PC 1.

Describe person centered approach including what Brooker’s (2007) acronym

VIPS.

Person-centred care aims to maintain and nurture the person with dementia. Person-
centred care involves building positive and enriching relationships to improve wellbeing,
and enabling the person living with dementia to communicate their wants, needs and
desires and retain a sense of identity.

The VIPS acronym / abbreviation is short for:

1. Values people: promoting the rights of the person.

2. Individual’s needs: providing individualized care to meet each person’s needs.
3. Perspective of service user: understanding care from the perspective of the person
with dementia.
4. Supportive social psychology: fostering social environments which enable persons to
remain in relationships.

PC 1.2

What can you find out from an individualized plan or care plan?

 A care plan is a framework for individual client care.

 The care plan will also provide appropriate strategies to ensure that the
appropriate care and support is given to the client.
 All staff will need to know the care requirements of each of their clients and any
issues they may encounter when attending to that client.
Examples-
 Physical and mental condition
 Physical observation
 Alcohol and other drugs
 Personal care and toileting

Give some examples of how you could help someone with dementia maintain a
good quality of life.
 Help the person with dementia feel safe and comfortable.
 Provide a relaxed environment and emotional support.
 Add meaningful activities.
 Add fun-filled activities.
 Spend time relaxing with them and talking to them.
PC 1.3
Why it is important to maintain stable environment for people with dementia?

Safety may be affected by dementia symptoms (such as confusion, memory loss and
disorientation), limited mobility and coordination, or by changes in the environment.
Many people with dementia find noisy environment annoying. Family, friends and health
professionals can help the person with dementia feel safe and be as secure as possible.
How can you address this in a residential environment?
 Install locks out of sight.
 Keep walkways well-lit.
 Remove and disable guns or other weapons.
 Place medications in a locked drawer.
 Remove tripping hazards.
 Watch the temperature of water and food.
 Avoid injury in the bathroom.

PC 1.4
How would you respond if you witnessed or knew an older person’s rights were
violated?

 see- recognize the warning signs of abuse

 Name it- talk to the older adult or someone you trust about your concerns
overcome your hesitation to help.
 Check it- Is it abuse? What can you do to help? Check with an expert on abuse
about what to do next, check for danger and suggest safety planning.

PC 2.1

What is active/ empathic listening and how can it be used to help care for person
with dementia?

Active/Empathy is the ability for one to walk in someone else's shoes and experience
their world to understand what person is experiencing. Active Listening Can
Help Improve Care and Peace of Mind and helps person with dementia feel heard,
respected, and understood.
PC 2.2

Create a plan for reality orientation session. Detail what skills it aims to develop
and who needs to be involved, as well as materials required.

The aim of reality orientation session is to reduce confusion in people with dementia.
Following are the skills developed and material used-

 Calendar- crossing date every morning help them identify date and day every
day. Automatic calendar can be helpful for individual who lose track of which date
or day it is. It can help to prevent them getting confused about time.
 Digital watch- simple watch can help them understand time and date easily.
 Picture cards- picture can help them to understand information or instruction
easily. It also can help them to communicate or express themselves easily.

 Identity tag- information that can be written in identity tag are:

 Name

 Close family member’s phone number

 Family portrait- family member’ or friends’ portrait can help them to identify
individual or event situation in that picture.

Skills development in reality orientation-

 Increase in confidence
 Reduction in depression problems
 Improvement of cognitive functions in older populations with dementia

PC 2.3

Write a role play for validation therapy between dementia patient and a carer.

Imagine that my father, who has dementia, lives with me in my home and frequently
calls out for his own father. People who practice validation therapy can use the following
techniques in that situation:
Center myself

Take a deep breath and slow down. My initial reaction may be to try to use logic when
my father who is 80 years old, starts calling out loudly for his father. But before you
react, think and breathe.

Use Extremes

I asked him if he always misses his father. This can allow him to process those feelings
of grief related to losing his father.

Match and Express the Emotion

Then I joined my father in his feelings and acknowledge the sadness of losing his father.

Rephrase

Rephrasing his feelings back to him can provide reassurance that you understand and
feel his loss. Saying "You must really miss your father" can decrease his anxiety.

Use Senses

Ask questions about his father. For example, ask about his favorite food how it smelled,
or how handsome his father was?

