Aids for living –
Aids for living can assist somebody to live at home independently. There are many things that can help the individual around their house like; food preparation and eating aids, personal care and grooming aids, clothing adaptation aids, reaching and mobility aids and personal home and safety aids. These things can range from small aids such as adapted cutlery and non-spill cups if somebody struggles with their grip, telephones with bigger numbers if they have developed sight problems also there are phones where there is a speed dial with a picture space so it can hold a picture of their doctor or a family member so it is much easier for the individual to remember who they are and also there phone number instead of having to remember it and dial it. To bigger adaptations such as stair lift’s Zimmer frames and enforced railings for people who struggle with balance, another adaptation for someone with Alzheimer’s is flash cards, instruction posters and post stick notes reminding them to do something and jogging there memory. To get these adaptations and advise the individual would contact there Occupational Therapist who will advise them on equipment and strategies hat can help them with everyday activities. If the individual does not have a care pan and therefore doesn’t have an occupational therapist then they can be contacted through there GP and social workers. The NHS can provide a certain amount of equipment such as walking sticks, walking frames and wheel chairs. Aids of living are a large support for somebody with Alzheimer’s as they starts to loose there recent memory they may need this extra support such as mobility support, memory joggers and instructions. Flash cards can start to become a regular memory exercise to slow the memory loss process down. Aids of living are designed for the individual who is developing Alzheimer’s to live independently as long as possible with the help of aids that are available to them.
Home care-
70% of people with Alzheimer’s are cared for at home it can give an individual some quality of independent living as well as their family a peace of mind that they are being assisted around their house. Home care can range from a few hours a week to the carer living at their home with the sufferer which is ‘round the clock care’ this is depending on the severity of the disease and how the individual is coping in their home living independently. Home carers help the individual with personal care, everyday tasks such as cleaning cooking and ironing as well as somebody to talk to. To receive home care a social worker will carry out a needs assessment to see if they need they are in need of home care. The individual may need this home care for a number of reasons one being that because the disease is acting fast and affecting their memory in a way in which stops them from being able to live independently. As well as this they may have had a family member caring for them and they may not be able to do so anymore because of time issue or other commitments, the disease may be progressing and they may have become a danger to themselves and others around them because of their memory loss and confusion etc., they may lose the skills they have such as skills they may use every day and if they are still in work skills needed for their job may be lost and they are no longer able to carry on working. They may have had a partner that cared for them and helped them remember everyday things and they could have passed away suddenly and this would have left them with nobody to care for them which can put them in danger of themselves and may not be able to cope alone and therefore need extra care around the house. Also home care can help and individual if they are prone to falling as there mobility can be affected they can be provided with extra support or if they did have a fall because they were unaided around the house by their carer the carer can tend to the individual in a mild case or get in touch with the emergency services if this is needed, this can give reassurance for close friends and family if they are working they know that there relative or friend is safe at home.
Day care-
Day cares centred are located all over the UK and they provide a place where people with Alzheimer’s can go to visit during the day. This is a safe environment where they can go to and feel safe and secure, this gives family members a piece of mind knowing that they are safe and able to have a good time while being looked after. Care centres are a great way of keeping the individual active and socially engaged, there are many activities provided at the centre which the guests are encouraged to be involved in these include singing clubs, vegetable growing which they can take home, drama, yoga, crafts and art and chicken dove and rabbit keeping this gives them a sense of responsibility and a feeling that they are able to do things with some assistance, also it is important that the individual stays active and able minded . The centres are specially equipped for people with dementia and Alzheimer’s the rooms are decorated specifically for individuals with the disease these special rudiments include special carpets and large clear navigation signs that make moving around as easy as possible for the visitors, because they are more mobile than they would be in their home they may find old skills easier to do in the centres such as gardening and dancing. Within the centres there are carers that make sure the visitors are safe and looked after properly, they can help out with mobility issues, feeding and going to the toilet that they may not be able to do so easy at home. Here is an example of a typical day care centre day:
9.30am Collected from home by taxi or minibus
10.30am Arrival at Day Centre, tea or coffee
11.00am Activities such as discussion, games, crafts, exercise, employment
12.00pm Lunch
1.00pm More activities ( listed above)
2.00pm Tea or coffee, prepare to leave
3.00pm Arrive home
The individuals attending this service will do so because there social worker and OT may feel that they can’t cope alone at home throughout the day because the disease is progressive , and may start to affect their memory in large way, they may receive night care which will help them changing, washing and getting into bed, but do not qualify within their needs assessment for day home care so they will be given the choice to attend a day care centre this way they are being cared for by trained staff but are also having a good time, socialising and keeping active.
