The Lottrey Essay Example

The Lottrey Essay The Use of Setting in â€Å"The Lottery† Shirley Jackson effectively uses setting in â€Å"The Lottery to foreshadow an ironic ending. In many stories, settings are constructed to help build the mood and to foreshadow of things to come. The story sets up the reader to expect good things from the lottery. However, the description of the setting foreshadows exactly the opposite of what the reader expects. Shirley Jackson develops this through a description of the physical setting, a general description of the residents, and subtle hints throughout the story.The story begins with the establishment of the setting. To begin, Shirley Jackson tells the reader what time of day and what time of year the story takes place. This is important to get the reader to focus on what a typical day it is in this small town. The setting set forth by Shirley Jackson in the beginning of the story creates a mood of peacefulness and tranquility. It also creates a visual image in the mind of the reade r of a typical town on a normal summer day. Shirley Jackson tells you that school has just been let out so you know that it is early summer. Analysis of Setting inA Setting Analysis of â€Å"The Lottery† Setting is, as defined by Dr. Hugh H. Paschal, â€Å"an author’s use of time, place, and props (374). Even though the setting in a literary work proves successful in achieving the author’s desired outcome, readers often neglect its importance. Using realism, the author brings the reader into his work and the environment feels natural to him. Setting can influence what the character does. His environment may contribute to his personality, values, attitudes, and problems. Organization provides the familiarity of a setting, allowing the reader to form a mental picture of the scene.Through detailed illustrations the author sets the atmosphere or mood of their work. Irony in setting allows the reader various insights of a literary work than what was initially presen ted (Paschal 46-49). For example, Shirley Jackson’s â€Å"The Lottery initially offers a sense of calmness and peace in an ordinary town and leaves the reader in shock with the stoning of a random member in the community. First, Jackson uses the aspect of time to describe the season the work takes place. She writes, â€Å"June 27th was clear and sunny, with the Analysis of The LotteryWhen developing an inspiration for a story, a writer must put many ideas into the process. There are numerous items that when combined create an interesting and pleasurable story. There are many characteristics that a story must encompass to be enjoyable. Shirley Jackson’s â€Å"The Lottery concerns a small town’s annual lottery drawing and the grim circumstances that ensue. In ths short but disturbingly profound piece of work Shirley Jackson communicates to the reader the theme of the story along with its implications concerning traditions. In The Lottery, tradition plays a key role in keeping one town happy and peaceful.The lottery occurs every year on June 27. Although the lottery may be a little morally unjust, it is still a tradition and traditions are hard to break. The lottery for the town is the backbone of the community. The lottery for the town brings a day of conversation and happiness. The boys run around and gather rocks. The girls talk to one another and the women â€Å" greeted one another and exchanged bits of gossip as they went to join their husbands (268). The men gather, â€Å" surveying their own children, speaking of planting and rain, tractors and taxes (268). The lottery is used to bring people toget

Free Essays on The Confederate Flag Controversy

Living in this diversified country, the one thing that everyone has in common is the fact that we all live under the American Flag. It symbolizes that this is the land of the free, and represents a part of this country’s history just as the Confederate Flag does. The Confederate flag for some people is a symbol of racism and oppression. For others it remains a nostalgic source of pride. Still for others, it’s simple design grants testament to that turbulent era in American history, where American stood against American, glared one another in the eye, and attacked with barely a thought as to why. Is history destined to repeat itself? Are we as Americans prepared to divide ourselves again over the Confederate flag? Will there ever be a day when at last man can sit back; taking with him one thing that has escaped unscathed from controversy? I think not! I fear we live in a restless society where issues like the Confederate flag will always be a problem. What symbol is so important that we spend years debating over, we waste lives fighting for, our best minds quarrelling over, and precious manpower defending? The answer is quite simple â€Å"The Flag.† This simple but complex piece of material holds many different meanings for many different people. Since its conception in late 1861, the Confederate flag was designed to represent the Southern Confederate States of the early Civil War era. While these Confederate States were based loosely on the concept of slavery, the flag was also established for still undetermined political reasons. As such, the flag exemplifies these same concepts. It was flown imperiously on Civil War battlefields and it came to represent the cause of the Southerner. Then again, this cause was just as ambiguous as its aim. Over the years, after its abuse by white-supremacist groups, namely the KKK, and the like, it has ultimately become a symbol of hatred and racism in the eyes of many. One example of h... Free Essays on The Confederate Flag Controversy Free Essays on The Confederate Flag Controversy Living in this diversified country, the one thing that everyone has in common is the fact that we all live under the American Flag. It symbolizes that this is the land of the free, and represents a part of this country’s history just as the Confederate Flag does. The Confederate flag for some people is a symbol of racism and oppression. For others it remains a nostalgic source of pride. Still for others, it’s simple design grants testament to that turbulent era in American history, where American stood against American, glared one another in the eye, and attacked with barely a thought as to why. Is history destined to repeat itself? Are we as Americans prepared to divide ourselves again over the Confederate flag? Will there ever be a day when at last man can sit back; taking with him one thing that has escaped unscathed from controversy? I think not! I fear we live in a restless society where issues like the Confederate flag will always be a problem. What symbol is so important that we spend years debating over, we waste lives fighting for, our best minds quarrelling over, and precious manpower defending? The answer is quite simple â€Å"The Flag.† This simple but complex piece of material holds many different meanings for many different people. Since its conception in late 1861, the Confederate flag was designed to represent the Southern Confederate States of the early Civil War era. While these Confederate States were based loosely on the concept of slavery, the flag was also established for still undetermined political reasons. As such, the flag exemplifies these same concepts. It was flown imperiously on Civil War battlefields and it came to represent the cause of the Southerner. Then again, this cause was just as ambiguous as its aim. Over the years, after its abuse by white-supremacist groups, namely the KKK, and the like, it has ultimately become a symbol of hatred and racism in the eyes of many. One example of h...

AVALANCHES AND LANDSLIDES Essays - Avalanches, Avalanche, Landslide

AVALANCHES AND LANDSLIDES Submitted to: Ms.Delgado GEOGRAPHY 12/9/96 By OUTLINE AVALANCHES AND LANDSLIDES 1. a.WHAT IS AN AVALANCHE OR LANDSLIDE? b.EXACTLY HOW DOES AN AVALANCHES OCCUR 2. a.I TALK A LITTLE ABOUT PAST AVALANCHES b.PAST DEATHS FROM AVALANCHES 3. a.CONCLUSION CLOSING OF MY REPORT AVALANCHES AND LANDSLIDES What is an avalanche? , well it's a large mass of snow and ice or of earth or rock sliding down a mountain side or a cliff. And how does an avalanche occur, well mainly they happen by vibrations caused by movement of the earth such as an earthquake, gunfire, rainy weather, and many more. Now I would like to talk a little about past avalanches and landslides that have occurred like the 1903 Frank landslide and avalanche that happened at the same time, in Alberta Canada it destroyed the parks canyons it's beautiful trees' it's wonderful sights and killed nearly one hundred people, and covered a small town near Alberta with ice and snow. Another devastating avalanche incident is the 1964 Sherman slide, in which a huge avalanche was triggered by the 1964 Alaskan earthquake. The slide spilled out onto the Sherman glacier, during the big slide several other smaller slides happened and those were the one that took lives in Anchorage, and destroyed property There are a couple of types of avalanches and how the destroy so much this one is named "Loose Snow Avalanches"1, it starts' in a small area then grows in size and mass as it descends.Another type is the "Slab Avalanche" it actually starts in a large area of ice and snow and then begins to slide. AVALANCHES AND LANDSLIDES On September 12 of 1717 crusaded down the Troilet, Italy glacier, gaining speed on a cushion of air reaching a falling velocity of km/hr over a 3600 m fall. Two towns were destroyed, with seven people killed and a 120 cows lost. The slosh of an avalanche ran up the far side of the valley at a speed of 125 km/hr. In developed areas such as ski resorts it is possible to predict avalanches because they are controlled with explosives and artillery. In a back-country areas it is possible to predict avalanches because the forecast relies on experience of the person making the observation. There are no computer models available to predict avalanches and therefore predictions are only accomplished by repetitive observations and knowledge of snow properties. Due to difficulty in reliable predictions method areas of avalanche hazards must rely on controlling or altering the effects of an avalanche. The back country explorer must be highly skilled in determining safe routes and rescue procedures over and above relying on predictions of avalanches for personal safety. Avalanches kill people many ways but the most common cause of death is suffocation. There is little air trapped in the avalanche and within a short period of time the victim loses consciousness and dies. A victim can also be killed from the force of the snow slamming into the body or by traveling in the avalanches and being smashed against trees and other objects. AVALANCHES AND LANDSLIDES Knowledge can help you avoid being caught by a snow avalanche, it may help you survive if you are buried. Snow avalanches are natural phenomena so complex one can never have all the information necessary to predict avalanche conditions with certainty. Well this is my report on avalanches hope you learned more on avalanches but we will never know all there is to know about avalanches, sorry it's not the five pages I was lucky to find this little amount of information. NOTES Mears,Ronald I., Design Criteria for Avalanche Control Structures in the Runout Zone,June1981. S.D., All You Ever Wanted To Know About Snow..., November 24, 1988. Snow Avalanches from Cold Regions Hydrology and Hydraulics,Ryan, W.L. Snow Avalanche Hazards and Mitigation in the U.S. BIBLIOGRAPHY World Wide Web author . Avalanche weather station author . Snow and Weather disaster station.

Departmental Meeting Report Essay Example | Topics and Well Written Essays - 250 words

Departmental Meeting Report - Essay Example On Wednesday the 17th of September, we held a department care plan meeting together with the MDS coordinator, the nurse and social worker to discuss the discharge plans with patients. Four patients were scheduled for discharge three of which were males and one female. Patients were brought to the meeting on their wheel chairs. After everyone present introduced themselves the meeting began and the pre-discharge plans were discussed. The therapist addressed the various issues the patients as well as every other member might need to know while the social worker addressed the plan of discharge including preparation for discharge. It was noted for instance the patients could need walkers as the go home. Overall care plan was also discussed in the meeting under the coordination of the nurse. Issues stressed included the importance of individualized informal meetings with patients and their families at different stages of their care plan which should focus on rehabilitation so as to guarantee a safe professional discharge for patients. Teamwork is very important for success of care plans and the importance of interdepartmental meetings was noted as a strategy to foster a team approach at haven discharge plans with each patient, informing patients of their recovery stage as well as how they are progressing with therapy. We also discussed collaborating with patients’ families to share information as not all the patients were given the date of discharge. This was informed by the fact that discharge date and communication of such information to patients depends on their stage of therapy and as such only those patients deemed ready were given the discharge

Examining of SCM models and practices and implement on Iran Automotive Thesis

Examining of SCM models and practices and implement on Iran Automotive Industry - Thesis Example Types of mixed research There are two types of mixed research: the mixed model research and the mixed method research. The former is a mixed research in which quantitative and qualitative approaches are mixed within or across the stages of the research process (South Alabama University, 2011). In the within-stage mixed model research, the researcher mixed the quantitative and qualitative approaches within one or more of the stages of research. For example, the researcher both utilized the closed-ended and open-ended questionnaire in the collection of data. The close-ended is used to obtain quantitative data while the open-ended is used to obtain qualitative data. Likewise, in across-stage mixed model research, the researcher mixed the quantitative and qualitative across at least two of the stages of research. For example, the researcher utilized open-ended interviews in order to both obtain qualitative data and quantitative data. ... For example, the researcher could perform quantitative experiment and qualitative study through conducting interview study to the respondents in order to find out if the experiment agreed with the results. Mixed method research is also categorized into two major dimensions: time order (i.e., concurrent versus sequential) and paradigm emphasis (i.e., equal status versus dominant status) (Leech & Onwuegbuzie, 2007). Stages of Mixed Research Process The mixed research process has 8 stages, although they are numbered, the researcher/s could still use the stages in different orders or move in multiple directions especially steps 4 through 7. The purpose of this is to address the particular needs and concerns that arise during the research study (SAU, 2011). The first step is to determine whether a mixed design is appropriate to the research study. Therefore it is important to consider the following questions: Can it best answer your research question(s)? and Will if offer the best design for the amount and kind of data you hope to obtain? Mixed research was applicable in this study because it both required quantitative and qualitative analysis. The quantitative research provided the detailed description of the implication of SCM to reduce Forrester effect in the automotive industry. It basically gives the generalization of the gathered data with tentative synthesized interpretations (SAU, 2011 & Traynor, 2011). The second step is to determine the rationale for using mixed design. It is important to consider because it ensures the validity and reliability of the research study. There are 5 most important rationales for mixed design: the triangulation,

