Evidence-Based Interventions For Major Neurocognitive Disorder Essay Paper

Focusing on the diagnostic classification of Major Neurocognitive Disorder, explore the current literature to make conclusions about evidence based interventions to ensure best practice in a clinical setting.

This assignment needs both pharma logical and therapeutic interventions. Ensure all arguments are supported by relevant literature.

Diagnostic Criteria

Dementia is a term referred to a problem associated with the mind. It alters the well functioning of the brain, thus interfering with the well being of a person. A person infected with dementia faces challenges since he or she finds it difficult to interact freely with people. Dementia can be serious do not serious to some extent. This is because it can be recognized in early stages and treated if possible. When detected, the doctors attend to the patient and ensure that the condition does not worsen. However, when dementia goes to the extent of being acute, the patient gets into crises. This therefore means that nothing can be done to alter the current situation. The patient therefore has to cope with the current situation up to the end of time, facing the challenges of the diseases. It is therefore the responsibil8ity of the family members to take care and be keen if their family has had history of dementia v in the past.

Dementia has been in the increase in the previous years, and so many people are finding themselves in the situation. Before they know till the disorder spreads to the sensitive parts f the brain, and become acute (Hinkelmann et al, 2009). This is because it takes some time to develop, and some people are ignorant. The people around such patients are advised to always be keen once they notice a suspicious behavior or habit that a person was snot part and parcel of the person’s life in the past. It is dangerous to as assume that some people are pretending to be mad, or have exchanged their habit. According to people, or otherwise the facts of psychology, a person must change a habit towards the positive and not to the negative. It is therefore advisable that one must be checked and put under palliative care if some habits which have been part and parcel of him, are changing to the negative. The patient is suppose4d to be treated like a child, t determine whether the brain is functioning normally or not. Evidence-Based Interventions For Major Neurocognitive Disorder Essay Paper

Some people tend to ask of the causes of dementia. Dementia is not a disease, but a combination of untreated brain disorders. It therefore exists in some people, due to ignorance of signs and symptoms of a certain disease in the past (Heaton et al, 2011). The commonly known disease that causes dementia is delirium. Delirium is a form of sickness; which is caused by the combination of untreated illness. Serious illness, such as malaria, tends to free itself from the body, thus disappearing without any form of treatment. The treatment plays a vital role, since it kills the protozoa, which are related to malaria. Once the protozoa mature, one finds it difficult to recognize the original a causative agent, since it erupts as a serious disease, which almost kills. It does not only leave some of the patients with dementia, because others die as a result.

Causes Of Major Neurocognitive Disorder

Dementia is very general terms that are used for the loss of memory of the individuals and the other mental abilities that are crucial enough to interfere in the daily lives of the individuals. It is caused mainly due to any form of physical changes in the brain. However the fifth edition of Diagnostic Statistical Manual have some criteria for this disease (Ismail et al., 2016). Thus, if the individuals are facing any of the symptoms that are listed in the diagnostic criteria they should immediately seek help from the neurologists. Therefore, according to DSM 5 the criteria are listed below (Ismail et al., 2016),

Impairment of the memory
The individual should be having any one of the listed symptoms

Aphasia

Apraxia

Agnosia

Disturbances in the executive functions of the brain

The cognitive of the deficit in the above two criteria causes a significant form of impairment for the social or the occupational functioning and represents a significant decline from the previous level of the functioning.
The cognitive deficits do not occur exclusively during the course of delirium

The treatment of dementia starts with the treatment of the underlying of the disease where it is possible. The major causes of the disease includes, malnutrition, hormonal imbalances, emergence of any tumor in the brain or any drug related to the related to the dementia that may be reversible to some extent (Sheehan et al., 2015). For many diseases including Alzheimer’s there are no cures that have been discovered. However, improvement of cognitive and behavioral symptoms can be achieved through a combination of appropriate medications and other treatments, including psychotherapy. The goal of treatment is to slow down the progression of dementia-related impairments and to control behavioral symptoms, which may be treated with a combination of psychotherapy, environmental modifications, and medication.