Multiple Sclerosis
P5 and M3
Medication –
The NICE guidelines state that if an individual has MS they should have access to a specialist neurological rehabilitation team; this includes specialist nurses, physiotherapists, occupational therapists. Speech and language therapists and a social worker. As well as providing this team they should be openly offered medication that can slow down the process of MS such as ;
Tysabri-This drug is available for people who have aggressive multiple sclerosis who have 2 or more relapses within a year, and rapid increasing lesions within the brain which show within an MRI scan. Tysabri is an antibody like the ones found naturally within the immune system (antibodies are the things that help fight away infection). The drug attaches itself to receptors which are on the outside of certain immune cells. This prevents these cells from leaving the individuals blood stream and entering into the brain and spinal cord where they can cause inflammation and damage, just like any other drug taken they have a number of side effects which include joint pain, fever, tiredness, feeling sick headaches and dizziness. Also they can cause mild allergic reactions like any other medication there is a risk of being allergic to.
Gilenya-
Gilenya was licensed in the UK for individuals who suffer from relapses and aggressive MS. This drug works by an immune cell called a t-cell is thought to be responsible for most of the damage caused by a relapse, it acts by trapping the t-cells from the bloodstream into the organs and in the body called ‘lymph nodes’ This prevents they t-cells from entering the brain and causing damage to the protective myelin which surround the, research has shown that the treatment reduced relapses by 54- 60 per cent and reduced the disability progression by 30 per cent. There are also side effects that can occur with the consumption of this drug it can cause the heart rate to slow and in some cases become irregular, it also can cause the picking up of illnesses such as colds and flu a lot easier as it reduces the number of white blood cells which fight infection.
Beta drugs-
Infernos are proteins that are produced naturally in the human body, and they help fight of viral infections within the immune system. It is thought that the beta interferon can reduce and can prevent the inflammation which can damage nerve fibres that cause MS. Clinical trials show that Beta interferon’s have reduces the number of relapses by about a third over 2 years (this research was compared with someone who had not taken any medication) they can also prevent the forming of disabilities, but on the other hand some trails show that it can sometimes not have any positive effects.
Aids for living-
Aids and adaptations for living are things that help the individual live independently as long as possible. The nature of MS means that some people may be left with minimal mobility and small everyday task can become very challenging thing like; getting in and out of bed, walking up the stairs and even opening a can, can become a large task this can be very frustrating for somebody with this progressive disease as they know what it was like to be able to do these things and now they can’t do so it can also can become very upsetting for the individual and can strip them from their confidence. But there are things that can help the individual live more independent for longer, things like built in railings, frames, stair lifts, electrical can openers, adapted cutlery, pressure cushions, adapted phones and hoists. The individual with severe MS will be incorporated into a care plan which will consist of a multi-disciplinary team this will include an occupational therapist , the OT will carry out a needs assessment and see where about around the house they are most at danger and how they can use aids and adaptations to prevent them from being in danger. Because MS is a very progressive disease needs assessments need to be carried out on a regular basis because the symptoms and effect it has on the physical body can change very fast. People are given these aids for this reason because they are finding it hard coping at home with or without home care, if in the worst circumstances the individual may be given the option of moving into a residential home or visiting a day care centre but living aids would be compulsory anywhere to help with mobility.
D2- Home care
Strengths and weaknesses for home care.