Cloud Computing Essay Example for Free

Cloud Computing Essay ABSTRACT: This white paper is an introduction to the terms, characteristics, and services associated with internet-based computing, commonly referred to as cloud computing. Also introduced are the benefits and challenges associated with cloud computing, and for those seeking to use communications services in the cloud, briefly presented are different ways of determining the interfaces needed to use these communications services. Cloud computing is where software applications, processing power, data and potentially even artificial intelligence are accessed over the Internet. Many private individuals now regularly use an online email application such as Gmail, Yahoo! Mail or Hotmail. The location of physical resources and devices being accessed are typically not known to the end user. It also provides facilities for users to develop, deploy and manage their applications ‘on the cloud’, which entails virtualization of resources that maintains and manages itself. 1. What is Cloud Computing? Cloud computing provides the facility to access shared resources and common infrastructure, offering services n demand over the network to perform operations that meet changing business needs. Definitions: â€Å"Cloud computing is a general term for anything that involves delivering hosted services over the internet.† – Wikipedia â€Å"Cloud computing is Internet-based computing, whereby shared resources, software, and information are provided to computers and other devices on demand, like the electricity grid.†- Wikipedia Basically a cloud is a virtualization of Resources that manages and maintains itself. CCSIT, Junagadh [emailprotected] Page 1 2. Types of cloud Public Cloud: the services are delivered to the client via the Internet from a third party service provider. Example: Amazon, Yahoo, Google Example of Clouds 3. Architecture Cloud architecture,[15] the systems architecture of the software systems involved in the delivery of cloud computing, typically involves multiple cloud components communicating with each other over application programming interfaces, usually web services and 3-tier architecture. This resembles the Unix philosophy of having multiple programs each doing one thing well and working together over universal interfaces. Complexity is controlled and the resulting systems are more manageable than their monolithic counterparts. Private Cloud: these services are managed and provided within the organization. There are less restriction on network bandwidth, fewer security exposures and other legal requirements compared to the public Cloud. Example: HP Data Centers Hybrid cloud: There is some confusion over the term Hybrid when applied to the cloud a standard definition of the term Hybrid Cloud has not yet emerged. The term Hybrid Cloud has been used to mean either two separate clouds joined together (public, private, internal or external), or a combination of virtualized cloud server instances used together with real physical hardware. The most correct definition of the term Hybrid Cloud is probably the use of physical hardware and virtualized cloud server instances together to provide a single common service Architecture The two most significant components of cloud computing architecture are known as the front end and the back end. The front end is the part seen by the client, i.e. the computer user. Hybrid cloud CCSIT, Junagadh [emailprotected] Page 2 This includes the client’s network (or computer) and the applications used to access the cloud via a user interface such as a web browser. The back end of the cloud computing architecture is the ‘cloud’ itself, comprising various computers, servers and data storage devices collaboration. For more information on collaborative working using Google Docs, you can watch the now classic video Google Docs in Plain English. Taking collaboration further still, the outputs of some SaaS applications can be embedded in other web pages as web service gadgets. For example, a Google Docs or Zoho Sheet chart can be mashed into another website. There it will automatically update when the data in the online spreadsheet that is generating it is changed. SaaS applications are also constantly updated, which can free users of the upgrade hell of a major traditional software package revision. The disadvantage of SaaS is that it is basically a takeit-or-leave-it form of cloud computing. This means that businesses and individuals who require direct access to cloud computing hardware on which they can run their own applications cannot use SaaS. Rather, they need to cloud compute at the platform or infrastructure level using either platform as a service (PaaS) or infrastructure as a service (IaaS). 4. Services of Cloud Computing SaaS(Software as a Service) PaaS(Platform as a Service) IaaS(Infrastructure as a Service) Services Of Cloud computing PaaS(Platform as a Service) A platform is a software environment used to develop and run applications. For example, Microsoft Word is an application that runs on the Microsoft Windows platform. When people choose to cloud compute using platform as a service or PaaS, they obtain access to an online platform provided by a cloud computing vendor. They can then use this platform to develop and deliver their own online (SaaS) applications. Applications developed using PaaS may be used privately by just one or a few users within a particular company. However, they can also be offered free or for-a-fee to anybody on the web. This means that if you have a great idea for a new online application then you can use PaaS to turn it into a reality! Several cloud suppliers now offer PaaS tools. Most notably these include Google App Engine, Microsoft Windows Azure, and Force.com. All such offerings effectively provide their customers with a box of cloud computing Lego. New applications are then constructed from the plastic bricks on offer. With Force.com, some applications can even be built using a simple drag-and-drop interface. Relatively nontechnical people can therefore create new online applications very quickly. SaaS (Software as a Service) Software as a service is where computer applications are accessed over the Internet rather than being installed on a local computing device or in a local data centre. So, for example, people may use an online word processor like Google Docs, an online database application like Zoho Creator, an online photo editor like Pixar, or an online invoicing application such as Zoho Invoice. Many SaaS applications are free to use, at least initially. You can find links to a great many in the Cloud Computing Directory. SaaS can provide its users with many benefits. These include the general cloud computing advantages of dynamic scalability and any device independence, as well as the benefit of being able to use an application without incurring fixed costs. Many SaaS applications are also collaborative. This allows multiple users to share documents and even to work on them at the same time.  For example, in the Google Docs spreadsheet different users can work on different cells simultaneously. The cells different users are working on are locked-off and highlighted in different colours. A real-time chat window can also be opened up alongside the spreadsheet to further enhance Indeed, Force.com claim that their simplified programming model and cloud-based environment mean [customers] can build and run applications five times faster, at about half the cost of traditional software platforms. Google App Engine and Force.com also allow an initial application to be created for free! Whilst PaaS is great in many situations, its users do need to be mindful of the involved flexibility verses power trade-off. What this means is that whilst PaaS makes it relatively easy to create new online applications, users are nevertheless constrained by the particular programming languages and tools provided by their PaaS supplier. In other words, PaaS vendors have total control over which Lego bricks they allow their customers to build with. Whilst this ensures that applications built using the tools on offer will always function correctly, it is nevertheless restrictive. It is for this reason that many companies and some individuals choose to cloud compute at the infrastruct ure level. Dedicated physical servers and virtual server instances can perform exactly the same functions. However, there are some differences between them. For a start, virtual server instances are cheaper to supply as each does not require its own piece of physical hardware in a cloud data centre. On the other hand, virtual server instances are sometimes seen as less secure by those who do not want to share server hardware with other customers. For this reason, four categories of IaaS are available. These are most commonly known as private clouds, dedicated hosting, hybrid hosting and cloud hosting. 5. How cloud computing works? In traditional enterprise computing, IT departments forecast demand for applications and capacity and invest time and money to develop those resources inhouse or purchase them from others and operate them in-house. IaaS (Infrastructure as a Service) Infrastructure as a service or IaaS is where a cloud supplier provides online infrastructure on which their customers can store data and develop and run whatever applications they please. IaaS therefore allows companies to move their existing programs and data into the cloud and to close down their own local servers and data centres. Whilst computing applications run on platforms, platforms in turn run on computing infrastructure. So, for example, whilst the Microsoft Word application runs on the Microsoft Windows platform, in turn the Microsoft Windows platform runs on the infrastructure of an IBM-compatible PC. How it works The fundamental building block of cloud computing infrastructure is the server. Cloud computing servers are basically computers on which online applications can be run and data can be stored. When provided by an IaaS vendor, cloud servers can also be real or virtual. Real or dedicated servers are individual circuit boards – known as blades – mounted within equipment racks in a data centre. In contrast virtual servers – also known as virtual server instances – are software-controlled slices of real, physical servers. Virtual servers are created by a process called virtualization that allows many users to share the processing power of one physical server. With cloud computing, institutions procure IT services from remote providers, and campus constituents access these resources over the Internet. E-mail, for example, long considered a staple of an institution’s IT operations, can be obtained from a range of sources, and a growing number of campuses contract with outside suppliers for this function. Software is hosted by the provider and does not need to be installed—or maintained—on individual computers around campus. In some cases, a large university or a consortium might become a provider of cloud services. Storage and processing needs can also be met by the cloud. Institutions pay only for the resources used, and users can access the applications and files they need from virtually any Internet- connected computer. In a mature cloud computing environment, institutions would be able to add new IT services or respond to changes in capacity on the fly, saving capital costs that can be redirected to programs of strategic value to the institution. Advantages †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ Reduced Hardware equipment for end users Improved Performance Lower Hardware and Software Maintenance Instant Software Updates Accessibility Less Expensive (Amazon example) Better Collaboration Pay for what you use Flexible 6. CHARACTERISTICS †¢ High scalability Cloud environments enable servicing of business requirements for larger audiences, through high scalability Disadvantages †¢ †¢ †¢ †¢ †¢ †¢ Security Issues (#1 concern) Internet connection Too many platforms Location of Servers Time for Transition Speed †¢ Agility The cloud works in the ‘distributed mode’ environment. It shares resources among users and tasks, while improving efficiency and agility (responsiveness) †¢ High availability and reliability Availability of servers is high and more reliable as the chances of infrastructure failure are minimal †¢ Multi-sharing With the cloud working in a distributed and shared mode, multiple users and applications can work more efficiently with cost Reductions by sharing common infrastructure †¢ Services in pay-per-use mode SLAs between the provider and the user must be defined when offering services in pay per use mode. This may be based on the complexity of services offered Application Programming Interfaces (APIs) may be offered to the users so they can access services on the cloud by using these APIs 7. CONCLUSION After so many years, Cloud Computing today is the beginning of â€Å"network based computing† over Internet in force. It is the technology of the decade and is the enabling element of two totally new computing models, the Client-Cloud computing and the Terminal-Cloud computing. These new models would create whole generations of applications and business. Our prediction is that it is the beginning to the end of the dominance of desktop computing such as that with the Windows. It is also the beginning of a new Internet based service economy: the Internet centric, Web based, on demand, Cloud applications and computing economy

The Effects Of The Various States Of Consciousness On Behavior Essay

Consciousness is the state or condition of being conscious. A sense of one's personal or collective identity, especially the complex of attitudes, beliefs, and sensitivities held by or considered characteristic of an individual or a group. There are several different stages of consciousness. Waking consciousness, altered states of consciousness and sleep.   Ã‚  Ã‚  Ã‚  Ã‚  Waking consciousness is the mental state that includes moving and thinking, along with anything else done while we are awake and alert. Behavior during this period is as normal as it can be. Although behavior can differ from person to person, although most people go through the relatively same behavioral patterns. While awake, people go through feelings of happiness, depression, anger, and boredom, to name a few. These feelings can cause people to do different things and act differently than normal. For instance, happiness, caused by having something give them pleasure in some way, can cause people to smile more or be more kind to other people, like doing other things for people just to be nice, or giving presents and gifts to people. Depression is caused by bad, non-pleasurable things happening to you. While depressed, people may become distanced from their family and friends, not want to interact with other people, and even, in severe cases, hurt themselves and/or others, and even commit suicide. Many things cause anger and aggression also. They can be caused by the interaction with other people like family and peers, but also frustration, hot weather, physical pain, and even noise. While angry pe ople may act overly aggressive, lash out at others, even loved ones, and also commit violent acts. Being bored can also cause people to act differently. While bored people may do things like act and think hastily and also commit crimes in hopes of satisfying their urge for fun and pleasure. All these feelings have different causes but most include interaction with people, television and different chemical balances and imbalances within the a person’s body.   Ã‚  Ã‚  Ã‚  Ã‚  Another type of consciousness is altered consciousness. There are many different types of altered consciousness. Daydreaming is one form of this type of consciousness. Daydreaming is when, due to boredom or mental fatigue, a person enters a dream-like state while awake. While not necessarily ba... ...rcoleptic are persistently tired and fatigued and experience loss of muscle tone. This loss of muscle tone can cause brief paralysis of functions and even for a standing person to fall to the ground. This disorder can effect a person’s behavior negatively because of the difficulty in conducting everyday activities with the fear of possibly losing consciousness or falling and getting severely injured. It is also harder to lead a normal sex life because the sudden sleep and loss of muscle tone can cause a person to become embarrassed to be close to someone or a person to be frustrated with their partners disorder.   Ã‚  Ã‚  Ã‚  Ã‚  In conclusion, the three states of consciousness can effect behavior in many different ways, whether it be positive or negative. Behavior is an important part of life although getting enough sleep and avoiding drug abuse can help, there are different things that can also effect people’s behavior in waking consciousness. Relationships with other people like friends and family can make a person have a lot of feelings like anger and happiness, and even television can also effect a person’s behavior by violent show’s making people more aggressive.

