End of Life & Dementia Care Essay

1.1 Dementia is a progressive disease where an individual’s brain functions deteriorate and affects their mental capabilities. This disease is incurable which is similar to another terminal illness such as cancer. Symptoms of dementia will affect an individual’s memory leading to loss and confusing, language/ communication, understanding and judgement. Medication can be prescribed to help slow down the progression of symptoms. Within the more advanced stages the individual will commonly suffer from incontinence, limited mobility and limited communication usually the individual will not be able to use sentences just limited words. Other symptoms that worsen similar to those with a terminal illness are: aspiration, difficulty with breathing, pressure sores from lack of mobility, unrecognisable symptoms of pain (may not be able to communicate) this could lead to the individual not being treated for pain. 1.2 The end of life experience may differentiate between those who have to dementia to those who individuals without. An individual may lack understanding surrounding the diagnosis being made, they may have had symptoms for a longer period of time before a diagnosis had been made. This can lead to confusion as to why they are having symptoms and the way they are feeling. An individual’s communication may be limited, so they may not be able to express their feelings, changes in symptoms and pain. This can lead to depression/ anxiety which impacts on the individual’s behaviour I.e. verbally aggressive, changes in appetite. Lack of communication regarding pain could impact on the quality of care and medical treatment, as care givers are the primary source of recognising an individual’s pain through sounds rather than speech and non verbal communication. Whereas someone who doesn’t have dementia may be able understand a diagnosis and engage fully on how this c an affect their health through an illness progressing. 1.3 Person centred care has come under Health and social care act which states â€Å"that people should make choices about their lives and they should be at the centre of all planning†. Is it important having the person at the centre of all care throughout the time of caring for someone and when end of  life is approaching. The care provided to an individual within this should be based around their choices, beliefs, values and decisions which may have been made in advance. Working as a carer these should be respected. For example knowing the individual’s likes/ dislikes surrounding food, drinks, clothing, to have permission to give medication when the individual is unable to verbally consent. 1.4 In the earlier stages of dementia it is important that the carer works alongside and includes the individual and their family to make plans to reflect the individual’s wishes to be cared for at the end of life, before the dementia progresses and leaves the individual unable to communicate their wishes. Otherwise an appointed person would need to make decisions for the individual which could leave them feel distressed and unhappy. Planning and assessing allows time to plan for the care over the few days of life including after death. These advanced care plans reflect the individual’s values, beliefs and choices I.e. lifestyle, finances, medication, DNAR’s, funeral plans, after death care, appointed person for as/when the individual lacks capacity under the Mental health act to make â€Å"best interest† decisions on their behalf. 2.1 Pain in individuals with dementia is poorly recognised and undertreated can be due to lack of communication. This is dependent on what stage the individual is at within their dementia and how well the care givers know the individual. Some people maybe able to verbally communicate to carers if they are in pain by using single words and using non verbal methods I.e. pointing to what hurts but as this diseases progresses the individual’s ability to express themselves will worsen. If pain is going unrecognised, then there would be no medical intervention, which could cause more pain and will impact on the individual’s health and behaviours. 2.2 In the earlier stages individual’s may be able to express pain through verbal and non verbal communication, together the carer could recognise that they are in pain and a rough area of where this is coming from. This will enable carers to be able to provide medical intervention if needed I.e. Administering PRN paracetamol or seeking medical attention from a nurse/doctor when required. Care givers should use clear questions when speaking to someone with dementia as it may take them a little longer to process what is being asked. As the dementia progresses the individual could be unable to communicate, but they may be able to express pain through noise I.e. screams, but these could be easily misinterpreted by care providers as a â€Å"normal† behaviour if these are regular occurrences. 2.3 When pain has been recognised by care providers, communication with the individual is important where possible dependant of their ability to be verbal and how much capacity the individual has to understand their pain. Care givers will continuously monitor and observe the individual for changes in needs and record these within the daily care notes within the care plan. Dependant on the type of pain will depend on what medical intervention will be best for the individual through advice from other health professionals. Health professionals offer support to care providers to work as a multi-disciplinary team to promote the well-being of the individual to observe, monitor symptoms as well as the care staff. Care staff can give over the counter medications as per care plan, or the doctor/ nurses can prescribe stronger pain relief and controlled drugs. As end of life gets nearer palliative nurse would be visiting to monitor the individual and advise staff on how