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How research helps nurses learn from patients with dementia

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VOL: 98, ISSUE: 49, PAGE NO: 33

Alison Breen, RMN, is community psychiatric nurse, Pathfinder, Twinwoods Health Resource Centre, Bedfordshire.

I read Jackson's article with interest as I knew it would be relevant to my practice and would provide me with up-to-date, factual knowledge to underpin my clinical work. I found it also led me to reflect on the two-way educational process within my role.

I read Jackson's article with interest as I knew it would be relevant to my practice and would provide me with up-to-date, factual knowledge to underpin my clinical work. I found it also led me to reflect on the two-way educational process within my role.

I have worked as a community psychiatric nurse, working with the over 65s, for three years and I have seen both typical and atypical presentations of most forms of dementia. I would argue that dementia presents itself differently in each individual, particularly as it affects our ability to communicate verbally and non-verbally and we all have our unique ways of doing this.

As Jackson's article shows, dementia has a physical aetiology. This in turn manifests itself in many health and social contexts. If nurses continue to enhance their understanding of the physical changes Alzheimer's has on specific areas of the brain, they could attempt to work out the aspects of a patient's ability that are the least affected as a result. They can then introduce measures and care plans to create a better quality of life for the patient and to enable them to maintain social skills for as long as possible.

When caring for patients whose brains are diseased, it is painfully obvious that their lives have 'fallen apart'. We take it for granted that our brains will function properly and that we will be able to make sense of the world around us. We rarely consider a time when this would not happen. Quite often when I speak to members of the public about dementia, they say 'If I ever get like that' then 'let me die' or 'put me out of my misery'. It is a misconception that dementia sufferers have nothing to contribute to society - society seems to shun them and assume that because they are confused they do not have any feelings.

Family members, upon whom the greatest burden falls, appear to appreciate the scientific explanation for a disease that causes so many problems. If they can be helped to realise that the brain is 'wearing out' they can make some equation with, arguably more acceptable, diseases such as heart disease and cancer. They can then attribute the patient's unpredictable actions and thoughts to a disease process and not to the patient themselves. Carers can then learn not to take the patient's behaviour personally and to seek help from services to which the patient is entitled such as day care, and medications that slow down or stabilise memory loss (for example, anticholinesterases).

As I carry out clinical duties and try to make a difference as a health professional, I feel it is a small contribution compared with the love and devotion shown by spouses, siblings and children. They provide a backbone of care for people with dementia and I find that I am constantly learning from them as well. The article has led me to reflect that it is a two-way educational process which makes my job worthwhile and interesting.

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