Persuasive Message Framing Health And Social Care Essay

The writer argue that, in the context of urging societal alterations, message framing can be used as one of communicating schemes in societal selling context. By utilizing message bordering attack, public communicating can be presented in footings of the benefits ( additions ) or costs ( losingss ) framed associated with a peculiar behaviour. Research shows that bordering of such persuasive messages influences many societal determinations. Peoples tend to avoid hazards when sing additions or benefits, and tend to prefer hazards when sing losingss or costs. This paper investigates the nature of message framing, the taxonomy of message framing effects and alternate signifiers of message bordering presentation. The writer explored the differential effects between negative and positive framed message, the context in which message bordering surveies much more have been conducted and the account by which message framing could act upon people ‘s attitude, purpose and behaviour. It is concluded that the message bordering surveies had been conducted in a broad assortment of wellness communicating context and can be expanded to many other societal alterations contexts. The differential effects between negative and positive framed messages were exist because of: 1. The different penchants about hazard, 2. The asymetry between negative and positive information and the presence of moderator variables. The persuasion which happened in message bordering presentation will act upon people ‘s information processing in three stairss: 1. The sum of attending directed to the message influence the grade to which it is integrated into a mental representation of the issue, 2. Peoples differ in their receptiveness to the peculiar frame advocated by the message, based on both their experience and current state of affairs, and 3. The influence of a peculiar frame on existent behaviour depends on the sensed map of the advocated behaviour. Aditional researches may be neede d to make up one's mind what sort of framed message and situational and dispositional moderator variables that proper for the specific context of societal job.Cardinal words: societal selling, message framing, attitude and persuasion.1IntroductionAbout every state faces societal jobs in their day-to-day life. Health issues such as advancing people to avoid familial diseases, carrying people to halt unhealthy life manner ( e.g. smoke, drug and intoxicant dependence ) , advancing people to forestall deathly diseases ( e.g. malignant neoplastic disease ) and doing household program, are parts of these jobs. Decreasing energy supply is besides one of the jobs that require people to execute energy preservation behaviour. Significant attempts are needed to carry people to halt blowing their energy ingestion. The increasing traffic denseness besides require people to alter their drive and siting behaviour to be more carefully and safely in order to take down the traffic accident rate. In s hort, there are many public attitudes and behaviours needed to be changed to work out the societal jobs. Solving societal jobs affecting societal alterations. It means altering single and group life wont by transforming their harmful behaviours toward more productive one, altering attitudes and values of the community and the whole society and making new societal tehcnolgy in order to increase quality of life [ 1 ] . However, altering human behaviour is non an easy thing and it possibly the most debatable issue in human relation.The Role of Social Marketing in Solving Social ProblemsIn order to accomplish the expected status in a society that full of societal jobs, it is expected that marketing subject non merely focuses on profit-oriented companies but besides accommodates the societal dimensions of the society. The jobs such as pollution control, public transit, instruction, drug maltreatment, safe drive, household planning and public wellness, need advanced solutions and attacks to derive populace ‘s attending and support. The troubles found by societal sellers to pass on their thoughts and societal ends have been the concern of the selling experts for a long clip. To reply these phenomena, Kotler and Zaltman [ 1 ] argue that marketing attacks can be used to work out specific societal jobs by implementing the selling rules such as analysing, planning and commanding the jobs of societal alterations. The selling constructs and techniques can be used efficaciously to advance single and group to execute recomended behaviour. Social selling is a promising model to program and implement the societal alterations. Kotler and Zaltman [ 1 ] define societal selling as a design, execution and control of plans carried out to act upon the acceptableness of societal thoughts that involved merchandise design, pricing, communicating, distribution and selling research. However, using the societal selling program attack does non intend that the societal ends will be automatically achieved because it merely develops a mec hanism which relates the experts ‘ cognition on human behaviour and the execution of the recommended cognition which brings good cause to the society. Different from Kotler and Zaltman, Andreasen [ 2 ] positions societal selling as the attempts to act upon the mark audience ‘s behaviour. Harmonizing to Andreasen, societal selling is the version of commercial selling engineering onto the analysis, planning, executing and rating plans which designates to act upon the behaviour of the mark audience to better their ain mental and physical life and/or the society in which they live. Harmonizing to Andreasen, the footing of societal selling is to alter one ‘s behaviour. Social selling is related to behavioural mentality. It stressed on instruction and propaganda plan that merely will be usefull if brings behavioural alterations. It is interesting to societal alterations practicioners as could partly explicate why people do certain behaviour. The consumer ‘s behavior attack, harmonizing to Andreasen [ 2 ] , can be applied in societal selling issues. The outgrowth of exchange theory is the chief stimulation to marketing faculty members to spread out the constructs of consumer ‘s behaviour and selling such as the usage of seat belt, blood giver, etc. Promoting the consumers to donate their blood, for case, does non affect offering merchandises or services, nor does it affect payment to be done by the consumers. However, it will convey many benefits for the quality of life of the society if the recomended behaviours were performed. Theories and theoretical accounts for societal selling abound, with small formal consensus on which types of theoretical accounts for what types of societal selling jobs in what sorts of state of affairss are most appropriate [ 3 ] . The basic constructs of societal selling involve alterations. Social sellers try to act upon other ‘s behaviour which consists of [ 2 ] : a. get downing certain behaviour, b. halting certain behaviour, c. altering certain behaviour. The get downing point of behavior class opens a figure of research chances in the field of societal selling such as disease bar, early sensing of diseases, birth control ( to get down a certain behaviour ) , the danger of smoke ( to halt a certain behaviour ) , and organic nutrient ingestion and environmentally friendly merchandise use ( to alter a certain behaviour ) . In the visible radiation of act uponing other ‘s behaviour, societal selling urges the execution of proper communicating scheme to carry people. In this paper, the writer argue that one of the effectual communicating methods which may be considered to carry people to execute recomended behaviour is the message bordering attack. Message framing can be the promising communicating scheme to heighten people conformity in order to do societal alterations. It could be implemented in wide country of societal issues such as wellness, safe drive, proenvironmental behaviour and so on.Framing Theory and Message FramingFraming theory starts from Prospect Theory introduced by Tversky and Kahneman [ 4 ] . Framing posit of prospect theory provinces that the manner an information presented, in footings of benefits and losingss, may act upon the behaviour based of two grounds. First, people tend to avoid hazards when sing additions, that is, when having messages in the signifier of positive fra ming. On the contrary, they are likely to take hazards when sing losingss or costs, that is, when having messages in the signifier of negative framing. Consequently, the penchants towards risk-taking to a great extent depend on whether the thought is presented in the frame of addition or loss contexts. Therefore, persuasive information may be presented by demoing the possible benefits earned if the information presented is purely followed or the possible losingss earned if the information is non taken. Second, this theory argues that people will probably to avoid hazards which make the losingss look much bigger than the benefits earned. In line with the chance theory, two logical statements of an issue, if presented in two different ways, may ensue in different determinations. The most popular illustration of this issue is the Asiatic Disease Problem experiment conducted by Kahneman and Tversky [ 5 ] : to 152 topics who were presented to the hypothesis inquiries which required them to conceive of that the US authorities had been fixing an action to forestall diseases in Asia. It was predicted that the disease might kill 600 people. There were two plans proposed to forestall the disease ; Program A and B. It was assumed that the estimated effects of the plan were as follows ( presented in positive framing ) : If plan A was chosen, they would salvage 200 people If plan B was chosen, 1/3 of 600 would likely be saved and 2/3 people would likely non survive. The consequences of the experiment showed that 72 % of the respondents preferred Program A instead than Program B. The same inquiries were besides proposed to the other 152 topics. This clip, the plans were Program C and D which were presented in negative framing with the undermentioned effects: – If plan C was taken, 400 would decease – If plan D was chosen, none of 1/3 of 600 would decease and 2/3 of them would likely decease. In this 2nd group of topics, 78 % preferable plan D. From the illustration given, it is evidently seen that A and C are similar to plan B and D. The response was rather predictable based on the rules of diminishing sensitiveness attached to prospect theory. The presentation of the options in the framing informing the figure of people to be saved has clearly shown the benefits of avoiding the hazards. It is much better to salvage 200 people, definite in figure instead than to salvage about 200 people, indefinite in figure. Meanwhile, the presentation of the options in the framing informing the figure of victims shows the topics preferred to take hazards when faced with the possible losingss. It is rather interesting to analyse the chance appeared in this instance. The survey of Kahneman and Tversky [ 5 ] shows that single determination is consistently influenced by how an issue is presented. Specifically, person will be given to avoid hazards when confronting messages presented in a positive framing ( emphasizing on benefits gained ) and s/he will prefer to take hazards when confronting a job presented in negative framing ( emphasizing the losingss gained ) . They argue that each individual relies on a figure of limited heuristics and prejudices in doing complex determinations. Each prejudice and heuristics depends on the preparation of the thought at the beginning of the procedure. Prospect Theory give us a canche to utilize its rule in showing a persuasive message in order to heighten message receiver ‘ conformity, called message framing. Message framing is the presentation of persuasive messages which stresses on the benefits to be gained if the messages are followed ( positive framed/gain framed ) , or on the hazard facets if the messages are non followed[ 2 ]( negative framed/loss framed ) . It is one of persuasive tactics which is strategically used in pass oning persuasive messages to other people. It is used as a paradigm to understand and look into communicating scheme and behaviour in a broad scope of subjects. The related subjects include psychological science, communicating, organisational determination devising, economic sciences, wellness communicating, media surveies and political communicating [ 6 ] . Pprevious researches on persuasive power of message bordering show that the presentation of different types of message framing will ensue in different persuasive effects.Taxonomy of Framing EffectssLevin et Al. [ 7 ] designs a taxonomy which differentiate the framing effects into three classs: hazardous framing, property framing and end framing. The effects of the first framing are those that can be explained as follows: for illustration, in a certain state of affairs, S+ describes a positive status ( such as being alive, winning and being healthy ) , with a figure of n response options which implies different terminal consequences with different degree of uncertainness ( r1, r2, aˆÂ ¦rn ) . On the other side, S- means a negative status ( being dead, being lost, being ill ) with the same figure of n response picks and terminal consequences. The consequence of hazardous framing is that one tends to take options with low uncertainness in S+ , and to take options with high uncertainness in S- . In other words, this status refers to the inclination to prefer definite options in positive frame and hazardous options in ne