For prisoners at the severe or late stages of dementia with severe impairment in physical and cognitive functioning, interdisciplinary teams should consider creating nursing care facilities or secure care community facilities ( Schoenly, 2010). For older adults with end-stage dementia, information about timely palliative and hospice care services should be offered ( Imhof & Kaskie, 2008). The provision of such information about palliative and end-of-life options may now be mandated by state law as it is in New York under the Palliative Care Information Act ( New York Public Health Law, 2010) and should not be withheld from older adult prisoners. Activities of Daily Living.— Identification of this phase is important for a number of reasons: to plan care, to prepare the family and carers for the end of life and make provision for adequate terminal care. A Senior Healthcare Assistant (HCA) and Dementia Champion within the Royal Preston Hospital Emergency Department developed an adapted patient identification wristband that supported staff to recognise that a patient may have additional needs related to their diagnosis of dementia. The innovation has been well received by patients, their families and carers and staff working at the Royal Preston Hospital. Where to look Office of the Public Guardian. (2019). Make, register or end a lasting power of attorney. Government Digital Service. [online] Available at: https://www.gov.uk/power-of-attorney [Accessed 4 Jul. 2019].

National Institute for Health and Care Excellence. (2018) Dementia: assessment, management and support for people living with dementia and their carers. Nice guideline 97. [online] Available at: https://www.nice.org.uk/guidance/ng97/chapter/Recommendations#diagnosis [Accessed 4 Jul. 2019]. Standard 1.2.13. This is caused by protein deposits (Lewy bodies)building up in the brain. 9Symptoms of Parkinson’s disease develop, although often these appear later in the illness. Symptoms include:It is more likely to cause personality and behavioural changes and problems with speech. Memory can be unaffected for a long time. There are 3 main types: Thakur, M. (2007). Pseudodementia. Encyclopedia of Health & Aging. SAGE Publications, Inc. pp. 477-8. [online] Available at: http://go.galegroup.com/ps/i.do?p=GVRL&u=cuny_laguardia&id=GALE|CX2661000198&v=2.1&it=r&sid=GVRL&asid=3ad1e77f [Accessed 4 Jul. 2019]. Simple diversion activities have a significantly positive impact, patients seem more relaxed and happier but it is important to find the correct diversion activity for each individual and not make assumptions. Get support if you are struggling with daily living or advice if others feel you are finding things hard to manage. There are many ways in which family, friends and services can help you to live independently for as long as possible.

Alzheimer’s Society. (2019). Normal ageing vs dementia. [online] Available at: https://www.alzheimers.org.uk/about-dementia/symptoms-and-diagnosis/how-dementia-progresses/normal-ageing-vs-dementia [Accessed 4 Jul. 2019]. People who know someone with Alzheimer’s will often notice subtle changes to their personality. They behave or react differently to how they did before they became ill.Prince, M. et al. (2014). Nutrition and Dementia: a review of available research. Alzheimer’s Disease International. London. [online] Available at: https://www.alz.co.uk/nutrition-report [Accessed 4 Jul. 2019]. By wearing your Forget Me Not badge and supporting the appeal, you can show people living with dementia that they have not been forgotten, that you understand and stand with them. The badge is a symbol of solidarity and shows that supporters, through their donations, are helping to provide life-changing dementia support. The introduction of the noticeboard and diversion activity has been a positive addition for patients with dementia.

If a person with dementia wants a discreet way to let others know about their diagnosis while out and about, we have free helpcards available. Advance care planning emerges as a consistent theme and palliative care plans for hospitalised patients with end stage dementia seem to reduce inappropriate interventions (for example, feeding tubes, phlebotomy and systemic antibiotics), 21 particularly as there is no evidence of any beneficial effect for patients with advanced dementia of: There may come a time when you start to find it hard to make decisions about important parts of your life, such as managing your money, or in taking medical decisions. You can givea trusted relative, friend or solicitor the rightto make such Department of Transport. (2019). Dementia and driving. Government Digital Service. [online] Available at: https://www.gov.uk/dementia-and-driving [Accessed 4 Jul. 2019].

A poster and cutter in the ED near the wristband machine is a useful reminder for staff to add the forget-me-not where necessary. FORGET ME NOT: By supporting the appeal you can show people living with dementia that they have not been forgotten (Image: Getty Images/EyeEm) The further development and validation of tools by which pain and other symptoms can be better recognised in non‐communicative patients with dementia should be a primary goal of future research. 14 Improving the outcome measures used is another developing area; scales such as the Palliative Care Outcome Scale are starting to be validated in the dementia setting to encompass key quality of life outcomes. 37 Another unexplored area is that of potential differences in palliative care needs for different subtypes of dementia (Alzheimer's disease, vascular dementia, dementia with Lewy bodies, and fronto‐temporal dementia).

A diagnosis of dementia is not a reason to stop driving in itself, but as dementia progresses, driving skills will decrease. This may be due to changes to your visuospatial awareness, reduced concentration or affected judgement and decision-making skills. Alzheimer’s Society. (2019). Driving and dementia. [online] Available at: https://www.alzheimers.org.uk/get-support/staying-independent/driving-and-dementia [Accessed 4 Jul. 2019]. A Medline search for “palliative care and dementia” yields 164 references compared with 265 for “palliative care and heart failure” and 9645 for “palliative care and cancer”. A recent systematic review of the evidence for a palliative care approach in advanced dementia concluded that despite the increased interest in palliative care in dementia, there is currently little evidence on which to base such an approach. 19 scratches on the side, which Eileen could not explain. She has also been unable to turn the TV on with a new remote. At first they put these problems down to her age and stress with caring.

Where to look

In Alzheimer's, proteins called amyloid and tau build up in the brain to form deposits called 'plaques' and 'tangles'. Damage happens to the brain in these areas, and this affects the chemicals in the brain which transmitmessages from one cell to The GP is concerned and so refers him to the memory clinic. After a brain scan they diagnose dementia with Lewy bodies. FMNs are active members of the Dementia Engagement and Empowerment Project (DEEP) and seek to engage with other national groups of interested people. FMNs operate on the belief that every person living with dementia has something to contribute towards making the world more dementia-friendly and the right to have their views heard. Eileen is an 82 year old retired secretary, who lives with and cares for her frail, 90 year old, husband. She is well physically and does not take any medication. One of the most important and basic rules of survival in prison is to follow directions to avoid disciplinary infractions and remain as physically independent as possible. Therefore, being obedient is essential for survival and to avoid institutional charges that may result in secure confinement.