PC 3.1

Create a list of ten suitable activities for someone who has limited mobility,
dementia and lives in a residential care home.

1. Music
2. Deck of cards
3. Fish tank
4. Threading yarn
5. Picture puzzle
6. Cutting pictures of old calendars
7. cupcake decoration
8. activities related to former life
9. pom poms
10. matching shapes
11. fabric box

PC 3.2

What are some of common risks associated with dementia patients?

Ageing-Age is the strongest known risk factor for dementia. Whilst it is possible to
develop the condition earlier – at least 1 in 20 people with dementia developed it at age
under 65. This may be due to factors associated with ageing, such as:

 higher blood pressure

 increased risk of cardiovascular diseases
 the weakening of the body’s natural repair systems
 Changes in the immune system.
1. Gender- Women are more likely to develop Alzheimer’s disease than men. This
is the case even if we allow for the fact that women on average live longer.
2. Ethnicity- There is some evidence that people from certain ethnic communities
are at higher risk of dementia than others. For example,-South Asian people
seem to develop dementia.
3. Genetics- Scientists have known for some time that the genes we inherit from
our parents can affect whether or not we will develop certain diseases.
4. Depression- People who have had periods of depression seem to have
increased rates of dementia.
5. Smoking
6. Unhealthy diet
7. Excessive alcohol

PC 3.3

What information you can gather from family carers and significant others to help
meet the care needs of dementia patients?

 Family history
 Stories about childhood
 School days
 Young adulthood
 Working life
 Information about where the person has lived
 What their interests
 Favorite music.

PC3.4

What kinds of problems can affect carers, family or significant?

Carers or family often ignore their own health and are 40% more likely to suffer from a
chronic health condition. Some health problems, like back problems, anxiety
and depression, can be directly linked to caring.

How can you help to address these?

  Help them when they are in need.
 Positive take with them
 Taking care of their eating
 Keeping up with them
 Attend a carers group for support.
 Access all available services and funding.
 Acknowledge and deal with feelings.

PC 3.5

What behaviors are of concern for those with dementia?

 Sleeplessness
 Restlessness
 Screaming
 Abusing
 Hitting
 Slapping
 Kicking
 Repetitive talks

What situations can be responsible for behaviors of concern?

 Mental stress
 Alcohol consumption
 Drugs
 Depression
 Type of medication
 Emotional state

How should you not react to behavior of concern?

 Keep calm
 Call for help
 Leave the person to calm down
 Take care to tone of voice used to person

PC 4.1

What types of matters might you discuss at a team discussion for someone with
dementia? Create a draft agenda for such meeting.
  communication needs
 eating and nutrition needs
 hygiene needs
 continence needs
 sleeping habits
 memory abilities
 Behavior

PC 4.2

Outline five psychosocial and their methodology.

Five psychosocial are-

 Sadness
 Anger
 Mood swing
 Anxiety
 Depression
 Feeling of helplessness

Methodology-

Laughing- is easiest and best method to reduce stress. Share joke, watch funny videos,
read comics.

Exercise- aerobic exercises are effective in mood lifting and mind relaxing. For
maximum relax do exercise for at least 30 minutes daily.

Learn to relax- take several deep breathes to remain relax. Deep breathes are simple to
do at any time of day and at any place.

Nutrition- healthy diet keeps mind healthy. Eating small but frequent meals through day
can keep your energy level up.

Relaxation methods- meditation, listening to peaceful music reduce your stress.

4.3

In an event sample observation, what information should you record?

  Behavior of person
 Causes of misbehavior
 Behaviors to be encouraged
 Strategies to be used
 Follow up

What is ABC method for analyzing behavior?

The ABC approach looks at:

A - Antecedents (what happened before the behavior occurred)
B - Behavior (description of the behavior that ensued – what, when, where, who and
why)
C – Consequences (the results of the behavior, including the responses of others to the
person)

5.1

What are your organizations’s reporting requirements for both written and verbal
reports?

 A description of a sequence of events

 Some clarification of the significance of events
 An evaluation of the facts or the results of your research
 outcomes of future courses of action
 Your recommendations as to a course of action
 Conclusions

5.2

How can you complete and maintain documentation?