gative frame. The experiment conducted by Kahneman and Tversky [ 5 ] can be used to explicate this job. The effects of 2nd framing or attributee bordering consequence can be elaborated as follows: for illustration, a certain property ( object or incident ) A+ indicates positive status ( success, nonfat, etc ) with a figure of n response picks which implies different degree of attractive force ( d1, d2, aˆÂ ¦dn ) . Meanwhile, the same property shows negative conditions ( failed, fatty etc ) indicated as A- with the same figure of response picks and the same degree of attractive force d1, d2, ..dn. The attribute framing effects are defined as the inclination of a topic to measure A+ with higher degree of attractive force and A- with lower degree of attractive force. It refers to the inclination of the topic to do a more positive rating on the presented stuffs in positive frame. The experiment carried out by Levin and Gaeth [ 8 ] revealed that beef was considered to be more delightful when positively labeled ( 75 % fat free ) compared to negatively labeled such as ‘contain 25 % fat ‘ . There are at least two different rules between hazardous framing and property framing. The first difference is that attribute framing does non affect hazard use. The 2nd 1 is that the mark is non in the signifier of taking the independent response picks, but in measuring the credence to certain points. The 3rd consequence is the effects of end bordering. They can be explained as follows: for illustration, a certain message M+ contains a positive frame ( chance to derive benefits or avoid losingss ) and the other message contains negative frame ( chance non to derive benefits or suffer losingss ) indicated by M- . The effects of end framing are the differences in the persuasive consequences between M+ and M- to accomplish a certain behaviour. Based on above taxonomy, the presentation of message framing in wide societal alterations context ( such as advancing disease sensing behaviour, disease bar behaviour, energy salvaging behaviour, birth control behaviour, pro-environmental behaviour, save driving behaviour, healthy diet and exercising behaviour and so on ) could be categorized into end framing as the presentation of negative framing or positive one could convey different persuasion effects to the message receiver.Forms of Message Framing PresentationLevin and Gaeth [ 8 ] argue that there are two types of message framings ( See Table 1 ) . The first type is how the negative or positive message is communicated across. The positive message emphasizes on the benefits received by the consumers for utilizing the merchandises or making the expected behaviour. The negative message emphasiss on the consumer ‘s losingss for non utilizing the merchandises or making the recommended behaviour. The 2nd type discusses the nega tive and positive facets of the message itself. Levin and Gaeth reference that the fat contained in the beef is 25 % fat or 75 % thin. As a affair of fact, there are really few merchandises which inform their negative effects to the consumers. In line with Levin and Gaeth, O'Keefe [ 9 ] maintains that the attractive force of positive and negative framing phrases can be presented in two different ways. First, whether the result described is the coveted result. Second, whether the result described is an achieved result ( gained, proposed, accomplishable ) or something to avoid ( gotten rid of, unexpected, unattainable ) . As displayed in Table 1, addition framed messages, for illustration, can be presented in: â€Å" if you comply the promoted action, you will derive the expected result X † or â€Å" if you do the recommended action, the unexpected result Y can be avoided † . Meanwhile the loss framed messages can be presented: â€Å" if you do non make the recommended behaviour, the expected result X will non be achieved † or â€Å" if you do non make the recommended action, the unexpected result Y will happen † . Nevertheless, it has non been really clear whether the assorted types of message pr esentation will impact the comparative effectivity of addition framed and loss framed messages. Table 1. Techniques of Message Framing PresentationPresentation techniquesTypes of FramingStatementOutcome is described in the expected or unexpected results. Positive frame â€Å" if you do the recommended actions, the expected result X will be gained † Negative frame â€Å" if you do non make the recommended actions, the unexpected result Y will happen. Results are presented as something achieved or avoided. Positive frame â€Å" If you do the recommended actions, the unexpected result Y may be avoided † . Negative frame â€Å" If you do non make the recommended action, the expected result X will non be gained. † Beginning: extracted by the writer.Differential Effectss of Positive and Negative Framing on PersuasionIn the last 30 old ages, 100s of empirical surveies have been conducted to demo and look into the framing effects in several different contexts. Around 15 surveies had been conducted on the effects of bordering each twelvemonth [ 10 ] . There are besides legion theories developed to explicate human behaviour based on the appraisal of benefits and losingss. However, findings on the effects of bordering have non shown any conclusive consequences [ 9 ] . Probe on about 70 old surveies showed [ 11 ] , so far, bordering researches are much more conducted in wellness and consumer behaviour contexts. In wellness behaviour context ( see Appendix 1 ) , many researches on message framing are conducted to promote the behaviour to make early sensing and bar to diseases [ 42 ] . Some of those researches were carried out in the context of chest malignant neoplastic disease sensing through chest ego scrutiny or mammography trial [ 12 ] , [ 13 ] , [ 14 ] and [ 15 ] , bad effects of smoking [ 16 ] , sexually-transmitted diseases [ 17 ] , the effects of cholesterin on bosom disease [ 18 ] , cholesterin testing [ 19 ] , the usage of dental floss [ 20 ] , fatty content on nutrient [ 21 ] and the usage of gargle [ 22 ] . In the field of wellness, persuasive power of loss framed tends to surpass that of addition framed. However, the consequences of the research in general are still inconclusive [ 21 ] , [ 15 ] , [ 23 ] . Some surveies found the effectivity of negative framed message [ 12 ] , [ 30 ] and the others found the opposite one [ 19 ] , [ 17 ] . Rothman and Salovey [ 31 ] province that loss framed messages are more persuasive in advancing disease sensing and other hazardous behaviour while addition framed messages are more persuasive in advancing disease bar and other low hazard behaviour. The advantages of the persuasive power of loss framed over that of addition framed in the old surveies is closely related to bordering determination. The surveies show different penchants between the two determination options ( which are fundamentally tantamount to one another ) when they are presented in different frames ( loss and addition framed ) . It is supported by Tversky and Kahneman [ 4 ] who maintain that, fundamentally, an person does non fond of losingss ( remaining off from hazards ) when sing the benefits or consequences, but takes hazards when confronting possible losingss or costs. Therefore, when results are presented in loss framing ( emphasizing on the facets of possible loss ) , a individual prefers to take hazards. This is based on Kahneman and Tversky ‘s classical experimental findings [ 5 ] on deathly diseases that have often been replicated to different topics[ 3 ]. There are at least three grounds that could be used to explicate the differential effects of framed messages [ 9 ] . First, the ground is related with the determination framing. Previous surveies showed that there are different penchants between two determinations ( that must be tantamount ) when the two determinations presented in different frames. Tversky and Kahneman [ 4 ] explain that people fundamentally do non like loss ( avoid hazard ) when they were sing hazards. So, when the result is presented in negative framed ( stressed the loss or hazard facets ) , people will prefer hazardous pick. This statement is based on Kahneman and Tversky ‘s experiment called fatal disease [ 5 ] . Second, the differential effects in negative and positive framed message are caused by dissymmetry between negative and positive information. Negative information by and large has unbalanced effects on determination compared with tantamount positive information. A negative stimulation is besides easy to be recognized. Research show that negative stimulations could be detected in a lower degree of exposure compared with the positive 1. In add-on, negative happening consequences in stronger and faster reactions. There are three accounts about asymmetrical places between positive and negative information. The first dissymmetry provinces that negative information normally has imbalanced influence to a determination compared to the similar positive information. The 2nd dissymmetry explains that negative stimulations can be easy detected on the lower degree of exposure compared to positive stimulation. Third dissymmetry is that a negative event consequences in a stronger and quicker reacti on [ 9 ] . The 3rd ground is the presence of moderator variables. Review on old researches [ 11 ] happen several moderator variables normally used and caused the differential persuasion effects of message bordering. They are the engagement of message receivers and content of the messages [ 19 ] , [ 17 ] , [ 13 ] , types of recommended behaviour ( in wellness context ) , and types of communicated results [ 9 ] . Another moderator variable which besides becomes the topic of research is the order of presentations [ 24 ] , credibleness of message beginnings [ 25 ] , single differences which include: demand for knowledge [ 26 ] , degree of message amplification [ 27 ] , message receiving system motive [ 20 ] and perceptual experience to put on the line [ 28 ] . Researches showed the presence of moderator variable streghtened the persuasive power of framed message. The findings of the researches on the effects of message framing are steadfastly supported by the effectivity of positive framing in the surveies conducted by Levin and Gaeth [ 8 ] , Maheswaran and Meyers-Levy [ 19 ] , Diamond and Sanyal [ 29 ] , Rothman et Al. [ 30 ] , Block and Keller [ 17 ] , and Donovan and Jalleh [ 21 ] . Previous surveies show that positive framing is more effectual when the communicated message contains recommended low hazard behaviorsuch as like cholesterin sensing to the topics who had low degree of engagement in Maheswaran and Meyers-Levy ‘s survey [ 19 ] or preventative behaviour [ 31 ] . It was found that the presentation of the message in positive framing may increase people ‘s inclination to give positive reappraisal of a merchandise which in bend addition the chance to take the merchandise [ 8 ] , [ 21 ] . This determination is consistent with Kahneman and Tversky [ 5 ] who province that an single tends to avoid hazard when confronting a jo b presented in positive framing. In some instances, the mixture of positive and negative messages turns out to be the most effectual manner. Meanwhile, another survey studies there are no differences between the two framing conditions. Lerman et Al. ( 1992 ) in Donovan and Jalleh [ 21 ] did non happen different effects among participants who read the message in negative framing and the message presented in positive framing about the importance of mammography written in the brochure. Besides, Tykocinski et Al. [ 32 ] did non happen different effects between positive and negative framing. Framing effects will be found when there is an interaction with personal concept named self disagreement. Assema [ 34 ] province that there are no bordering consequence in his survey in healthy diet context. Beyond many research in wellness context, research about message framing besides conducted in the country of energy preservation [ 35 ] . Gonzales et Al. [ 10 ] , conducted a quasi experiment technique based on the rules of societal psychological science. Hence, the findings of his survey support the effectivity of loss framed messages. Research on message framing is besides carried out on environment-friendly behaviour, including recycle, preservation, and green life style in a survey by Davis [ 36 ] . This research findings revealed that negative framing gave the most positive response and the highest purpose to take part in environment-friendly behaviour. From the abovementioned account, the author draws decision that though assorted researches on the effects of bordering have been conducted, so far, there is no conclusive consequences in which bordering signifier is most effectual [ 13 ] . Some of the surveies argue that negative framing is more effectual than positive bordering [ 12 ] , [ 31 ] , yet others mention the opposite consequences ; positive framing is more effectual than negative bordering [ 8 ] , [ 21 ] . Some of the findings of the surveies indicate that the effectivity of a certain framing depends on situational and dispositional factor [ 6 ] . Based on his meta analytic, O'Keefe [ 9 ] province that loss framed entreaties are non by and large more persuasive than addition framed entreaties. For promoting disease bar behaviours, gain-framed entreaties are more persuasive than loss-framed entreaties ; for promoting disease sensing behaviours, gain- and loss-framed entreaties do non differ significantly in strength. The co mparative strength of otherwise framed entreaties seems small influenced by ( a ) whether the gain-framed entreaties emphasize the attainment of desirable