best to care for the individual and what symptoms to look for in the last few days of life I.e. changes in skin colour, increase of secretions. Medications maybe increased I.e. syringe drivers, which will help ease the pain and to make the individual more comfortable. Advice from colleagues and other health professionals will support care givers about non medicated techniques, these can be how best to position the individual, how often they should be repositioned to prevent pressure sores, skin care – keep the skin clear of sores, trying to keep the mouth clean as there would be increased secretions from the mouth, advice on fluid intake, methods how to try and encourage fluid intake i.e. spooning drinks, changes in food I.e soft. The individual should have an advanced care plan which care givers would be using to meet the individuals needs and wishes for example if they have a DNAR in place, then CPR would not be given. 3.1 Carers may feel guilt and stress and the end of life of an individual with dementia because they may have felt negative emotions towards the individual throughout the stages of dementia. At diagnosis the carer may not have accepted the diagnosis and treated the individual normally which could have caused frustration between the individual/ carer or they could have been in denial of the diagnosis and treated the individual â€Å"normally†, so the needs of the individual may not have been met fully. This could of impacted on the behaviour of the individual to become agitated or withdrawn if they feel they are a burden. The carer may not fully understand the symptoms of dementia especially challenging behaviour I.e. shouting out/ aggression. The carer may have felt negative emotions such as embarrassment and may have lost their temper or felt like hurting the individual and they are frustrated with the constant needs of support the individual has. When dementia has progressed and the carer may have been stressed from taking on the responsibility of caring if they have not had regular breaks. But on the other hand the carer may feel guilty for taking breaks and leaving them for other services to look after them. The carer may have had to make difficult decisions regarding accommodation for the individual such as going into residential care as they feel they can no longer cope with the responsibility of looking after them. After death the carer may feel they have let the individual down and not cared for them well enough based on their own expectations of themselves, they may also regret certain decis ions I.e. residential care. 3.2 Carers can be supported by other professionals to understand how the end of life process may differ for individuals with dementia. Any health professional involved with the individual’s care can provide support and advice I.e. GP’s, nurses, palliative nurses and social workers. They can also suggest informative services offered to carers as support where they can go and discuss the process with trained professionals and other carers. Communication between family, carers, health professionals is vital with end of life care as this can provide reassurance that the individual is being cared for is comfortable as possible, also to keep informed of any changes in the individual’s health I.e. refusal/ lack of ability to drink. A family  member may have been chosen to be the individual’s power of attorney in the advanced care plan once capacity has been lost. This would have been documented under the Mental Health Act. This chosen person would need to be involved in decisions alongside doctors. All the people involved with the care of the individual will support each other, answer any questions, and work alongside any advanced plans which should have been put in place. As towards end of life the individual won’t be able to make their own decisions so someone else will have to do this in the best interest of the individual. 3.3 Anyone supporting an individual with dementia will feel loss and grief at the end of his or her life. Some people may experience loss and grief at the time of diagnosis or once the dementia has progressed further as there will be a lack of recognition between family and the individual as they may feel the dementia has taken over. People may feel all different kinds of emotions through loss and grief. Some may have accepted the diagnosis/ changes of the individual and feel sadness. Others may find this a relief that the individual has passed and no longer having to carry on with progressing symptoms causing them pain and a poor quality of life. 3.4 Carers can have support from health professionals to make decisions and some of these decisions have to be made with health professionals, for example for a Do Not Attempt Resuscitation decision has to be made by a GP has to sign this document off in order to meet their best interests. Other decisions may need to be made if an advanced plan hasn’t been made such as where the individual will reside at home or within a residential placement. 3.5 At the final stages of end of life it is important to have good communication between all relevant parties (carers, family and colleagues). This is important so relatives are kept informed about how the individual’s health is, any changes in medications as towards end of life as it is common to be prescribed a higher dosage of pain relief I.e. morphine syringe drivers, as changes as in the final stages changes can happen quickly. Relatives may also want to know about the individual’s health as they may want to visit to say their last words or even be present at the time of death. Good communication is also important between carers as in  residential placements there will be staff change overs which they will need to know the individuals health state, information about medication, to read end of life care plans, if anyone relatives need calling, any other info I.e. visits from nurses/ GP’s.