There are always strengths and weaknesses for types of different care. One of the strengths is that the individual will feel at ease knowing that they can be checked on regularly by their carer, so if the individual has a fall or are going into a relapse then they know that the carer will pick up on and seek medical advice, as well as this it also give their family a piece of mind knowing that there family member is safe while they are living independently and they are having no rights taken away from them, home care also provides a sense of normality in the individual and the family’s life knowing that their loved one in within their own home and being assisted instead of being moved into a residential home. People with MS may become socially disengaged because they may feel that people can’t understand there speech or they may be embarrassed that they can’t grip things properly but when they receive home care a regular carer will visit there home daily or hourly depending on how sever the disease is, this can give them a sense of socialisation and again some normality, because they know that this carer has seen people in these circumstances before and that they won’t be judged because this can be very difficult for the individual if they are being judged it can effect there confidence in many ways. When the carer visits they will make sure that the medication if being distributed and given on time and also make sure that they are taking it properly so it can have the full effect on the disease, there may be a risk of the person not taking this medication if they are left to take it independently because they may refuses or forget about taking it. This person or team of people will become familiar with the individual and they will become more relaxed and at ease with these people, and they may become more of a friend figure to them than a carer or a nurse and they may become lazy and not want to do things and not do their exercises they are given etc. The individual may start to look forward for them arriving and giving there care to them because they enjoy socialising with them. As well as becoming familiar with the caring team they are within familiar surroundings so they feel relaxed and not tens and the best possible care can be given to them, as they are in their home environment they will have all their physical aids there such as hoists, frames an railings and they are familiar with mobilising around their home so it can become easier to give the best possible care.
Strengths and weaknesses for care homes.
There are many strengths and weaknesses to long term residential care; the main strength is that the individual at the centre of the care is receiving care around the clock. Usually they will have a ‘buzzer system’ installed this is where the individual can press the buzzer when they need assistance and a nurses will be available for them 24 hours 7 days a week. This is very important because they may not be able to receive this level of care within their home. This also can make the individuals family at ease and able to get on with their own life’s knowing that their family member is safe and is receiving the care that they now need. As well as this strength there is also the fact that the individual may feel a sense of community as they can begin to socialise with all the other patients within the care home which they may not have the option to do this if they are living in their own house. Living within their own house can make an individual with disabilities very isolated and secluded whereas when they are in a care home they are able to socialise, meet new people and also they are able to go out with their friends to local places such as shopping malls, hair dressers etc. Also within a care home mobile hair dressers are able to come into the home, this can give the individual a sense of normality because they may have had a mobile hair dresser coming to their house doing their hair regularly and also socialisation , as well as hair dressers coming into the home to cater for the individuals needs there doctors that they had while they were at home are also available to come into the home so that they feel secure and a change of doctor could upset and disorientate the individual.
But like any care facility there are also disadvantages, if the individual are not covered to be helped financially to pay for the care they receive from the care home they may find it hard to pay for these facilities as they cannot work and may not have received a pension from their previous work. Paying to stay in a care home full time can be very expensive the average price of staying within are care home is £26,500 but if the individual would like to go privately then the cost can be a lot more from £50,000 or more. This can be hard for an individual to pay for on their own so they may need financial help. Care homes have also received a lot of bad advertisement as many people have died within them. This can be due to the lack of care being given or even abuse can be going on without anyone picking up on this, as well as inadequate living conditions. There are cases that have been reported within the UK of residents not receiving adequate care for example there toe nails had not been cut for several or longer and resulted in them growing so long they had dug into their skin, some patients had been reported to have gone into the care home without bed sores and had developed numerous bed sores on their lower back and bottom due to the individual not having the right facilities such as air beds and pressure cushions which can relive the pressure form the individuals bottoms as they are sat down most of the day. These incidents have been reported and dealt with by a higher authority. Because of the negative stories that have been leaked into the press and media this can put a lot of individual off going into a care home and it also can make the families and friends worried about the individual when they go into residential care.
But overall residential care is very beneficial because it enables the individual’s family to carry on with their life’s knowing that their family members are safe and are being given the correct amount of care. Residential care provides 3 square nutritional meals per day this also ensures to the individuals family and doctors that they are eating properly and if they are rejecting their meals this will be recorded.