provinces or the turning away of unwanted provinces or ( B ) whether the loss-framed entreaties emphasize the attainment of unwanted provinces or the turning away of desirable provinces. Our treatment about the wide context of message bordering surveies indicate that bordering attack can be considered as one of communicating attacks to advance societal alterations trough altering public values, attitudes and behaviour. As one of societal selling publicity scheme, as proposed by the writer, message framing could be implemented in the degree of single or community behaviour. However, it is needed extra surveies in more assorted context to analyze the proper message bordering attack and situational and dispositionalvariables to considered in each specific country, in order to acquire cognition, what sort of framed message does more persuasive in each country.How Can the Framed Message Influence Attitude Change and Behavior?The common result variable of the framed message theoretical account was persuasion, as assessed through attitude alteration, station communicating understanding, behavioural purpose and behaviour [ 9 ] . Persuasion is an attitude alteration as a cons equence of exposure to information achieved from other parties. This exposure can be in written or verbal messages sent by the beginning to the receiving system [ 38 ] , [ 39 ] . Variables impacting persuasions normally operate by giving hints or statements, making prejudice in information processing, and make up one's minding the figure of amplifications done in a message [ 40 ] . Refer to Eagly and Chaiken ( 1984 ) in Seethaler and Rose [ 37 ] , there are three attacks in persuasion mechanism, i.e. : 1 ) Cognitive Response Approach, 2 ) Attributional Reasoning Approach, and 3 ) Heuristic Processing Mode. Prospect theory, from which message framing originated is one of theories that explained attributional logical thinking attack. Harmonizing to this attack, message receiver seek to explicate the message s/he receives through causal reading related with societal norms or environmental status. So, it is clear that message framing is one of persuasion beginnings. Persuasion which happened in a framed message presentation is one of persuasion beginnings caused by the message features. Harmonizing to Olson and Zanna, there are several issues which encourage persuasion to take topographic point: beginning of the message, features of the message and features of the message receivers [ 38 ] . The effects of message framing may go on to all degrees of message receiver. It can be applied in the degree of interpersonal, intrapersonal, groups, organisations, inter organisations, and society [ 6 ] . Although there are more research conducted on the consequence of framing in single degree [ 12 ] , [ 19 ] , [ 31 ] , [ 8 ] , [ 30 ] , [ 21 ] , [ 13 ] , [ 15 ] dan [ 23 ] . However, there are besides some researches on the effects of bordering in the group degree [ 41 ] . The information processing when person receives a framed message can be closely related to psychological procedure used in proving the information, doing determinations, and pulling decisions about the surrounding. There are several account how people treating a framed information. Refer to Hallahan [ 6 ] , bordering operates by making prejudice in person ‘s cognitive procedure of information through at least two mechanisms. The first mechanism is giving contextual intimations that direct the receivers in doing determinations and pulling decisions of a message. Tversky and Kahneman [ 4 ] argue that negative or positive framing in a determination works as cognitive heuristic or regulation of pollex which directs the determinations to uncertain or hazardous state of affairs. The negative reaction to losingss or hazards is consistent with the findings which province that negative information is considered more earnestly than positive information and given more attending. This is b esides consistent to the motivational theory which states that person of course acts to make self-defense. This statement can explicate, why some research findings [ 4 ] , [ 12 ] , [ 19 ] uncover the advantage of negative framed messages than positive 1s. The 2nd mechanism is through priming. It is a procedure where a human being organizes the gained cognition in the memory through cognitive construction or strategy which acts as barrier in constructing and construing a state of affairs and event. How a framed messages influence people ‘s determination besides can be explained based on the information processing phases. The procedure by which framed messages influence opinion and behaviour could be explained at least in three of import phases. First, the sum of attending directed to the message influence the grade to which it is integrated into a mental representation of the issue. Second, people differ in their receptiveness to the peculiar frame advocated by the message, based on both their experience and current state of affairs. Third, the influence of a peculiar frame on existent behaviour depends on the sensed map of the advocated behaviour [ 31 ] . Harmonizing to Rothman and Salovey [ 31 ] , in order to react to framed message, people have to comprehend the message foremost. But, to simply comprehend the message is non sufficient to actuate behavior alteration. Framed message can act upon the behaviour merely if it integrated into a individual ‘s cognitive representation of the issue. Given that behavioural determinations are thought to reflect the consideration of relevant beliefs, a individual ‘s perceptual experience of an issue needs to reflect the peculiar place advocated by the framed entreaty. The construct of Elaboration Likelihood Model [ 40 ] besides can be used to explicate how people respond to a framed message. Petty and Cacioppo [ 40 ] explain, there are two alternate manners in which persuasive entreaty are processed: 1 ) Systematically ( attending to the peculiar inside informations of the message ) , and 2 ) Heuristically ( attending to come up characteristics of the message ) . The mode in which a framed message is processed significantly affects its ultimate influence. The cognitive assimilation of the frame provided by a peculiar entreaty is likely contingent on the systematic processing of that entreaty [ 31 ] . Some old researches in diverse set of contextual variables showed that comparative strength of addition and loss framed was limited to those participants who processed the message consistently [ 19 ] , [ 30 ] . Systematic processing of a framed message is a necessary stipulation to detect the predicted advantage of addition bordering particularly in w ellness behaviour context ( addition framed message in bar behaviour and loss framed for sensing behaviour ) . How do people accept the framed message? Rothman and Salovey [ 31 ] province that even though people may be motivated to treat a framed entreaty consistently, they may non be receptive to the frame advocated by the message. There are two factors were sing in discoursing the willingness to accept the peculiar frame provided by an entreaty. The first factor is an on-going temper that may determine one ‘s receptiveness to a framed message. One ‘s temper may act upon whether a state of affairs is perceived in footings of losingss or additions as feelings can function as information about one ‘s current state of affairs. Sad tempers may corroborate that possible losingss are possible, whereas happy tempers may underline the saliency of possible additions. However, temper had no consequence on perceptual experiences of possible additions. Peoples who felt happy perceived greater cost to a possible loss compared with participants in a impersonal temper. The influence of te mper on perceptual experiences of likeliness mediates the comparative strength of gain- and loss-framed statements ( Wegener et al. ( 1994 ) in [ 31 ] ) . Participants were more persuaded by gain-framed statements when in a happy temper, but loss-framed statements were more persuasive when they were in a sad temper. The 2nd factors that are impacting willingnes to accept framed message are anterior cognition and experience that may curtail one ‘s willingness to follow a peculiar frame [ 31 ] . Using wellness information context, Rothman and Salovey say that the information presented is understood within the context of an person ‘s experiences and cognition. When the issue is either new or unfamiliar, people have few preconceived impressions about the issue, which should ease the acceptance of the frame emphasized in a recommendation. To the extent that the position provided by the framed entreaty is consistent with one ‘s initial apprehension, one should hold small trouble following the suggested frame. However, when the frame does non fit one ‘s experiences, the unexpected position should arouse systematic processing of the message, but this does non needfully connote that the advocated frame will be adopted. If the initial position is strong plenty, it is possible that people might reframe a message that did non fit their dominant position. Unfortunately, the grade to which people efficaciously reframe messages and their subsequent impact on determination devising has non been tested through empirical observation. Although the abovementioned phenomena are used to explicate the wellness behaviour context, the writer argue that this besides can be used to explicate the information acceptance in broad scope context of societal alteration messages. So far, we have discussed the importance of message bordering use in persuade people to execute recomended behaviour and how they will treat and have the framed information. However, the most of import end of any framed message is to advance a peculiar behaviour. Rothman and Salovey [ 31 ] told that, even when a framed has been processed and assimilated, its peculiar impact on behaviour is contingent on perceptual experience of the behaviour itself. They suggest that beliefs refering both the effectivity of a behaviour ( response efficaciousness ) and one ‘s ability to execute that behaviour successfully ( self efficaciousness ) predict the likeliness of the behaviour being carried out. Based on Protection Motivation Theory they suggest that efficaciousness beliefs may be peculiarly of import when people act in response to a loss framed entreaty. It has been observed in Meyerowitz and Chaiken [ 12 ] survey that revealed adult females who received a loss framed pamplet recommend ing BSE later held the strongest ego efficaciousness beliefs and that to keep strong efficaciousness beliefs partly mediated the influence of the loss frame on behaviour. Based on my reappraisal on old surveies [ 11 ] , it is non all of them utilizing behavior as dependent step. The trouble of longitudinal survey to mensurate the existent behaviour may be the reply of this issue. Studies who involved behavior as the dependent step can be find in Meyerowitz and Chaiken [ 12 ] by comparing immediate step and subsequently step as the placeholder of behaviour and Detweiler et Al. [ 43 ] utilizing sunscreen with SPF order. Most of old research limited their dependen step on behavior purpose or behaviour inclination and this bound the significance of their research findings [ 44 ] . Decision From above treatment, several decision could be drawn. The being of several societal jobs require us to acquire involved in making the expected status in our society by implementing societal selling knowlegde. Social selling attempt to act upon other ‘s behavior including [ 2 ] : a. get downing certain behaviour, b. halting certain behaviour, c. altering certain behaviour. One of communicating attacks that we could utilize to accomplish these purposes is message bordering. It could be implemented in assorted different context of societal job to carry people to execute recomended behaviour. Harmonizing to the taxonomy of bordering effects, message framing can be categorized into end framing, as the presentation of negative framed or positive one could convey different persuasion effects to the message receiver. It can be presented in two alternate signifiers, the first is the signifier in which the result is described in the expected or unexpected results and the 2nd is the signifier in which the result are presented as something achieved or avoided. Assorted surveies in message framing context showed us that there are differential effects of message bordering persuasive power. However it is non easy to make up one's mind which one of the framing message signifiers that most persuasive. It is true that there is a inclination of negative framed advantages than positive one, based on asymetri of negative framed comparison to positive one. But we besides acknowledge the consequence of chairing variable in each specific context. Given the chief inquiry for faculty members is, how we can better the effectivity of a message to the populace in order to increase conformity with the recommended action, the writer conclude that utilizing framed message is an alternate manner to accomplish this end. Furthermore, what type of framing should be used will depend on the context in which the message was conveyed. The extent to which the effectivity of the usage of message framing will besides depends on chairing variable involved. The interaction between framed message with the moderating variables involved is expected will increase the effectivity of the framed message in assortment different contexts. Future researches in more diverse research contexts are still needed to make up one's mind what sort of framed message and specific moderator variables have to be considered.

