While the implementation plan prepares students to apply their research to the problem or issue they have identified for their capstone change proposal project, the literature review enables students

Picot

GCU NRS-490

Yeni Hernandez

Picot

This paper discusses the unprecedented complexities and issues related to dementia and particularly people living with dementia (PWD) and research in the field utilizing the quantitative measures to understand the severity of the symptoms as stipulated by Pan et al. (2013) of 51 patients with vascular dementia. The primary focus of the study is based on the demographics of old or aging populations who have been outlined as people at higher risks and prevalence of vascular and dementia complexities.

Problem/Patient Population

The research analysis presents the aging population as the primary population considering that dementia affects people in their senior years. The severities of the behavioral and psychological symptoms consistent with vascular dementia are outlined based on the metrics set through quantitative measures for 51 patients in three environments, diurnal, evening and nocturnal events. Considering that dimension is mainly characterized by amnesia and memory loss the conflict in this population especially with the old or aging population is presented through the delivery of care and achieving better patient outcomes for the PWD patients. It is critical to note that dementia reduces the functionalities of the patients increasing the risks of other issues including becoming unfit due to lack of exercise among other concerns.

Intervention

For this particular group of patients, the intervention is solely based on improving outcomes and maintaining a comfortable lifestyle for the outlined patients at risks (Hughes & Common, 2015). The intervention is based on a combination of two aspects; exercise and medication. By integrating exercises to patients with dementia, it has been shown that exercise can improve memory loss symptoms as well as keep the patient fit. It has been shown that regular exercise improves brain functions in two ways; indirect methods and direct methods. Indirectly exercise helps stimulate and improve mood, sleep, as well as reduce stress and anxiety. This is characteristics of vascular dementia among the older generations. Directly the benefits are derived from the ability of exercise to reduce insulin resistance, reducing inflammation and stimulation of the growth factors. In the old people with dementia “chemicals or growth factors in the brain affect the health of brain cells, induce growth of new blood vessels in the brain as well as indices the abundance and survival rates of the new brain cells”.

Comparison

It is notable that the majority of the patients are immobile due to old age issues and conditions. This means that they cannot engage in productive or useful exercises to stimulate their brains and growth factors. It is therefore imperative that a supportive environment through informal caregiving is instituted to facilitate their safety and relaxation. Supportive environment allows the patient to access all the care services through the help of their informal caregiver or family member. This provides a comparison point to measure how much the success of the intervention for the patients that are can engage in productive and useful exercise (Neubert et al., 2018).

Outcome

The results or outcomes of an integrated exercise for dementia patients prompt health care facilities to consider their choices with regards to the patient's abilities and informal care availability in improving the outcomes of dementia patients. In other words, the teams must make decision-based on what is best for the entire health status of individual patients. The outcome of the study is etched on improving the overall safety of a patient living with dementia by reducing and improving the symptoms to prevent cases of re-hospitalization resulting from injuries such as fall incidences.

Time

The data collection for the study was done in 2013 by nurses who primarily utilize questionnaires. The data collection also utilized diverse scales and tools of assessment to establish dominant symptoms such as the Neuropsychiatric Inventory (NPI), symptoms assessments the BEHAVE-AD scale among others (Pan et al., 2013).

References

Hughes, J., & Common, J. (2015). Ethical issues in caring for patients with dementia. Nursing Standard, 29(49), 42-47. doi: 10.7748/ns.29.49.42.e9206

Neubert, L., König, H., & Brettschneider, C. (2018). Seeking the balance between caregiving in dementia, family, and employment: study protocol for a mixed method study in Northern Germany. BMJ Open, 8(2), e019444. doi: 10.1136/bmjopen-2017-019444

Pan, W., Yoshida, S., Liu, Q., Wu, C., Wang, J., Zhu, J., & Cai, D. (2013). Quantitative evaluation of the severity of behavioral and psychological symptoms of dementia in patients with vascular dementia. Translational Neurodegeneration, 2(1), 9. doi: 10.1186/2047-9158-2-9