Performing a Business Impact Analysis for an IT Infrastructure Essay

Overview Answer the following questions, specific to the creation and focus of Business Impact Analysis as well as BCP documentation. Lab Assessment Questions & Answers 1 What is the goal and purpose of a BIA? To identify which business units, operations, and processes are crucial to the survival of the business. 2 Why is a business impact analysis (BIA) an important first step in defining a business continuity plan (BCP)? BIA identifies what is crucial which sets the path for what will be included in the BCP. 3 How do risk management and risk assessment relate to a business impact analysis for an IT infrastructure? Risk Management/Risk Assessment identify risks/vulnerabilities to the 7 domains of an IT infrastructure. BIA is basically doing the same thing but at the entire organization level. 4 True or False – If the Recovery Point Objective (RPO) metric does not equal the Recovery Time Objective (RTO), you may potentially lose data or not have data backed-up to recover. This represents a gap in potential lost or unrecoverable data. False 5 What questions would you have for executive management prior to finalizing a BIA report? What is the Maximum Acceptable Outage of a specific server or service? What are some critical business functions? What are the recovery objectives? 6 How does a BCP help mitigate risk? Mitigates risk by ensuring the organization is better prepared for disasters. 7 What kind of risk does a BCP help mitigate? Â  It is mitigating the risk of disaster that either destroys the server or building the server is in. 8 If you have business liability insurance, asset replacement insurance, and natural disaster insurance, do you still need a BCP or DRP? Why or why not? Yes you still need a BCP/DRP as insurance will reimburse you money to help rebuild, but they cannot provide you company data and that is what is needed for survivability. 9 What does a BIA help define for a BCP? Defines what systems and services are critical to the survival of an organization. 10 Who should participate in the development of BCP within an organization? IT Personnel and top level management. 11 Why does disaster planning and disaster recovery belong in a BCP? BCP ensures that the entire business can continue to operate in the event of a disruption, this includes disaster planning and recovery as loss of systems or services affects the organization. 12 What is the purpose of having documented IT system, application, and data recovery procedures and steps? So in the event something happens IT is not scrambling to try and figure out what to do. They set clear guidelines and instructions on what to do and when. If this is not clearly documented the RTO could be impacted which will result in UNHAPPY management and possible loss of revenue. 13 Why must you include testing of the plan in your BCP? Having a BCP is great but testing it proves that it works. You would not want to be in a situation when you need to failover and it is not working and this could have been resolved prior to the actual outage if it was tested. 14 How often should you update your BCP document? This should be updated at a minimum annually, semi-annually is probably a better target to shoot for.

The Case of Revision R v G and Another Essay Example | Topics and Well Written Essays - 3000 words