Dementia: Alzheimer’s Disease and Social Care Diploma

Unit DEM 301 Understand the process and experience of dementia This unit provides you with the knowledge on the neurology of dementia including the causes, difficulties and needs of the person with dementia. This will help to support your understanding of how people may experience dementia. With the development of improved health care and healthier lifestyles, people are living longer. With an increase in an ageing population come age-related conditions such as dementia. Age is not the only cause of dementia as you will discover within this unit. In this unit you will learn about: the neurology of dementia he impact of recognition and diagnosis of dementia how dementia care must be underpinned by a personcentred approach. 1 Level 3 Health & Social Care Diploma 1. Understand the neurology of dementia 1. 1 Causes of dementia The word ‘dementia’ is a term which describes a serious deterioration in mental functions, such as memory, language, orientation and judgement. How ever, the causes are still not yet fully understood. Research in this area is ongoing and to date a number of types of dementia and their causes have been identified. The brain is a complex organ and is divided up into different areas that control different functions within the ody. The brain contains around 100 billion cells. In dementia some of these cells stop working properly. The part of the brain that this occurs in will affect how that person thinks, remembers and communicates. Senile dementia is a term that refers to dementia in people aged over 65. It is not uncommon for people under the age of 65 to develop dementia. This is known as early onset dementia. Cerebral cortex Ventricles Healthy brain Hippocampus Cortical shrinkage Moderately enlarged ventricles Mild Alzheimer’s disease Dementia is a major health condition which affects over 820,000 people in the UK. Worldwide, more than 35 illion people are estimated to have dementia, with 4. 6 million new cases being di agnosed every year. Shrinking hippocampus Severe cortical shrinkage Severely enlarged ventricles Types and causes of dementia Alzheimer’s disease Many people ask if dementia and Alzheimer’s disease are the same thing. The short answer is no. Alzheimer’s disease is the most common cause of dementia. It is responsible for approximately two-thirds of dementia in older people. Dementia is a contentious topic, with many proponents wishing to enable rights and choices of individuals with dementia Alzheimer’s is caused by nerve cells dying in certain areas of the brain. In addition to this, the connections between affected nerve cells deteriorate. As he disease progresses, it spreads and affects cells in other parts of the brain. The cause of the brain cells dying and the deterioration of the connectors is not fully known. 2 Severe Alzheimer’s disease Severe shrinkage of hippocampus Brain affected by dementia and unaffected brain. Vascular dementia Vascul ar dementia is a form of dementia caused by damage to the brain through deprivation of oxygenated blood. Oxygenated blood is carried around your body and brain through arteries. Deoxygenated blood is carried through your body in veins. It is these arteries and veins that make up part of your vascular system.When an organ in your body is deprived of blood, that organ (or part of it) will die. This is what happens to the brain in vascular dementia. The conditions which can cause these problems are preventable and include high blood pressure, heart problems, diabetes and high cholesterol. When supporting people into leading a healthy lifestyle, it is important to bear this condition in mind, in the hopes of preventing the onset of vascular dementia. Understand dementia Rarer forms of dementia Creutzfeldt-Jakob disease (CJD) CJD is a form of dementia caused by prion disease. Prions are proteins which are found in mammals.When these proteins cluster together in the brain, they cause brai n cells to die. When these cells die they leave holes in the brain called spongiosis. Examining the brain under a microscope reveals the cells to appear spongelike. This damage to the brain causes neurological difficulties and dementia. There are four forms of CJD: †¢ †¢ †¢ †¢ sporadic familial iatrogenic variant. Although each of these conditions is very rare, their prognosis is extremely poor. The affected person’s life expectancy is radically reduced, with death occurring usually within 6 to 24 months from early diagnosis. The isease can take many years from the time it infects a person to it causing recognisable symptoms. The cause of Sporadic CJD is unknown and its onset is very fast. It affects people over the age of 50 and can cause death within a matter of months. Familial CJD is an inherited form of the disease. Its symptoms usually affect the person at an early age from 20 to 60 years. Death occurs between two and ten years of symptoms beginning. Iatrogenic CJD occurs as a result of contaminated blood or tissue entering the healthy person’s body. This can take place with corneal transplants, grafts or the use of growth hormones.To prevent the risk of contamination, transplants are no longer taken from people known to have the disease and growth hormones are now developed artificially. Because prions cannot be destroyed using normal sterilisation procedures, any surgical instruments used on people with CJD are not used on other patients. The last form of CJD is known as Variant CJD. This form affects people at a younger age with the average age of death being 29 years. The average time the person is affected by this disease is 14 months. Variant CJD is caused by bovine spongiform encephalopathy (BSE) – a form of prion disease which affects cattle.The person contracts this disease by eating infected beef products. Unit DEM 301 To reduce the risk greatly of infected beef products reaching the market, manufacturer s now remove the animal’s brain and spinal cord from general sale. Functional skills Maths: Recording data This information can be used to record data in a chart and shows the use of working out averages for statistical purposes. Biswanger’s disease This is a form of vascular dementia in which damage occurs to the blood vessels in the deep white matter of the brain. It affects people over the age of 60 and is often as a result of long-term hypertension or high lood pressure. Dementia and learning disabilities Some people with learning disabilities are at risk of developing dementia in adult life. People with Down’s syndrome are at risk of developing Alzheimer’s disease. The risk of Alzheimer’s increases as the person gets older. It is estimated that over half of the people with Down’s syndrome will develop Alzheimer’s disease when they are in their 60s. Fronto-temporal dementia Fronto-temporal dementia is a rare form of dementia. It t ends to affect younger people and is more common within men. The condition is caused by damage to the frontal lobe and/or the temporal parts of the brain.These areas are responsible for the person’s behaviour, emotional responses and language skills. The condition includes those known as Pick’s disease, Frontal Lobe Degeneration and dementia associated with motor neurone disease. Dementia with Lewy Bodies (DLB) Lewy Bodies are tiny protein deposits which are found inside the nerve cells of the brain. These deposits alter the way the brain functions and can be found in people with either dementia or Parkinson’s disease. Approximately four per cent of the older population who have dementia are affected by DLB. This form of dementia has characteristics of both Alzheimer’s andParkinson’s disease. 3 Level 3 Health & Social Care Diploma 1. 2 Types of memory impairment commonly experienced with dementia Within humans, the term ‘memory’ refers to information stored in the brain. Apart from storage, it also includes the retention or keeping and recalling of that information. A person’s brain is extremely complex and can store, retain and recall many, many pieces of information for many, many years. The ease with which the person can remember information will vary depending on the subject, the person and their state of mind. If the information is unusual or interesting, they ay remember this more so than information which is uninteresting or mundane. Memory loss can be defined in different ways depending on the situation it is being used for and the type of memory which is lost. Memory loss can be the inability to retrieve information from the long-term memory. This type of memory loss usually happens when the person is distracted or is not fully concentrating when the memory is formed. Another form of memory loss is when new memories are stored within the brain replacing older memories. Think of your brain as a fil ing cabinet; there is only so much information you can store n it at any one time. To make room for new information, you will need to take out or discard some old information. This type of memory loss is normal and is experienced by everyone. Memory loss can also be described as the fading away of memories. This sort of memory loss can occur with telephone numbers, facts or people’s names if you have not used them for a while. Think back to when you were at school. You would have known the names of many of the students and teachers. Can you recall all of the students’ and teachers’ names now? You may barely remember what their faces looked like and you may be truggling to remember everyone’s names. This could be because you have not had any reason to remember this information. It is not something you have had to use on a regular basis. Memory loss due to the ageing process can be defined as being the shrinking of the hippocampus, which is responsible for the storage of long-term memories. The hippocampus is usually the first part of the brain which suffers damage, leading to Alzheimer’s disease. Hippocampus Location of the hippocampus. Case study Recognising normal memory loss Christine is 43 years old and is concerned about her memory. She is a very busy lady with a stressful job.Christine is walking down the corridor at work heading to yet another meeting. She is going over in her mind what she needs to raise in the meeting and checking through her diary to see what time she needs to leave to get into town for her third meeting of the day. Carol, one of Christine’s colleagues, bumps into her and tells her that Mark has telephoned and would like to see Christine later today at 3. 15pm in the staff canteen. Christine says, ‘OK,’ and carries on to her meeting. 4 At 3. 30pm Christine is sat at her desk writing up the minutes from a meeting last week when the telephone rings.It is Mark; he is in the staff can teen waiting for Christine and he is not very happy. He asks if she had received his message. This jogs her memory and she realises she should be in the staff canteen. She apologises and tells him she is on her way. 1. Explain in detail why you think Christine forgot about meeting Mark. 2. Why is it that Christine is able to remember what was discussed in a meeting a week ago, yet cannot remember what she was told earlier that day? Understand dementia Functional skills English: Writing; Reading In this unit there are a number of examples of case studies. These studies have all been laid out using a uitable format and attention has been paid to ensure that spelling, punctuation and grammar are accurate. You will need to use these skills when writing case studies in your place of work. You will need to read and understand both straightforward and complex texts, and use the information in an appropriate way. Within psychology, memory loss is usually defined as the inability to retrieve declarative memories from the long-term memory. An example of this could be amnesia. The person experiencing amnesia may not be able to remember facts or declarative memories, but they retain their procedural memory which is responsible or remembering skills such as riding a bicycle, reading or talking. People with dementia may experience short-term memory loss. Their ability to store, retain and recall information may be affected due to the damage of the cells within their brain. Short-term memory loss Short-term memory can differ from one person to another. Research has been carried out on this by asking subjects to remember numbers. A list of numbers is read out at approximately one per second. The subject is then asked to recall these numbers and on average it has shown that a person can remember seven consecutive numbers.A person with dementia may have difficulties remembering things that happened only a short while ago. However, the same person may be able to remember things that happened many years ago. Other memory difficulties could include: †¢ †¢ †¢ †¢ †¢ †¢ a difficulty in recognising people or remembering their names the inability to find the right words for things or objects repeating conversations that they have already had asking the same question in a short space of time forgetting appointments or recent events misplacing items, forgetting where they have put things or where they are usually kept †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢Unit DEM 301 the inability to recall what they have had to eat or even forgetting they had eaten the loss of skills such as self-care, washing, dressing, putting clothes on in the wrong order, shopping and cooking the inability to judge time, thinking it is time to get up when it is the middle of the night forgetting where they live becoming unaware of their surroundings forgetting to take medication, possibly thinking they have already taken i t forgetting their disabilities such as getting up to walk even though they are not able, which results in their falling an inability to have empathy which could make the erson appear selfish personality changes – if previously extrovert, they could become introverted and vice versa the loss of social etiquette including making thoughtless comments, being rude or exhibiting sexual behaviours in public. Initially people experiencing these memory losses may feel frustrated or angry with themselves. They are angry because they know that they have forgotten, and frustrated because they are unable to remember as they used to. Activity 1 Memory impairments Think about the people you support. What types of memory difficulties do they experience and how do you know about this? Functional skillsEnglish: Speaking and listening Have a discussion with colleagues about the types of memory difficulties that people you are working with have. Ensure you take an active part in the discussion and that you show effective listening skills. It is important to keep in mind that no two people’s memories will be affected by dementia in the same way. The inappropriateness of their behaviours is caused by a physical change to the brain and therefore the person has no control over it. 5 Level 3 Health & Social Care Diploma 1. 3 How individuals process information with reference to the abilities and limitations of ndividuals with dementia The workings of the brain are very complex. As stated previously, the human brain is made up of around 100 billion cells. In the main these cells are called neurons. It may be easier to think of these neurons as switches which are either switched on or switched off. If the neuron is switched off it is resting; when it is switched on it fires electrical impulses along its body known as the axon. At the end of this axon there is a small part which releases a chemical. The chemical travels over a gap known as the synapse where it turns on ano ther neuron. These chemicals are known as eurotransmitters. There are 60 identified chemicals involved in the brain’s activity. The following are some important neurotransmitters relating to the process of memory and associated functions. Dopamine The chemical dopamine is critical for controlling your body’s movements. If you do not have enough dopamine, you will not be able to move or control your movements very well. Dopamine also controls the flow of information from other areas of the brain, especially memory, attention and problem-solving tasks. Serotonin The chemical serotonin is the neurotransmitter enhanced by many antidepressants, such as Prozac, nd has become known as the ‘feel-good’ neurotransmitter. It has a profound effect on mood, anxiety and aggression. Acetylcholine (ACh) ACh controls activity in the areas of the brain that are connected with attention, learning and memory. People with Alzheimer’s tend to have low levels of ACh in th eir brain. Glutamate Glutamate is vital for making the links between neurons that are the centre of learning and long-term memory. Reading about these chemicals and what they do can help towards explaining how the person with dementia, 6 who has damage to these neurons, has difficulty with their memory.Because the neurons are damaged or destroyed, they are not able to produce or transmit important chemicals which are required for the person to function fully. Nerve cell Synapse Axon Dendrite The amount of electricity the human brain produces when each of its neurons is firing is equivalent to a 60-watt light bulb. Left-sided and right-sided brain The collection of 100 billion cells or neurons in the brain is divided into two halves, known as hemispheres. The right side of the brain is responsible for putting information together – for example, information received from eyes. If you see a lady the information goes from our eyes to the right side of your brain, firing neurons, putting the information together so you are able to say, ‘I can see a lady. ’ The left side of the brain analyses information which is collected by the right side of the brain. It enables you to expand on what you see so you are able to say, ‘I know who that lady is, it’s my sister Michelle. ’ People with dementia who have damage to the neurons on the right side of the brain will have difficulty putting information together. They will be able to ‘see’ things, items or people, but will not be able to make the connection of what those things, items or people are.People who have damage to the neurons on the left side of the brain tend to be affected by depression. They will have more organisational problems and will have problems using language. Understand dementia 1. 