 Identify what documents are needed

 Determine who is responsible for obtaining information
 Ensure that all documentation complies
 Establish a document control process
 Establish review timelines

How can you make records identifiable?

 Record Type Name or Description

 Record Type Part Number
 Originator Name –Person who recorded the data
 Date -The date on which record was recorded
  Status of the Item: Accept or Reject
 Serial Number or Lot Number

6.1

What are the ten signs of stress in caregivers and how can you manage them?

Ten signs of stress in caregivers-

1. Anger
2. Anxiety
3. Depression
4. Concentration loss
5. Change in eating habits
6. Insomnia
7. Exhaustion
8. Health problems
9. Overreaction to minor situations
10. Gain or loss of weight

Ways to manage them-

1. Learn ways to better help your loved one

2. Listening to peaceful music
3. Ask for and accept help
4. Meditation
5. Improve eating habits
6. Take time for yourself
7. Take care of your health
8. See doctor for regular checkups

6.2

What are self-care strategies could you employ to minimize the development of
stress and manage any that surfaces?

 Avoid Caffeine, Alcohol, and Nicotine

 Indulge in Physical Activity
 Get More Sleep
 Exercise
  Social
 Spiritual practise
 Try Relaxation Techniques
 Talk to Someone
 Keep a Stress Diary
 Take Control
 Manage Your Time

Assessment 2

1. Write a short essay (1-2) on the latest findings of dementia research.

The dementia has significant impact on health care and social costs in the wider
community. In 2007 there were an estimated 220,050 people with dementia; by 2030
this figure will have more than doubled to 465,460 and by 2050 the figure will reach
731,030 people. Dementia is the chronic disease that is expected to show the greatest
increase in disease burden by 2023. The direct cost to the heath and care system of
dementia is projected to rise to $8.2 billion by 2022-23. Investment in dementia
research, whether in cause, cure or care, is a key strategy for addressing the epidemic.
Historically, medical research in Australia has produced returns of $5 for every $1
spent. Economic modelling has shown that if the onset of dementia could be delayed by
5 years there would be significant savings to the health and care system. Australian
researchers have contributed significantly to the global effort in dementia research and
are world leaders in research on the aetiology of dementia, epidemiology, carers, and
dementia management. Relative to current disease burden and current direct cost of
care, dementia research in Australia is significantly under-funded. Annual expenditure
on dementia research is currently $12.8 million (0.57% of the total direct cost of
dementia). In comparison with other major diseases, this is about:

• 50% of research funding for cancer, relative to current disease burden.

• 30% of research funding for cardiovascular disease, relative to current direct cost of
care.

• 20% of research funding for cancer and diabetes, relative to current direct cost of care.

• 5% of current research funding for cancer, relative to predicted direct cost of care in
2023.
2. List all of the different manifestations of dementia.

 Alzheimer's disease.
 Vascular dementia.
 Dementia from Parkinson's disease and similar disorders.
 Dementia with Lewy bodies.
 Frontotemporal dementia (Pick's disease)
 Creutzfeldt-Jakob disease.

3. Describe dementia as a progressive neurological condition and the

pathological feature of amyloid plaques, neurofibrillary tangles and loss of
connection between cells and cell death.

Dementia is actually a progressive neurological condition. The main feature of

progressive neurological condition is memory loss, language problems, difficulty
with movement, problems with object recognition and difficulty with numbers,
difficulty in problem solving, abstract thought, planning, organization, judgment
and insight. There are also changes in behavior, personality and mood which
family and carers often find most distressing.

Amyloid Plaques

One of the hallmarks of Alzheimer's disease is the accumulation of amyloid

plaques between nerve cells (neurons) in the brain. Amyloid is a general term for
protein fragments that the body produces normally. Beta amyloid is a protein
fragment snipped from an amyloid precursor protein (APP). In a healthy brain,
these protein fragments are broken down and eliminated. In Alzheimer's disease,
the fragments accumulate to form hard, insoluble plaques.

Neurofibrillary Tangles

Neurofibrillary tangles are insoluble twisted fibers found inside the brain's cells.
These tangles consist primarily of a protein called tau, which forms part of a
structure called a microtubule. The microtubule helps transport nutrients and
other important substances from one part of the nerve cell to another. In
Alzheimer's disease, however, the tau protein is abnormal and the microtubule
structures collapse.

