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Reducing Health Disparities for Dementia Patients


Given the morbidity, mortality, and cost savings associated with reducing nosocomial infections, similar savings would be realized by reducing health disparities. Health disparities also violate the civil and human rights principles of equality, equal value to society, and nondiscrimination (Braveman et al

Reducing Health Disparities for Dementia Patients


Together, these studies reveal that dementia patients, regardless of the care setting, continue to experience health disparities. Culturally Appropriate Health Promotion Plan The core elements of the Chronic Care Model (CCM) should help reduce health disparities in a home-based palliative care setting (Brodaty & Donkin, 2009)

Reducing Health Disparities for Dementia Patients


DNP-prepared nurses will have had cultural competency training in preparation for practicing in racially, ethnically, and socioeconomically-diverse communities. In practice, however, the main elements that can increase patient satisfaction, compliance, and continuity of care are improved provider-patient communication and exchange of information (Castro & Ruiz, 2009)

Reducing Health Disparities for Dementia Patients


Communications between patient and provider was also limited, because Whites were the only demographic group to almost reach the goal of 4% of patients who had their end-of-life care wishes ignored. The authors of a recent systematic review of the literature concluded that there is evidence that minority status for dementia patients predicts health care outcomes, such that African-Americans were less likely to have an advanced directive and more likely to have medical care withheld and receive aggressive treatment (Connolly, Sampson, & Purandare, 2012)

Reducing Health Disparities for Dementia Patients


2%. One of the main contributors to health disparities has been differential access to care, however, studies have also revealed that even for minorities with equal access the quality of the care provided differed along racial and ethnic lines (Fink, 2009)

Reducing Health Disparities for Dementia Patients


As discussed above, provider-patient communications would be an important focus of CCM implementation for home-based palliative care in terms of cultural competency. For example, over 70% of low-income African-Americans fail to apply for Medicaid benefits despite eligibility (Kingsberry & Mindler, 2012)

Reducing Health Disparities for Dementia Patients


A care manager could assist minority, low-income dementia caregivers with filling out the necessary forms and submitting the applications to the appropriate state agencies. The recommended strategy for providing a culturally-competent health promotion plan is to first develop community partnerships with community leaders, academic organizations, and health departments (Lettlow, 2008)

Reducing Health Disparities for Dementia Patients


Importantly, the race and ethnicity of the provider is not necessarily a barrier to achieving above average levels of patient satisfaction, although language barriers could prove to be significant for providers fluent in English only. Health Disparities among End-Stage Dementia Patients Elders can experience neglect and abuse in a variety of care settings, including at home and in nursing homes (Lindbloom, Brandt, Hough, & Meadows, 2007)

Reducing Health Disparities for Dementia Patients


For example, the estimated prevalence of central-line associated blood stream infections declined by 58% between 2001 and 2009 in the U.S. (Srinivasan et al

Reducing Health Disparities for Dementia Patients


This success story can probably be attributed in part to mandated changes in how CMS reimburses for iatrogenic events. After these rules were implemented in 2008, nosocomial infection rates declined significantly in California hospitals (Stone et al

Coping With Dementia


Owing to this, there is a need to conduct further research to find appropriate approaches (Johnson, Griffin & McArthur, 2006). The proposed working medical management of FTD is through SSRI (Atchinson & Dirette, 2007)

Coping With Dementia


There are different types of dementia, and statistics show that it affects 3.4 million people in the United States alone (DiZazzo-Miller et al

Coping With Dementia


In such, occupational therapists are helping caregivers to modify routine tasks to stress the positive elements of care and this is a way to promote the occupational performance of the caregivers. For instance, caregivers are trained on how to choose and grade routine activities to help the patients adjust to social demands (Donovan & Corcoran, 2010)

Coping With Dementia


In the context of regulation, functions include self-control, emotional control, behavioral control, decision-making, and many others. The cognitive skills incorporate information at higher level across other cognitive domains (Giovagnoli et al

Coping With Dementia


This includes the use of other people such as a family, or any other person who has an insight into the patient's problem. In addition, there are many considerations to make when dealing with FTD, especially because of the clinical aspect of the disorder (Jicha & Nelson, 2011)

Coping With Dementia


As the disorder, progresses the patients become irresponsible in all aspect of life, including talking, behaving, and others. They often behave impulsively, show inappropriate sexual behavior and labile emotionality (Malloy et al

Coping With Dementia


Damage to the executive functioning system will result to socially inappropriate behavior, challenges in the verbal fluency, disinhibition, inactiveness, and many others. Damage to the most forward sections of the frontal lobes, including the cortical and sub-cortical structures that link to the frontal lobes have a link to executive dysfunction (Matuszewski et al

Coping With Dementia


(2007) used the trail-marking test, stroop test, running span and categorical and phonetic fluency tasks to find out the same. In the study, it is apparent that patients suffering from FTD had gone through severe executive function impairment in terms of shifting, inhibition, and strategic processes from the results obtained (Piolino et al

Coping With Dementia


FTD is a familiar variety of dementia, and its pathology varies when compared to the commonest form of dementia, which is Alzheimer's disease. In comparison, FTD is prevalent on the frontal or temporal lobes, and it is more prevalent than Alzheimer disease (Riedjik et al

Coping With Dementia


As FTD progresses, the patient also will develop progressive disturbance of executive functions, initiative loss, loss of mental flexibility and organization. Afterwards, the patient will experience loss of language, which results in aphasia (Scarmeus & Honig, 2004)