Psychotherapy is an impressive form of a behavioral approach to treat the diseases that are used for reducing the frequency or the severity of the various forms of the problematic behaviors that includes the aggression or the socially inappropriate form of the conduct. The identification of the triggered problematic behavior is then devised according to the changes in the environment of the person or the reactions of the caregiver to the behavior that are effective for them (Dennis et al., 2014). The other form of the strategies includes the breaking down of the tasks that are complex in nature and the being involved in the simpler steps by reducing the amount of activities of the patients in the environment for avoiding any form of confusion and agitation.

The other form of therapy includes the modification of the environment that can increase the safety and the comfort by decreasing the rate of agitation. The modification for the safety includes the safety of the and mainly observes the removal; or the lock ups of the hazards due to sharp knife, dangerous forms of the chemicals and the tools. The childproof latches may be used for the limited access (Dennis et al., 2014). The bed rails and the bathroom safety rails are the important measures of safety as well. The other example includes the lowering of the hot water temperature that reduces the risk of the burning and disabling the stove and the stove with the childproof knobs that may be necessary for preventing the accidents while cooking.

Treatment Of Major Neurocognitive Disorder

The medicines are also provided to the patients who are going through the symptoms of dementia. There are several the drugs that are available in the recent times for the improvement of the brain functions. There are typical form of the anti dementia drugs and the other forms of the psychotropic drugs are prescribed. There are more current forms agents of the anti dementia agents that belongs to the inhibitors of the acetyl cholinesterase (Dennis et al., 2014). The Acetylcholine is one of the substances of the chemical fields that allows the brain cells for the communicate with one another, the so-called neurotransmitters. The research suggests that acetylcholine hyas been reduced in the brain of AD patients. These kinds of drugs are there to prevent the acetylcholine are being eliminated very quickly, with the prolonging their ability for conduct the chemical messages between the cells of the brain cells. They are been shown in the clinical trials of the drugs with the deterioration of the disease that could be delayed by at least 12 months. Apart from preserving and partially improving mental capacities, and coping with daily activities, a delayed onset of behavioral disturbances and a reduction in caring time could also be demonstrated. Psychotropic drugs can be used as a supportive therapy in the treatment of behavioral problems in dementia. For instance, antipsychotic medications (typically used to treat disorders like schizophrenia) can be effective in reducing persistent aggression, and in patients who have been unresponsive to non-pharmacological approaches, and where there is a risk of harm to themselves or others; however, such treatments should be used on a short-term up to six weeks rather than a systematic basis. Anti-anxiety medications (typically used to treat anxiety disorders) can also be prescribed to help treating agitation and restlessness (Huntley et al., 2015). Likewise, antidepressant medication can be prescribed to alleviate symptoms of depression. Therefore, the prescribed medication are to be administered with caution with the patients who are through dementia in the lowest possible way for the effective doses for minimizing the side effects of the medicines. With the medications, the side effects are associated with them (Huntley et al., 2015). There are no evidences that can say that the life of the patients will be normal and prolonged with this sort of disease. Rather, there are medications that are helpful for some of the patients for the better functioning of their life for a longer period (Huntley et al., 2015). The therapies may also help persons with dementia with activities of daily living. Physical therapy may improve mobility by teaching patients to use canes or walkers properly and showing them how to get in and out of chairs or beds. Aroma, music, reminiscence, or occupational therapy, as well as art activities, may be beneficial and have a calming or rewarding effect for the person with dementia.

Psychotherapeutic Approaches

Finally, a growing number of herbal remedies, vitamins and other dietary supplements are promoted as treatments for AD and related diseases (Pezzati et al., 2014). They can be appealing to some people as they come from natural ingredients. Although many of these remedies may be possible treatment options, using these drugs as an alternative to or in addition to physician-prescribed therapy raise legitimate concerns. For example, the efficacy that are tolerability and which have the guarantee for safety of these products are not been established and they do not need to undergo further scientific testing. Further, they may not be manufactured consistently by all vendors or always contain the ingredients listed on the label. Moreover, herbal and nutritional supplements can interact with prescribed medications in harmful ways (Pezzati et al., 2014). Therefore, no supplement should be taken without first consulting a physician or informing the doctor treating the dementia patient.

Apart from treating the specific symptoms of dementia, it is important to observe the general state of health because a good general condition improves the feeling of well-being and might prevent or delay the onset of the disease.