4 How other factors can cause changes in an individual’s condition that may not be attributable to dementia Experiencing a loss or reduction in memory does not always i ndicate a form of dementia. There are other health conditions which could affect somebody’s level of memory. These are often referred to as reversible dementias. The part of the brain that has become damaged will determine how the person will be affected.Unit DEM 301 Drug and alcohol induced memory loss The effects of drug misuse including excess alcohol can cause damage to the neurons in the brain, resulting in neurological difficulties including memory disruptions. Myalgic Encephalomyelitis (ME) Conditions affecting memory ME, otherwise known as Chronic Fatigue Syndrome (CFS) or Post-Viral Fatigue Syndrome (PVFS) is a chronic, disabling neurological disorder. It is characterised by persistent fatigue and muscle pain. Symptoms can include cognitive problems such as loss of memory and concentration, recurrent sore throat and enlarged neck glands, disturbed sleep patterns and ersistent headaches. Brain injury Medication Injuries to the brain can be caused by external trauma su ch as a blow to the head, or internal factors such as a result of a stroke or aneurism. The level of brain injury can be anything from mild to severe. This can result in both short-term and long-term or permanent difficulties. Some prescription medications can have side effects which can affect somebody’s memory. Brain tumour A tumour of the brain can be benign (slow-growing, non-cancerous) or malignant (invasive, often growing rapidly and cancerous). sensation hearing movement speech, movement and sensory functions Parietal obe Frontal lobe Occipital lobe Temporal lobe Cerebellum hearing and vision Brain stem Parts of the brain and their primary functions. Diet Some foods can have an effect on a person’s memory. It is believed foods such as those containing vitamin C and sugars can have an effect on memory. Encephalitis Encephalitis is an inflammation of the brain, usually occurring as a result of viral infection. Huntington’s disease Huntington’s diseas e is a hereditary, neurodegenerative disorder of the central nervous system. It can cause emotional, intellectual and movement problems. The course of Huntington’s is characterised by involuntary ovement of the limbs, trunk and face, progressive loss of mental abilities, and the development of psychiatric problems. Huntington’s disease usually appears in middle age (30–50 years) but can develop in younger and older people. Hydrocephalus Hydrocephalus is usually associated with Spina Bifida and is caused by a build-up of cerebro-spinal fluid (CSF) in the brain. This condition can also be caused by infections such as meningitis, premature birth, head injury or stroke. Hydrocephalus can lead to problems with concentration, short-term memory, organisation and coordination. Lack of sleep/insomniaPeople who have difficulty sleeping may experience various health problems including memory difficulties. 7 Level 3 Health & Social Care Diploma Lyme disease Lyme disease is an infectious disease caused by the bacterium Borrelia Burgdorferi. The disease is transmitted to humans through the bite of an infected tick. If left untreated, Lyme disease may affect a person’s memory. Multiple sclerosis (MS) MS occurs as the result of damage to myelin – the protective sheath surrounding nerve fibres of the central nervous system. This damage interferes with messages between the brain and other parts of the body.Parkinson’s disease This is a progressive neurological condition, which can affect the person’s ability in talking, walking, swallowing, writing and memory. Stress Stress is the emotional and physical strain caused by your response to pressure from the outside world. Stress can affect your health in many ways, including memory difficulties. Stroke A stroke occurs because of a disruption to the blood supply to a particular area of the brain, causing damage to that area of the brain. 1. 5 Why the abilities and needs of an individ ual with dementia may fluctuate Each person may experience dementia in different ways.There is no definitive direction or path that the condition will follow and there are no exact timescales in which the condition may progress. You have examined how the person’s condition will deteriorate over time, but during that time it can also fluctuate or come and go. Fluctuation of needs and abilities It is not fully known why somebody with dementia can have ‘good days’ and ‘bad days’. Part of the answer for this could be because we all have good and bad days. This very much depends on how we are feeling, how much sleep we have had, what activity we are doing and how much we want to do that activity. 8When you are having a bad day, everything you do seems to go wrong. Could this be simply because you are feeling so negative? Can your attitude have an effect on the outcome? Think about this for a while. If you do not like doing something, it seems to take fore ver to get it over and done with. The time drags and your level of boredom or uninterest rises. On the other hand, when you are doing something you enjoy, the time rushes by so that before you know it the activity comes to an end. This theory could also relate to the person with dementia. If the person is doing something that is familiar to them, something that they have done many imes and have developed a routine for, the person may appear very confident and able to do it with ease. They may appear to show no signs of dementia. However, take the person out of their familiar surroundings and out of their routine, and their confusion will grow, causing their symptoms to be more obvious. Stress has been identified to have an effect on our memory. In the early stages of dementia, the person may be fully aware that they have forgotten where they have put things. This can cause their stress levels to rise, resulting in added memory difficulties, frustration and confusion.In these earlier stages it is important for you as a care worker to give the person emotional support. Do not be tempted to take over what they are having difficulty with. Help them to calm down and think about what they are doing. The more the person becomes agitated, the greater their difficulties will become. As the condition progresses, the more support the person will require. This will include support with day-to-day activities. You can give support through reminding the person what they need to do. Do not overload them as this will increase their stress and therefore their symptoms. If the person asks you a question and epeats it several times within a short space of time, answer it as though it is the first time you have heard the question. Do not show your frustrations as this will only cause them to become upset when they see how their behaviour is affecting you. In the later stages, the person will become emotionally and physically frail. Their reliance on care will increase to the point where they are no longer able to care for themselves. They may lose their ability to eat, walk or speak, with only the occasional word being shouted or crying out. Understand dementia Unit DEM 301 2. Understand the impact of recognition and diagnosis f dementia 2. 1 The impact of early diagnosis and follow-up to diagnosis For most people, receiving the diagnosis of dementia is very distressing. It is also very upsetting for their family. Many people today still think of dementia as being a condition which causes people to go ‘mad’. It is these negative images that can add unnecessary distress to both the person and their family. funeral through the drawing up of a will. They can be encouraged and supported to sort out any bills and arrange for future bills to be paid for by direct debit so that important bills are not overlooked. The person may ind comfort in keeping busy during the initial stages and they may feel reassured that their future has been planned to meet t heir needs. If you are supporting somebody who is exhibiting any signs or symptoms of forgetfulness, confusion or the inability to find the right words when communicating, it is important that they see their GP. Diagnosis can be difficult to make in the early stages as the symptoms of dementia can develop slowly. They can also be similar to symptoms of other health conditions. The GP or health professional will be able to monitor any pattern of symptoms and undertake tests over a period of time o measure any changes in the person’s mental ability. A brain scan can help with diagnosis; this could be a CT scan or MRI. If a diagnosis is made, the person may be referred to a specialist for further treatment. Early diagnosis The early diagnosis of dementia is essential in order to: †¢ †¢ †¢ rule out other conditions that may be treatable access advice, information and support allow the person with dementia and their family to plan and make arrangements for the futur e. Receiving an early diagnosis of dementia can help the person and their family to plan and prepare for the future. Although there is no cure at present, there are arious medications available which can help improve symptoms and, for some, slow down the progression of the disease. Early diagnosis can help the person to identify and access sources of advice and support for their condition. The early education of the person and their family can help them to develop a better understanding of what the future may hold. The person will have time to put their finances in order and to make wishes for their Discussing the future with the person can help with understanding and accepting. Following diagnosis, the person may want to live as independently as they can for as long as they can.They may not appreciate someone taking over their life in these early stages where they are still able to care for themselves. To enable the person to remain as independent as possible, it may be an idea to encourage them to contact social services, if they have not already done so, to find out what support they could be entitled to. In order to aid their memory the person could place a list of important telephone numbers by their phone. This way they will always know where a telephone number is if they need it. Labels could be placed on cupboard doors to remind them of the contents. Notes could be placed n doors as a reminder to lock them. Lists could be put on a noticeboard of things to do and days to do them on, such as putting the rubbish out for the refuse collectors. 9 Level 3 Health & Social Care Diploma The most important thing to support the person with is in continuing to enjoy their life. Support them to continue with their hobbies or interests. One good activity which will help them in the future is the development of a life history book. Encourage and support them to collect together photographs of people who are important to them, events which hold important memories such as the birth of their first randchild, their wedding day or family holidays. Encourage the person to label each photograph clearly in the book so that they can look back at it at any time and be reminded of good memories. Early diagnosis can enable the early introduction of specialist services. The services may include: †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ †¢ family GPs – referring the person for further tests, reviewing medication district nurses health visitors community psychiatric nurses consultants memory clinics neurologists geriatricians neuropsychiatrists physiotherapists dieticians clinical psychologists speech and language therapists.In the very early stages of dementia the person may have days or episodes of forgetfulness which could be put down to the person being off-colour or having an off day. These episodes may be masked by their ability to recall past events easily. They may be able to give a re ason as to why they cannot remember what you have just said to them. They may say that the television was too loud and they did not hear you. They may even be adamant that you had not told them anything, giving rise to you questioning your own memory. The person may have difficulty understanding or following new ideas or regimes. To cover these ifficulties they may say that they preferred the old way, as it is not as confusing. They could hide occurrences of misplacing items, making out that someone has moved the item or someone has taken it. All of these events, happenings and reasons could be very genuine and indeed the person themselves may believe in what they are saying to be true. If they were all true, the person would be a very unlucky person to be experiencing all of these negative events. The likelihood of them all occurring to the same person in a short space of time would be rather remote. Recording all of these occurrences would enable you nd the team to build up a pict ure of the person’s mental and physical health. Recording times that they In many cases, the earlier the diagnosis and follow-up, the sooner the person can start regaining their life again. This is not to say that they will receive a cure – at this moment in time the only option open to people is acceptance and treatment in slowing down the progress of the condition. 2. 2 Recording possible signs or symptoms of dementia in line with agreed ways of working The health and well-being of a person should be monitored on a regular basis to ensure any resulting needs can be actioned without delay.When monitoring somebody’s condition, it is important to record any findings in line with your organisation’s policies and procedures. 10 Misplacing items can be one of the first symptoms of dementia. Understand dementia needed reminding to do something or became confused or disorientated would enable you to look back and identify frequencies to ascertain if their memor y is deteriorating. Involving the family When supporting somebody with dementia, it may be of immense benefit to involve the family. Encourage and support the family to keep a diary of the person’s symptoms. As a care worker, you may not see the erson as much as their family do and therefore they can help to give you a better picture of the person and their needs. The diary that the family compiles could help them and you to identify changes in the person that may be otherwise missed. The diary could also aid in monitoring any current interventions and the resulting benefits to the person. Unit DEM 301 Suggested monitoring and recording The person’s GP or neurologist may benefit from the information recorded in altering any medications or treatment the person receives. The following areas are those which it is important to monitor and record in the erson, as these will show what changes have occurred and over what period: †¢ †¢ †¢ †¢ †¢ †¢ †¢ memory behaviour personality ability to cope with daily living skills care-giving strategies – have they worked? activities the person enjoys any medications they have taken that day (including prescriptions, over-the-counter and herbal remedies) with details of medication name, dosage, and when and how many taken daily. Case study Identifying dementia Geoffrey had been living in sheltered housing for a number of years following a stroke. His confidence in his own abilities since the stroke had been very low and he as often heard mumbling to himself. Geoffrey is visited every morning by the warden Leona to check that he is OK. Geoffrey always met Leona on his doorstep as he put out his empty milk bottle. One morning Geoffrey was not on his doorstep as usual, which concerned Leona. She rang his doorbell and waited. Geoffrey came to the door and greeted her with his usual smile. ‘Are you all right Geoff, you haven’t put out your empties? ’ she asked . Geoffrey nodded, scratched his head and replied, ‘I’m fine, I haven’t finished the bottle yet as I didn’t drink much yesterday. ’ ‘As long as you are all ight then,’ Leona replied, waving goodbye as she turned and walked away. The following day, once again Geoffrey was not on his doorstep. Leona rang the doorbell again and was greeted by Geoffrey still wearing the same clothes as he had on the previous day. ‘No milk bottles to put out again today? ’ she asked. Geoffrey agreed, saying he had decided to drink more water: ‘I’m cutting down on my cups of tea, getting a bit of a beer belly,’ he joked. Leona was a little concerned but then shrugged it off, believing Geoffrey was always getting his words mixed up, due to his age. As the weeks passed Geoffrey had days when he did ot put out any empty bottles, and then he would put out three or four at a time. Some days Geoffrey looked unwashed or unshaven, whi ch was unlike him. Leona was concerned but on talking to Geoffrey she felt she was worrying about nothing. Geoffrey’s behaviour had been up and down for over 12 months when Leona announced she was changing her job and a new male warden, Patrick, would be taking over. Geoffrey did not take this news very well and he became agitated, blaming Leona for the death of his wife. Leona was very shocked by this, especially as Geoffrey had never been married. She mentioned this to Patrick during her andover and explained she thought something was not quite right but she could not quite put her finger on it. Patrick asked how long had this been going on for and then said he would take care of it. 1. After visiting each resident in the sheltered housing, what actions should Leona have taken? 2. What concerns would you have had regarding Geoffrey? 3. How would records of Leona’s visits to Geoffrey have been of benefit? 4. What actions should Patrick take now, especially regarding G eoffrey? 