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Thursday, October 14, 2010

COMMUNITY HEALTH SERVICES

By : Lamiaa Moustafa Elbosaty

Many families care for their elders with very little outside support and a lack of awareness of existing social programs. Family caregivers are often so isolated from support systems that they are not aware such support is needed until they become exhausted (Swanson & Carnahan, 2007).

Family persons providing care for the patient with dementia should familiarize themselves with services offered by community agencies. Some of these services are geared to meet the patient's need, while other addresses the need of the family caregivers. The availability of these services will vary from community to community, as will costs and funding sources (Gauglar, et al., 2003).

An estimated 10 million American needed long-term care in 2000 (Rogers & Komisar, 2003). Most but not all persons in need of long-term care are elderly. Approximately 63% are persons aged 65 and older, the remaining 37% are 64 years of age and younger (Gibson & Writer, 2008). By 2050, the number of individuals using paid long-term care services in any setting (e.g., at home, residential care such as assisted living, or skilled nursing facilities) will likely double from the 13 million using services in 2000, to 27 million people, this estimate is influenced by growth in the population of older people in need of care (USDHHS & US  Department of Labor, 2003).

In Egypt, the healthcare systems have largely ignored the needs of the elderly, there are only sporadic programmes to care for the elderly, mainly initiated by the community or within the private sector. Those above 65 years old represent 4.4% of  Egypt's population, and there are 34 old people's homes for over a million elderly people and some of these homes have waiting lists of over 1000 persons (Okasha, 2004).

The long term care differs from other types of health care in that the goal of long term care is not to cure an illness, but to allow an individual to attain and maintain an optimal level of functioning. Its income passes a wide area of medical, social, person, and supportive and specialized housing services needed by individuals who have lost some capacity for self-care because of a chronic illness or disabling condition (Schulz & Matire, 2004).

The number of dementia people residing within the community is steadily increasing. Community services can alleviate the burden experienced by families, but are used infrequently by family of demented persons. Older and less educated caregivers had higher levels of uncertainly about service availability. Depressed caregivers were less likely to know about service availability (Collins et al., 2001).

Tuesday, September 21, 2010

Introduction To Dementia

By : Lamiaa Moustafa Elbosaty

 

Dementia is the seventh leading cause of all deaths in the United States and the fifth leading cause of death in Americans older than 65 years. Unfortunately, the main cause of dementia or the relationship to other brain abnormalities such as vascular disease and Lewy bodies is not known. There are also no good preventive or treatment strategies (Kuller & Lopez, 2008). Moreover, caring for a patient with dementia is more challenging than caring for a patient with physical disabilities alone. Peoples with dementia typically require more supervision, are less likely to express gratitude for the help they receive, and are more likely to be depressed. All of these factors have been linked to negative caregiver outcomes (Pinquart & Sorensen, 2007).

Caregiving has all the features of a chronic stress experiences; it creates physical and psychological strain over extended periods of time, is accompanied by high levels of unpredictability and uncontrollability, has the capacity to create secondary stress in multiple life domains such as work and family relationships, and frequently high levels of vigilance (Vitaliano, 2003).

Caring for a person with dementia can cause emotional, psychological and physical problems. In most cases of dementia, at least two individuals are affected; the person with condition and the caregiver. (Mannion, 2008).Carers are at high risk of mental health problems and that the comprehensive burden of caring has social, economic and health based elements. Dementia caregivers reported greater levels of physical burden and psychological distress than other caregivers (Kim & Schulz, 2008). Many problems can face the caregivers of people with dementia, which include the effective loss companionship and support of a life partner, social isolation and complex financial, legal and social decision-making. The burden of caring is financially, emotionally and physically significant (Thompson & Brigg, 2000).

Monday, September 20, 2010

INTRODUCTION

INTRODUCTION

By : Lamiaa Moustafa Elbosaty

Dementia is an umbrella term, when we hear that someone is diagnosed with dementia there is more to the story as a patient, family person, and the type of dementia. Each disease under the umbrella has different courses of illness, different symptoms and different challenges. The drugs' treatment and interventions may be different as well (Cooper, et al., 2007). Dementia is frequently associated with the elderly, and is often incorrectly assumed to be a part of the aging process. Actually, many elderly people retain their intellectual functioning into their eighties and nineties. Dementia becomes a public health issue facing the whole world in the next decades (Brierley, 2008).

 The number of persons with dementia was estimated at about 25 million persons worldwide (about 0.5% of the whole worldwide population), of which 59% were females, 52% live in less developed countries. The number of new cases of dementia in 2000 was estimated to be 4.6 million, and it is forecasted that by 2030, 63 million people will suffer from dementia. More than 5 million American are estimated to have dementia. In Europe there are 7.2 million persons have dementia and it will be 16.5 in 2050. In Africa, there are 1.3 million and it will be 6.3 million in 2050, while in the Arab world there are 1.5 million person suffering from dementia. In Egypt, there are about one million cases and it is expected to continue to increase in the coming decades (Ashour,2007). Significant cost implications related to dementia include an estimated $148 billion annually direct (Medicare/Medicaid) and indirect (e.g., caregiver lost wages and out-of-pocket expenses, decreased business productivity) costs (Alzheimer's Association, 2008).