It however becomes difficult for those with tender age to bear with dementia. It is too dangerous for them to survive, and that is why it does not respond to medication in their cases. Though some surgery is done to make sure that the disease is dealt with, it goes wrong for some people, and where else others are lucky enough to regain their normal condition (McClintock et al, 2010). However, there are some tasks, which are not authorized to b carried out by these types of patients. Some difficult tasks w such as over thinking and activities that strain the brain are not advisable for use by these patients. They are required to carry out simple tasks, which take a shot while, and without the use of excess brain power, or in other term, over thinking

The capacity of the brain is formed in a way that it can accommodate a certain percentage of activities. The brain can therefore accommodate some information at a different time. In addition, it releases a certain capacity of thoughts at a given time, more so when one takes a nap, in the form of sleep. The brain therefore re-circulates and re-functions gain. It therefore rests too, and one refreshes. However, the brain malfunctions and one is said to have increased blood pressure. The state of the mind interferes with the flow of blood in the blood vessels, thus increasing the amount of pressure required in the normal pumping of blood (Lee, 2012). The high blood pressure sometimes increases to a higher and dangerous level thus causing the eruption of some sensitive and crucial blood vessels in the brain. The inner bleeding of the mind is dangerous and can cause dementia. It is therefore important for resumes to be fast enough to rescue people from accidents. Most people who have had previous cases of accidents are prone to dementia, and must therefore attend clinics all through until the doctor confirms that the patient can go free, or be declared totally healed. Internal neural- bleeding does not have different side effects to any age, or gender. It affects everybody equally, and so immediate action must be taken against the bleeding. If not attended in time, the bleeding leads to a delirium which is said to be the main cause of dementia.

Environmental Modifications

Other diseases, associated with dementia are stress and fatigue and intense pain. Some people undergo through circumstances which affect them negatively. Some circumstances are so critical that one cannot do away with them. The stress therefore accumulates in the body, and may later cause fatigue. The main cause of fatigue is stress, and straining (Heaton ET AL, 2012). . Stress strains the brain, thus sending a negative message to the feet muscles. The rest of the body becomes strenuous and find it difficult to carry out simple tasks. The body muscles relax, and one adapts a funny feeling, since the normal function of the body is altered.

The stress evolves and gains another standard which later makes some people to lose conscious. In such a situation, the person fells in to a risk of contracting other mental contradictions. The person is supposed to be attended immediately, and handled with care at the same time (Godard ET AL, 2011). It is therefore advisable for one to get counseling and advises before resuming to normal activities. However, before the treatment is done, the patient must be undertaken through various tests to determine whether the stress has interfered with sensitive parts of the bran r not. Some serious cases of brain damage come about as a result of minor injuries or to extend of a minor disease, which was ignored in the past.

Psychiatrists are technicians who deal with people, in need of counseling. They therefore assist much in the prevention of dementia (Marazziti ET AL, 2011). They can handle such cases with care, and are therefore put in place of other local advisors, to deal with technical problems that may affect the well functioning of the brain. They take their time and carry out a test on the blood pressure of the client, before getting into a serious session.

Dementia patients are the less fortunate in the society, since the family members find it difficult to entitle some property or assets to them (Belmaker et al, 2008. They therefore grow without any thing to give to their spouses or children. However, Wills written by the lawyers are helpful and contribute much in as much as these patient families are concerned. The lawyers make sure that everything that was entitled to the dementia patients’ families is shared as directed by the patient.

Some people in the society however, tend to neglect these kinds of people. Dementia is just a disorder, and has no adverse effect on the entire brain functioning. It is not all the time therefore, that the patient is in an abnormal condition (Heaton ET AL, 2012). Sometimes, the patient acts normally, and carries out common duties normally. They also communicate with the best of the people in a normal way without making mistakes. These people therefore have a minor brain problem, which can be corrected. They can be given property and assets to use in the future, though not to man them. The people around them should not therefore take advantage of their current condition to take all what they have, since it can be dangerous to the entire family.

Pharmacological Treatment

The affected people are therefore advised to take great care of dementia patients, since love, and palliative care can lead a better life of the person, who is likely to recover in the future. They should take care of their families, and take up responsibility, to avoid creating other cases of similar disorders in the family (Godard ET AL, 2011). In addition, the parents of such people should be cautioned against straining children in a tender age. Children need much time to relax, peaceful environment and a conducive environment. Children perform well in a good environment, and also relate to others as per their background.