The Case of Revision R v G and Another - Essay Example However, the House of Lords overruled, on the grounds that an element of men's rea was a requirement in all cases involving serious offenses. The boys were therefore not found guilty of arson, or the crime of causing damage by fire3. The former was classified as objective recklessness and the latter as subjective recklessness and this had to be assessed by reference to the reasonable man. The case of Cunningham4 established conclusively that subjective recklessness involving offenses committed â€Å"intentionally and recklessly† will make the accused liable. But Caldwell imputed liability for objective recklessness as well, although Lord Edmund Davies noted a dissenting opinion on the objective recklessness of the defendant as follows: â€Å"†¦a jury could not on those words alone, properly convict him of recklessness simply because they considered that the risk ought to have crossed his mind†¦Ã¢â‚¬ 5 The House of Lords decision however overruled on the grounds that foresight or the ability to make an assessment of the consequences was deemed to be an essential part of recklessness as laid out under Section 1 of the Criminal Damage Act. The basis upon which the lower Court’s decision was overruled was that when a judgment was made on the liability for objective recklessness without making any allowance for the youth of the defendants or for whether they had the mental capacity to understand the consequences of their actions, it is bound to be erroneous. The House of Lords held that since the boys did not maliciously and deliberately set out to cause damage to the property, neither did they foresee the risk of the damages that could occur through the spread of the fire, they could not be deemed to be guilty of arson. A conviction for a crime should prove not merely an act of omission leading to a crime but also a culpable state of mind, in accordance with the principle of m en's rea. Therefore a defendant who genuinely did not perceive the risk cannot be exposed to serious punishment.

Principles On Drug Abuse Treatment Research Paper

Principles On Drug Abuse Treatment - Research Paper Example According to Belenk, offenders need to provide urine tests on a regular basis. The court further assists offenders to secure entitlements such as medical, housing, or welfare allowance. Offenders need to visit probation officers on a frequent basis well as visit counseling sessions. However, drug courts are not effective in the treatment of drug-related cases. This is because such courts use coercive means, which offenders conform to for just some time. Drug offenders like programs that give them the chance to volunteer. Courts, however, have strict regulations and procedures, which is not effective. Rehabilitation centers that offer such services voluntarily serve better to offenders. Drug treatment as a routine is effective in reducing recidivism among offenders. These programs, however, take various forms. These treatments include the use of voluntary service centers such as rehabilitation stations. It may also take the form of mandatory treatment programs that include the use of the drug courts and law enforcement. Drug abuse leads to the loss in the national governments' funds. Funding such program costs lots of dollars. On the health of offenders, drug treatment saves offenders from mental health complications. Despite the success of drug success of drug treatment program, it faces several challenges. Such challenges include the unavailability of high-quality programs, the difference in priorities and the inability of such programs to benefit offenders after prison time.

None Essay Example | Topics and Well Written Essays - 500 words - 26

None - Essay Example Factors such as corruption and injustice have prevented the establishment of infrastructure in rural areas that would help in job creation. Leaders using public offices for personal gains have contributed to the migration. They include issues affecting the society such as education, health and security among others (Branigan 24). Some individuals move into urban areas to seek better health facilities due to lack of hospitals in rural areas. Higher learning institutions in major Chinese towns also attract students who later settle in these urban areas as they seek employment opportunities. Increasing population in some rural regions of China has also led to people migrating to less occupied urban centers. A persons health status in a city will depend on the economic stability of the individual. Most people in urban areas are employed, therefore, have a stable income part of which may be used in payment of health services. However, there are individuals who do not secure jobs in urban areas leading to low class settlement schemes such as slums. In China, the high population in urban areas has contributed to development low living standards where individuals do not have access to good health and education services. Individuals living in cities have access to improved health institutions with qualified doctors unlike in the rural areas where quacks have taken over the health sector. Since most rural regions in China have already invested in Agriculture, most individuals do not find the importance of education. In urban centers, children come up with jobs such as delivering counterfeit goods and drugs which have led to high insecurity rates. According to research, urban areas have higher insecurity rates than rural areas contributed to by increased rural-urban immigration. To survive in these Chinese cities, one had to come up with modern day strategies such as coming up with business ideas. Individuals should

Hnd Computing And Software Engineering Essay Example | Topics and Well Written Essays - 2500 words

