about the ‘critical windows’ for introducing psychological therapies to dementia patients so that treatment strategies stand a better chance of success (Bates et al, 2004, p 645).
Psychotherapeutic approaches to dementia care are ethical, in that they promote user participation, holistic ‘whole person’ care and place the needs of the patient as the first priority (Bates et al, 2004). Particular interest in psychotherapeutic measures rests with the desire to overcome the temporal and spatial disorientation aspects of dementia that can be most distressing to patients (Baldelli et al, 2002).
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