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Case Study: Treating a Patient with Vascular Dementia
Grand Canyon University

Case Study: Treating a Patient with Vascular Dementia
Vascular dementia is one of the most common causes of dementia, Alzheimer being the most common. Vascular dementia causes around 10% of cases while Alzheimer causes around an estimate of 60% to 80% of cases. NHS Choice (2015) defines dementia as “a loss of mental ability (cognitive impairment) associated with gradual death of brain cells” (para. 2). Vascular dementia occurs when the blood flow to the brain is reduced and usually happens from strokes, it also can be caused by a variety of diseases and damages that affects the brain. One of the most common type of vascular dementia is the Multi-infarct dementia which is caused by minor strokes or (which sometimes are called “mini strokes” or silent strokes”) that at times could go unnoticed. Unlike Alzheimer's disease, there are no licensed treatments for vascular dementia (O’Brien and Thomas, 2015)
Multi-infarct dementia is more common in older men than women around the ages of 60 to 75 years old. Vascular dementia is really rare in anyone younger than 65. Global, 48.5 million people have dementia, about 70% of that is Alzheimer’s and around 10% are vascular dementia, there are 7.7 million new cases every year.
This case study looks further into Vascular Dementia and the people who have them and shows how a great care system and collaboration can help the patient. A case study will be conducted for the patient while using a long term nursing home.
Case Description
Tania Joseph, female, age 78, was recently checked into a long term nursing home. Tania was healthy until a year ago, which was when Tania was involved in a terrible car accident and had a concussion but after a couple of days was told that she would recover nicely. A couple of days later she had a serious of strokes back to back without noticing. She assumed it was some type of spasms and excused it. It was not until a couple of months ago, when one of Tania’s daughter noticed that she was having a difficult time thinking and understanding things lately and she seemed agitated more than often. On January 23, 2016 Tania got her annual health checkup. Her physical exam at first all came back fine. Tania’s daughter had to explain that her mother could not create new memories, was having difficult time thinking and understand and seemed very agitated. The doctor brushed it off and said she was just probably going through somethings in her life. It was not until Tania told the doctor that almost a year ago she had a funny spasms resulting in the doctor giving her another physical exam, which involved a full mental exam, laboratory and imaging test. He knew for certain that she had dementia but just not which type. The doctor then referred her to a neurologist and a gero-psychologist. One week later after seeing both specialists, Tania received two calls and received the news that she had vascular dementia. Tania was taken to a nursing home, after repeatedly giving problems to both her daughter and home health aide.
Healthcare Delivery Team
The same way it takes a village and plenty of help to raise a child; it takes the same dedication and time of physicians and health care workers to help a patient with vascular dementia. Having such a team helps the patient manage their symptoms and gives them and their families less stress.
For better results and managing patients in an orderly and safe manner any and all health care facilities should have a variety of professionals from different specialties who will work together to provide their ideas and helpful hands to any patients, from as early of screening and diagnosis, to their treatment, follow up care and recovery if there is any. All of these things apply to a patient with vascular dementia.
Everyday Health (2015) recommends having these certain types of medical specialists and health care workers to help patients with dementia, which includes: * Specials Physician (Neurologist or Geriatrician)
The neurologist specializes in problems with the nervous system which includes the brain. The geriatrician specializes in aging and the problems that may follow * Psychiatrist, Psychologist, or Neuropsychologist
Being that depression can occur in patients with dementia, it is very important to have specialist in the nursing home that are there to help a patient who is having a mental problem and needs advanced help * Geriatric nurse, Social worker, or Care coordinator
These professionals are needed for a more hands on help and helping the patient reduce any symptoms that they may have * Home Health Care worker
If it is best for the patient to be home and not at another care facility, the patient would need someone who can help feed, bathe, and dress them
In my patient case, Tania, she will need medical specialists and health care workers to help her improve. The Neurologist will check her every few months to make sure her brain activity is normal. A psychiatrist will check her state of mind and make sure that she is not depressed. The home health care worker will be the hands on person in taking care of Tania and the geriatric nurse will check all her symptoms and make sure everything is normal.
Indicators and Determinants of Health
There are a number of risk factors that could indicate or determine vascular dementia. Help Guide (2016) explained the risk factors for vascular dementia is the same for stroke or heart disease which includes: * High Blood pressure (hypertension) in which high blood pressure place extra stress on blood flow * Increasing age * High Cholesterol * Atherosclerosis which occurs when some cholesterol or plaques build up in the arteries and narrow blood vessels, reducing blood flow to the brain * Diabetes * Smoking * Atrial fibrillation, the abnormal heart rhythm w=that can reduce blood flow to the brain and increase the risk of blood clots
Financial and Resource Analysis
If the patient does not have enough money to help pay for their care they have a good amount of plans to help them.
If a person with dementia worked while they had early stages of dementia, they may have benefits of having paid sick leave, short term disability benefits and a flexible spending account. The patient could also receive money from their retirement benefit plan. Retirement plans usually include: individual retirements accounts (IRAs) in whom the person with dementia could withdraw money and Annuities.
The patient may also be eligible for Medicare, since it is the primary source of coverage for people 65 years of age or older. Adding on the Medicare, the person with dementia could qualify for plenty of government programs that would aid them financially. Some examples are Social Security Disability Income (SSDI) for people younger than 65, Supplemental Security Income (SSI), Medicaid veteran benefits and tax deductions and credits.
Team Based Approach Advantages
A team is a group of people who work together to accomplish something that they are responsible for. Advantage of a team based approach would be having a handful of people who are all specialized in different areas in a nursing home helping patients by giving out their different ideas and communication with each other to help make the patient feel better and at home.
Gradually, studies have showed that a more based-team approach to care will be a huge solution to health care problems. UC San Francisco researcher has been a huge success in showing how team-based approach is effective and cost-efficiency of not only the patient but also the nursing home (Masterson, 2014).
Being in a nursing home, means that the patient would need 24 hour supervision because having dementia means that the patient will not remember anything, such as eating, bathing, putting clothes on. The patient needs a team to help them 24 hours of the day.
In conclusion, vascular dementia is one of the most common dementia in the world, coming up as number two right after Alzheimer. It is mostly found in people who are around the age of 65 to 75 and most found in men than women. There are numbers of possible risk that comes with vascular dementia. Once diagnosed, vascular dementia needs 24 hour round the clock team that consist of Specials Physician, Psychiatrist, Psychologist, or Neuropsychologist, Geriatric nurse, Social worker, or Care coordinator to help take care of the patient because the patient will not be able to take care of their selves. If the patient needs aid to pay for the nursing homes or any other medical needs, there are plenty of non-profit organizations, and plans to help them.

Reference
Masterson, K. (2014). A Team-Based Approach to Primary Care. UC San Francisco. Retrieved from https://www.ucsf.edu/news/2014/08/116856/team-based-approach-primary-care
NHSChoices. (2015). Nhs.uk. Retrieved from http://www.nhs.uk/pages/home.aspx
O'Brien, J. & Thomas, A. (2015). The Lancet. Retrieved from http://www.sciencedirect.com.lopes.idm.oclc.org/science/article/pii/S0140673615004638
Thompson, D. (2015). Assembling Your Alzheimer's Care Team. Everyday Health. Retrieved from http://www.everydayhealth.com/alzheimers/alzheimers-care-team.aspx
Vascular Dementia: Signs, Symptoms, Prevention, and Treatment of Multi-Infarct and Other Types of Vascular Dementia. (2016). Helpguide.org. Retrieved from http://www.helpguide.org/articles/alzheimers-dementia/vascular-dementia.htm

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