Physical Health Needs of Dementia Patients

Dementia is a deficiency characterised by memory loss, changes in behaviour, loss of executive functions of the brain among others. Research shows that an approximate population of 850, 000 people residing in the United Kingdom are suffering from dementia. Currently, the Alzheimer’s disease, vascular dementia, and frontotemporal dementia are the most common types of dementia (Andrews, 2015, p.76). The study aimed at investigating the physical health needs of adults with dementia. It utilized PubMed as the search engine in reviewing the available literature. The study came with various findings such as food, shelter, sexual needs, pain management, appropriate body temperatures, and access to the toilets as the primary physical health necessities of adults with dementia.

According to Maslow (2014), the hierarchy of needs can be pictorially presented in the form of a pyramid, with the most critical needs occupying the bottom part. The first layer is known as “physiological” or “physical.” For survival in this world, food, air, and water are required primary commodities. Shelter and clothing offer necessary protection from various elements. There exist numerous essential physical needs which are essential for human survival. Failure to meet these necessities leads to malfunctioning of the human body. Thus it's crucial to consider fulfilling the requirements every day especially for adults with dementia (Thielke et al., 2012, p.470).

Human beings have critical physical needs and generate powerful messages within the brain which assists in regulation and meeting of the internal needs. The signals generated helps people to adapt to the environment ref. The various crucial physical needs for adults with dementia include shelter, food, drinks, sexual needs, suitable body temperatures, and access to the toilet. When such requirements are met for adults with dementia, they can remain calm and relaxed (Thielke et al., 2012, p.471). Failure to comply with these needs forces dementia patients to show discomfort in various ways ref. The subsequent sections discuss some of the physical necessities for adults with dementia.

Shelter

A survey conducted on the aged showed that old people desire to enjoy the best possible quality of life ever. One of the essential elements affecting the quality of life for adults with dementia is the place in which they reside ref. A study conducted in 2014 by the Alzheimer’s society on adults with dementia showed that only 50% of the people surveyed felt they are living well with the disease (Bartlo and Klein, 2011, p.220). Another research points out that the components of housing in the National Dementia Strategy and other proposals of the government are somewhat underdeveloped ref.

The most common choices made by adults with dementia is to remain in their own homes of course with support provided by caregivers or to move to the nursing or residential homes. The dementia adults residing in their own homes experience various challenges such as social segregation and loneliness. According to the Alzheimer’s society (year) survey, 40% of the victims reported feelings of isolation as one of their most significant challenges. Besides, the kind of care and support offered in homes is limited and often fails to meet the standard conditions (Bartlo and Klein, 2011, p.221). Furthermore, the maintenance of houses is sometimes challenging, and the costs of running such residential become an enormous problem.

Food and Nutrition

Adults with dementia often experience challenges in eating, and this puts them at the risk of malnutrition ref. There are several reasons why adults with dementia find difficulties in feeding, including problems of coordinating movements to get food in their mouths and challenges in maintaining attention while eating (Aselage, 2010, p.621). Moreover, the feeding problems come along with other challenges such as agitation, depression, resistance to care and decreased level of intellectual capacity and physical impairments. The environment is one of the crucial factors that impact adults with dementia regarding the improvement of their quality of life ref. For example, a proper dining environment is essential in both residential and nursing homes. The caregivers should put the necessary efforts to create a setting that is comfortable, relaxing and welcoming as this increases the food intake rate for the dementia patients (Kitson et al., 2013, p.8), and consequently minimizes the feeding challenges of adults living with dementia.

The prevailing rates of eating challenges among adults with dementia residing in both nursing and residential homes vary across different studies. Lin et al. (2010, p.53) recorded a rate of 30.7%, Slaughter et al. (2011, p.172) indicated a proportion of 40.8% whereas according to Chang and Roberts (2011, p.36) it is 60.2%. However, despite the variances in the prevalence rates, all studies agree that feeding problems and loss of weight are common to adults residing in care homes (Keller et al., 2016, p.42). According to a study conducted by Slaughter et al. (2011, p.173), a dining environment that is comfortable and welcoming has the capability of increasing the rate of food intake, arouses the senses and increases social interaction rates. The environment makes the eating experience more enjoyable thus minimizing feeding challenges in people living with dementia. Bosch et al. (2012, p.721) pointed out that dysphagia mostly affects the victims with more advanced conditions of dementia. The state (what do you actually want to say? What 'state'?) together with pneumonia is one of the primary indicators that adults with dementia are in the last year of life (Bosch et al., 2012, p.721).

Sexual Needs

One of the behavioural and psychiatric symptoms of dementia (BPSD) is sexual disinhibition and explains a favourite reason for referring adults to psychiatric services. The referrals often come from nursing homes and sexual disinhibition is one of the reasons for seeking alternative placements for the residents ref. People living with Alzheimer’s disease recorded 7% cases of sexual disinhibition as presented by a study conducted by Burns et al. (2015) but the facts are more frequent in other dementia types like frontotemporal dementia. Sexual problems arising from dementia include false sexual allegations, inappropriate sexual acts in public, sexual abuse and inappropriate sexual talks (Haddad and Benbow, 2013, p.631). Increase or decrease in libido is one of the causes of the problems and the change in roles and identity of an adult with dementia dramatically impacts established relationships.

There are numerous causes of dementia-related sexual problems in adults which include neuronal loss in the temporal and frontal lobes, disturbances in moods, misinterpretation, psychosis, and misidentification of social cues arising from cognitive impairments (Haddad and Benbow, 2013, p.632). All human beings have a right to sexuality, and many adults with dementia continue to enjoy satisfying sexual relationships ref. The engagement in sex improves our wellbeing regardless of sicknesses or age. Sexuality, which is composed of romance, touch, companionship, and affection is critical in predicting the quality of life (Rheaume and Mitty, 2016, p.342). The World Health Organisation (WHO) (2012) emphasises that sexuality is a “fundamental aspect of being human throughout the life.” There are various ways of experiencing and expressing sex such as through thoughts, desires, attitudes, behaviors, relationships, fantasies, beliefs, values, roles and practices (WHO, 2012).