Hnd Computing And Software Engineering - Essay Example If we are to analyze the elements stated above should be followed and must be present in order to do these things. First, one must have to plan the necessary movements and execution of it for it is the backbone of the task. Included in this task is the ocular of the place including surveying of the place, determining the available resources such as the electricity, nearest Internet service provider, the place where satellites and cables should be installed are among those things that should be given enough attention. In this case, problems definitely would arise and it is a common saying that in every problem, there is a solution. However, one cannot solve the problem if it is not analyzed and classified whether it is a well-defined or ill-defined one. To be able to know the differences of these two, it is necessary to define them. Ill-defined problems are those that are hard to define and most of the times they do contain things and elements that are hard to describe. In the same thing, most of experts and analysts agree that many important problems are ill-defined. On the other hand, the website http://www.si.umich.edu/SI502/slides/lecture11/tsld012.htm (2006) stated that well defined problems can be known as such "if initial conditions, solution, and methods can all be described." These things are best illustrated by mathematical problems, jigsaw puzzles and the likes. The same thing in this kind of problem, there is only a certain solution which one can easily track and preempt the outcome of the problem. By knowing these two types of problems, the shortcomings and other related troubles would be known and would be given solutions. Going back to the focal point, in the first problem wherein installation of internet network is required to three branches of the institute, the recognition as to whether it is a well or ill-defined problem is vital. If we are to analyze, problems that may be included in the well defined are the likes of the number of computer needed to be fielded in a certain branch, the type of internet service provider, the required number of memories that each of the computer set needs, the strategic location where the computer sets should be placed and the number of manpower needed for the installation and maintenance of the aforementioned gadgets are among those things that should be considered in this category. HND COMPUTING AND SOFTWARE ENGINEERING 3 In the ill-defined problems, the dilemma regarding what virus might struck in the computer sets, the capability of the manpower to execute the demand, the uniformity of performance of the computer sets in the three branches and other related problems are among those that are to be included in this kind of problem. The next thing after determining the problems is the execution of things that are to be done in order to have solutions in these things. For example in the well defined category, in determining the number of computer sets that are to be fielded in every branches, the size of the location of each branches is vital and is a big factor in order to know if how many computer sets would fit in the location without sacrificing the quality of the performance of the computer and the comfort of those who are using the facility. The determination of the internet-service providers

Effects of coffee Essay Example | Topics and Well Written Essays - 750 words

Effects of coffee - Essay Example Coffee contains caffeine which is considered a Central Nervous System (CNS) stimulant (Lovett 2005). Accordingly, â€Å"caffeine is the worlds most widely consumed psychoactive substance†. Balentine, Harbowy & Graham (1998) stipulated that â€Å"many natural sources of caffeine also contain widely varying mixtures of other xanthine alkaloids, including the cardiac stimulants theophylline and theobromine and other substances such as polyphenols which can form insoluble complexes with caffeine†. In the Science of Cooking, the article on caffeine exhibited its following properties, to wit: â€Å"soluble in ethyl acetate, chloroform, pyrimidine, pyrrole, tetrahydrofuran solution; moderately soluble in alcohol, acetone; slightly soluble in petroleum ether, ether, benzene†. In another study made specifically on Caffeine, it is found that â€Å"caffeine is metabolized in the liver by the cytochrome P450 oxidase enzyme system (specifically, the 1A2 isozyme) into three metabolic dimethylxanthines, which each have their own effects on the body: Theophylline (4%) Relaxes smooth muscles of the bronchi, and is used to treat asthma. The therapeutic dose of theophylline, however, is many times greater than the levels attained from caffeine metabolism.† (The Pharmacogenetics and Pharmacogenomics Knowledge Base) According to Bolton & Null (1981), the â€Å"precise amount of caffeine necessary to produce effects varies from person to person depending on body size and degree of tolerance to caffeine. It takes less than an hour for caffeine to begin affecting the body and a mild dose wears off in three to four hours. Consumption of caffeine does not eliminate the need for sleep: it only temporarily reduces the sensation of being tired. The International Coffee Organization presented that â€Å"of all the physiological effects of coffee, the best known is that it is a stimulant to the nervous system. One or two cups of