Generally, it is the responsibility of the parents, to take care of their children (Marazziti et al, 2011). Those with little babies are advised to ensure that every miner infection is attended to accordingly without delay, to avoid the increase or rather the accumulation of diseases in the body of the child.

The government must create a law concerning the mentally challenged people. They have faced, and are still facing challenges in their entire lives today. This is because, there are no strict or tough actions taken against the people who violate their rights. Examples of such people include women or young girls, who run away from their homes to the streets. (Wingo et al, 2009).

These female patients face a tough moment out there, since they are raped and get unwanted pregnancies (Belmaker ET AL, 2008). They bring about unplanned children who face challenges too, since they are raised in orphanages and may never know their biological parents. These patients can also acquire diseases, such as HIV AIDS. Other challenges include that they may be involved in serious crimes such killing, theft and prostitution. Some of these people die in the stress as a result of either sickness, pain during birth or minor injuries.

In a situation where one have some assets; he or she finds it difficult to know the exact amount of money that the assets are worth (McClintock, 2010). This is because, mild NCD is believed to have some changes in the well functioning of the brain, thus the person may end up making wrong calculation. These types of people are therefore likely to lose property worth millions of money. On the other hand, they can also end up having strong and firm stand, thus making it difficult to negotiate on a price of a certain asset. The assets may therefore remain unproductive for a longer period of time.

Anti-Dementia Drugs

In a court of law, where the same people are having a case, they experience difficulty since they are unable to give the right evidence on a certain issue. They may find themselves beating around the bush without having a stand, all though the case. Though some have lawyers, the case may not be presented as per the wish of the person complainant or suspect. Most of the time such cases are just withdrawn and thrown away, since the person in charge is not normal.

Some people find it difficult to accept these kinds of people (McArthur ET AL, 2010). They are however important in as much as complete life is concerned. These people have responsibilities and could have been better people in the society, before issues occurred.

Male patients also face challenges in the society since others are said to have been their own cause of the dementia. Drug abuse, being the main cause of dementia, is said to be a willing method of seeking mental problems (Heaton, 2011). These kinds of people are therefore mistreated once the brain disorder affects them. They therefore find it difficult to interact freely with other normal people in the society. They work a lot but get less pay, or sometimes get no pay at the end of a hard task. These people are however as delicate as any other person and their rights should be preserved. The government should therefore give them a priority, and put aside some amount of money to cater for their needs.

Psychotropic Drugs

References

Acharya, D., Harper, D.G., Achtyes, E.D., Seiner, S.J., Mahdasian, J.A., Nykamp, L.J., Adkison, L., Van der Schuur White, L., McClintock, S.M., Ujkaj, M. and Davidoff, D.A., 2015. Safety and utility of acute electroconvulsive therapy for agitation and aggression in dementia. International journal of geriatric psychiatry, 30(3), pp.265-273.

American Psychiatric Association, 2013. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub.

Belmaker, R.H. and Agam, G., 2008. Major depressive disorder. N Engl j Med, 2008(358), pp.55-68.

Chancellor, B., Duncan, A. and Chatterjee, A., 2014. Art therapy for Alzheimer’s disease and other dementias. Journal of Alzheimer’s Disease, 39(1), pp.1-11.

Cohen-Mansfield, J., 2015. Non-pharmacological interventions for agitation in dementia: various strategies demonstrate effectiveness for care home residents; further research in home settings is needed. Evidence-based nursing, pp.ebnurs-2015.

Dennis, M., Francis, D.J., Cirino, P.T., Schachar, R., Barnes, M.A. and Fletcher, J.M., 2009. Why IQ is not a covariate in cognitive studies of neurodevelopmental disorders. Journal of the International Neuropsychological Society, 15(3), pp.331-343.

Ganguli, M., Blacker, D., Blazer, D.G., Grant, I., Jeste, D.V., Paulsen, J.S., Petersen, R.C. and Sachdev, P.S., 2011. Classification of neurocognitive disorders in DSM-5: a work in progress. Evidence-Based Interventions For Major Neurocognitive Disorder Essay Paper