It is formed from the breakdown of a larger protein, called amyloid precursor

protein. One form, beta-amyloid 42, is thought to be especially toxic. In
 the Alzheimer's brain, abnormal levels of this naturally occurring protein clump
together to form plaques that collect between neurons and disrupt cell function.

4. What are common indicators and symptoms of dementia?

 Appear more apathetic, with less sparkle

 Be unwilling to try new things
 Be unable to adapt to change
 poor decisions making
 take longer with routine jobs
 Blame others for lost items
 Become more forgetful
 Be more likely to repeat themselves or lose the thread of their conversation
 Upset with failure
 Have difficulty handling money
 Confusion
 Mood swing

5. Explain the different behaviors of concern (also known as changed

behavior, or unmet needs, or behavioral and psychological symptoms of
dementia(BPSD)
 Repetitive behavior
 Depression
 Mood swing
 Sleep disturbance
 More forgetful for recent events
 Unable to adapt changes
 Show poor judgment
 Loss interests in hobbies

6. What kind of impact can the disease have on the patient and their family?
 Loss of role – the family members or spouse becomes carer
 Loss of best friend – couples who always used to talk and do most things
together may not be able to behave same.
 Loss or change of plans for the future
 grieving for the person that was – over time the person with dementia will not
be able to function normally
 Physical and emotional fatigue – Family members may experience strong
emotions, such as guilt, anger, sadness, fear, anxiety and depressed mood.
  Lack of understanding from relatives and friends sometimes leading to social
isolation.

7. What are the principals of person-centered support?

 A non-judgemental acceptance of the uniqueness of each person
 Respect for the past experiences and learning of each person
 Recognising the whole person as having emotional, social, physical and
spiritual needs
 Staying in communication requires flexibility, lateral thinking, and acceptance
of other viewpoints
 Nourishing attachments means ensuring people feel welcome and included.
 Creating a feeling of community gives us a sense of belonging, of where we
fit in and what is expected of us
 Maximising freedom for people to contribute to their care and eliminating
unnecessary controls
 Allowing ourselves to receive from others and valuing what they give
 Building and maintaining an environment of trust - protect from bullying,
exploitation and other abuses of power.
8. What are some activities that enhance a person’s self-esteem and help to
bring pleasure to a patient’s life?
 Pay attention to your desires and need
 Eat healthy
 Take care of yourself
 Dress something that makes you happy
 Set goals to achieve
 Self-esteem collage
 Laughing
 Positive self-talk
 Contribute something to society

9. Explain the need for and list the different types of verbal and non-verbal
communications strategies.

Four Types of Verbal Communication

 Intrapersonal Communication. This form of communication is extremely private and
restricted to ourselves
 Interpersonal Communication. This form of communication takes place between
two individuals and is thus a one-on-one conversation
 Small Group Communication
 Public Communication
Need- verbal communication is use for sharing of information between individuals by
using speech. Individuals working together need to effectively use verbal
communication to convey their ideas. Effective verbal communication between
employer and employee increases level of job satisfaction.
Types of Non-verbal communication
 Facial expression
 Gestures
 Eye gaze
 Appearance
 Haptic
 Touch
 Voice
Need- Nonverbal communication represents two-thirds of all communications. It is most
common form to communicate with children. Nonverbal communication can portray a
message both vocally and with the correct body signals.

1. Provide support for two different people living with dementia in a

residential home setting.
 The learner must implement a person centred approach to support
throughout both sessions with each person.
 The learner needs to use appropriate communication strategies for each
patient. As each person is different, a tailored communication approach
will be required.
 The learner should also assist the care team in implementing a range of
suitable activities for each patient. All activities will meet the person’s
unique needs.
 References

 About dementia. September 7, 2015, from http://www.nsh.uk

 Living with Dementia. September 9, 2015, from http://www.alzheimers.org.uk

 Reality Orientation. September 10, 2015, from

http://www.memorymatterssw.co.uk

 https://www.brightfocus.org/alzheimers-disease/infographic/amyloid-plaques-
and-neurofibrillary-tangles
 https://www.dementia.org.au/files/20080600_Nat_NP_16AustDemRes.pdf