11 Level 3 Health & Social Care Diploma The diagnosis of dementia does not generally occur following the first visit to the GP.Generally there is a process in which the person goes through in order to receive a definitive diagnosis. During this process it is vital that any potential signs of dementia are reported following your organisation’s policies and procedures, and in line with government guidelines. National Institute for Health and Clinical Excellence (NICE) NICE has devised detailed guidelines in supporting people with dementia. This also includes the early diagnosis of dementia. Within this guide it states that primary health care staff should consider referring people who display any signs of mild cognitive impairment (MCI) for ssessment. MCI is a relatively new term to describe those who show some difficulties with their memory but do not have dementia. Studies have shown that 50 per cent of people with MCI go on to develop dementia later in life. NICE al so includes in its guidelines information regarding the diagnosis and assessment of dementia. It states that diagnosis should only be made following assessment to include: †¢ †¢ †¢ †¢ the person’s history a cognitive and mental state examination a physical examination a review of all medication including over-the-counter remedies. As a care worker, your input in reporting possible signs f dementia would go towards the person’s history. Your input can help them receive the care that they need, when they need it. It is for this reason that you should ensure timely reporting of any observations you make or concerns you may have. To report a concern, you must follow your organisation’s guidelines. If you are unsure of what these guidelines state, you should speak with your line manager as soon as possible to ensure your actions follow best practice for the person. In general terms, most reports are given to a designated member of staff. This may be your line manager, supervisor or manager.Your verbal report should be factual and to the point. Try to avoid giving your own opinions. Although opinions can help to look 12 at and clarify various issues from differing viewpoints, they can also be unhelpful if used inappropriately. Once you have given a verbal report, you should back up what you have discussed with the appropriate person, by writing a written report. Again your written report should be factual and detail all of the actions you have taken. Some reports will have an increased impact if they are delivered in a certain way. For example, you may have been asked to monitor somebody over a set period of ime and report back your findings. Simply writing those findings down may not have the same effect as plotting your findings on a graph. A graph or chart will give a visual representation of your findings, which may give a better explanation as to the person’s mental state and any changes that have occurred. 10 Inc idence of wandering 2. 3 Reporting possible signs of dementia within agreed ways of working 8 6 4 2 0 Week Reporting occurrences such as wandering can have a greater impact if plotted on a graph. Activity 2 Process of reporting Speak with your manager or line supervisor to identify our organisation’s policy and procedures on the process of reporting information. Functional skills English: Speaking and listening This discussion can be either formal or informal and can give you the opportunity to practise taking part in a one-to-one discussion. Understand dementia Reflect Imagine you, or someone you love, had just been given the news that you or they had dementia. Being honest, what would be your initial thoughts or feelings? Do you feel it is OK to feel or think this way? Is there anything you feel that society can do to help with the acceptance or understanding of dementia?Unit DEM 301 2. 4 The possible impact of receiving a diagnosis of dementia on the individual and their f amily and friends Receiving news which you know will have a major impact on your future and those who are close to you can be very frightening and overwhelming. The person may feel very insecure at the time, despite possibly having family and friends around them. The impact on the person and their family and friends can vary; some may see it as a relief that the cause of their difficulties has been diagnosed, while others may be in disbelief, preferring not to acknowledge what they have been told.Many older people fear becoming a burden on their family more than they fear death. 13 Level 3 Health & Social Care Diploma Feelings NICE requirements The person may be shocked on first hearing the diagnosis; this can often turn to denial. One theory on loss or grief shows that the process usually goes through five stages including: NICE guidelines state that following a diagnosis of dementia, health and social care professionals should provide the person and their family with written infor mation regarding: 1. 2. 3. 4. 5. †¢ denial anger bargaining depression acceptance. It is felt that the person may not necessarily go through ach stage in this particular order, and indeed can go backwards and forwards, repeating various stages a number of times before reaching and remaining at acceptance. The person may experience fear or the concern that they will lose control over their lives and their future. They may also fear becoming a burden on their family and friends. Some may feel guilty, blaming themselves, thinking that they could have prevented their condition happening. Whatever feelings the diagnosis creates in the person, you should encourage and support them to talk about their feelings. Some may not feel comfortable voicing heir feelings to their family and friends, preferring to talk with someone they do not know. The person’s family and friends should not be upset by this decision and should respect the wishes of their loved one. Initially the person may simply want to curl up and lock out the world around them. Family and friends need to be supportive in these situations. Telling the person to ‘get a grip’ or that what they are doing is silly is not going to be of any benefit – in fact, it will often make things worse. 14 †¢ †¢ †¢ †¢ †¢ †¢ †¢ the signs and symptoms of dementia the course and prognosis of the condition treatments ocal care and support services support groups sources of financial and legal advice, and advocacy medico-legal issues, including driving local information sources, including libraries and voluntary organisations. Any advice and information given to the person and their family should be recorded in the person’s care notes. The confidentiality of the person should be respected if they decide they do not wish any information to be given to their family. Understand dementia Unit DEM 301 3. Understand how dementia care must be underpinned by a per son-centred approach 3. 1 Person-centred and nonperson-centred approaches to ementia care It is important to remember that people with dementia are individuals first, with their condition of dementia coming second. They may also be mothers, fathers, brothers, sisters, sons or daughters. They may have led a fulfilling life before the condition of dementia took hold of their memories and personality. How could the care of any person be anything other than individual, specific to their needs, involving and respecting their views on how they want their care to be delivered? Person-centred care is a way of providing care with the person at the centre of everything you do. Another way f describing it is individualised care – care that is given to the person according to their needs, wishes, beliefs and preferences. One would hope that gone are the days when everyone in a care home got up at the same time, ate their breakfast at the same time, got washed and dressed at the same time , even going to the toilet at the same time. These regimented routines of care homes were devised for the benefits of the staff, not the people being supported. The day revolved around tasks, duties that had to be met, more often than not putting the people’s specific needs at the end of the priority list.If you needed support, which type of care home would you choose? Earlier on in this unit we looked at how dementia can affect people and identified that no two people would necessarily follow the same process through the condition of dementia. This being the case should automatically exclude all people with dementia being treated in the same way. Studies have shown that a person-centred approach can help reduce agitation in the person with dementia. Agitation is often caused by the person’s frustration in not being able to express themselves. The expression could be one of sadness, pain, thirst, hunger or tiredness.Other studies on a person-centred approach have shown that the person often remains living in their own home for longer. A person-centred approach can also ensure that the person does not endure the degrading, discriminatory and abusive practices which could otherwise occur. People and all those involved in their care should feel safe, feeling that they are a part of what is going on, receive continuity of care, have purposeful goals which they are supported to progress towards and have a feeling that they do matter. How does a person-centred approach benefit the person? As a care worker, you should identify the specific needs f the person with dementia. These needs could arise from their gender, ethnicity, age, religion and personal care. Other needs could also arise from their physical health or physical disability, any sensory impairment, communication difficulties, problems resulting from poor nutrition, poor oral health or learning disabilities. The person’s needs should be identified with input from the person, their fami ly, friends and any other persons that may be important in that person’s life. Once the person’s care needs have been identified, plans should be made to draw up a support plan which will describe how those needs will be met.As with the assessing of needs, the person must be at the centre of the support planning process. Nothing should be planned for them without them. 15 Level 3 Health & Social Care Diploma Case study The importance of a person-centred approach It is approaching lunch time but Mrs Lancaster is not really hungry. She would like a drink and would prefer to remain in her room as she is comfortable and her favourite television programme is about to start. Mrs Lancaster is not able to voice these preferences verbally, as she finds it very difficult to verbalise and so has given up trying. Tracy, one of the senior care workers, entersMrs Lancaster’s room and makes her jump, as Mrs Lancaster did not hear Tracy entering. ‘Come on then love, your dinner’s ready,’ Tracy tells Mrs Lancaster. She then promptly holds Mrs Lancaster under the arm and says, ‘Up you come chum. ’ Mrs Lancaster reels back in pain and cries out. Tracy responds saying, ‘Don’t be silly, now come on, your dinner’s going to get cold,’ again pulling up under Mrs Lancaster’s arm. Mrs Lancaster pulls away, which makes Tracy annoyed. She bends down and puts her face close to Mrs Lancaster’s and says, ‘I’ll leave you here to starve if you carry on like that. ’ Mrs Lancaster cannot take any more bullying or hreats from Tracy so she brings her head back and then sharply forward, head-butting Tracy. ‘You nasty woman, you ought to be locked up doing things like that! What have I ever done to you to deserve treatment like that? ’ Tracy shouts, leaving the room with a bloodied nose. 3. 2 Different techniques to meet the fluctuating abilities and needs of the individua l with dementia people with dementia. Seize the challenge and look forward to the unexpected. As the saying goes, ‘variety is the spice of life’. 1. Explain six things in detail that could have possibly led to Mrs Lancaster head-butting Tracy. 2.What should Tracy have done to prevent this occurrence? 3. Describe a way Mrs Lancaster could be supported to communicate in future. 4. Describe how her care could be given using a person-centred approach. Knowing the person Many people with dementia are able to live in their own homes for most of their lives with care being given to them by their families. It is important that the person is supported to recognise that the condition that they have is not the fault of anyone, especially not their own. When supporting the fluctuating needs and abilities of the person, it is very important that you recognise that hey are not responsible for the things that they do. It is not the person who is spitting out their food; it is the cond ition’s effects on the person’s ability to communicate which is preventing them from saying, ‘I don’t like that. ’ It is not the person who is constantly wandering around the environment; it is the condition that has taken away their spatial awareness. As a support worker, you must focus on the skills and abilities that the person has, rather than those that they have lost. Ensure that you are fully aware of and respect the person’s background, their history, likes and dislikes.Be prepared for changes and adapt a flexible approach. No two days may be the same in supporting 16 By learning about each person’s history and background, you can design the care and support you provide around their specific needs. For example, the person may have been a sergeant major in the army, which could account for his shouting out his orders. The person may have experienced a traumatic event in their lives such as being trapped in a collapsed building, which could account for them becoming agitated and screaming when the lights are switched off in their bedroom at night. Without this background knowledge, nd more importantly understanding, the person who shouts his orders may be wrongly labelled as being noisy and dictatorial. The person who screams in the dark may be wrongly labelled as disruptive and attention-seeking. A person’s physical condition can be affected by their dementia. Their mobility may be reduced as may the person’s ability to maintain their own personal care or diet. Combining these factors can increase the person’s susceptibility to other illnesses such as chest infections or physical conditions such as pressure sores. Understand dementia Ensure the person’s support plan is kept as up to date s possible and shows alternative methods to use for various fluctuations in their support needs. Support other care workers by sharing proven practices. As a support worker, you may have identif ied triggers to somebody’s behaviour. Do not keep this information to yourself; inform other care staff and have it recorded in the person’s support plan. This would be the same for identifying any new method or way of supporting the person to meet their fluctuating needs. Provide a stable environment and suitable surroundings One of the main triggers resulting in somebody with dementia becoming agitated and confused is a change n their routine. Any changes to the person’s life or daily routine can cause them to become unsettled, which could lead to inappropriate behaviours. To ensure stability it is important to: †¢ †¢ †¢ †¢ have consistent, regular staff. Unfamiliar faces can cause the person great upset. Ensure they know the staff and ensure the same staff member provides care to the person in their own home maintain a familiar environment. It is an eventuality in everyone’s life that their surroundings will change at some point. Th is could simply be through redecoration or changes in furniture. Where possible, if decoration needs to be undertaken within the erson’s environment, try to make the new decor similar if not the same as it was previously. If relocation is required for the person, ensure this is minimised by confirming the suitability of the new location. This will save on the person needing to be relocated again due to the environment not being suitable for their needs ensure the person is in a non-stressful, constant and familiar environment establish a regular routine, regular physical activity and adequate exposure to light to improve any sleep disturbances. Specific strategic support People with dementia may behave in a way that is completely out of character.Some of these behaviours can be disturbing to onlookers and especially the person’s family, seeing their loved one behaving in a way they have never seen before. The following are examples of the types of behaviours people wit h dementia may display. Unit DEM 301 Wandering People with dementia may tend to walk or wander apparently aimlessly for a variety of reasons. This could be because they are bored or they feel they need to escape or get out of the environment they are in. The person may simply need to use the bathroom but cannot remember where it is. On occasions this wandering may take them out of the house or even own the street. This could lead them into becoming ‘lost’ if they are unable to find their way back home. For most people, wandering may only be a short phase that they go through. And, although little comfort at the time, people with dementia often retain a good degree of road sense and are seldom involved in traffic accidents. To reduce incidents of wandering, promote physical activities to reduce the person’s boredom and to help use some pent-up energy. What dangers could wandering have for somebody? Incontinence Loss of bowel or bladder control usually occurs as th e dementia progresses. Sometimes these accidents may appen because the person cannot remember where the bathroom is or cannot get there in time. If the person does become incontinent, you need to help them to maintain their dignity and respect by being understanding and reassuring. Incontinence pads, sheaths or catheters can be obtained to help keep the person free from unnecessary embarrassment and frustration. 17 Level 3 Health & Social Care Diploma Agitation Agitation can include behaviours such as sleeplessness, verbal or physical aggression and irritability. These types of behaviour often increase with the stages of dementia and can become quite severe.Agitation may be triggered by a variety of factors including environmental factors, fear and tiredness. Most often agitation is triggered when the person feels as if they are no longer in control of the situation. You can help reduce episodes of agitation by reducing the intake of caffeine, sugar and processed foods. The reductio n of noise or crowds can also help, as does the maintenance of the person’s routines. is a list for further reading which will help your knowledge and understanding further. Doing it well Meeting the needs of people with dementia †¢ Know the person well, including their history and background. Keep their support plan up to date. †¢ Provide a stable environment and suitable surroundings. †¢ Ensure specific strategic support. †¢ Improve your knowledge and understanding. Repetitive speech or actions It is a common occurrence with those who have dementia to repeat a word, statement, question or activity more than once in a short amount of time. This repetition can be frustrating and stressful to the care giver and their family. Repetition is often as a result of the person becoming anxious, bored, fearful or agitated. One way of reducing this is to provide them with reassurance. Alternative strategies could include isplaying reminders of activities around thei r home such as ‘Dinner is at 6:30pm’ or ‘Dave comes home at 5pm. ’ This may assist with reducing anxiety and uncertainty about anticipated events. Paranoia People with dementia may suddenly become suspicious, jealous or start accusing others of things. When this happens, the person will believe in what they are saying and therefore you should not try to argue or disagree with them. Stay calm and encourage the person to calm down. Ask them what is wrong and let them know that you are there to help them. Improve your knowledge and understanding Many organisations have helpful information on nderstanding and supporting people with dementia. Set yourself a goal to develop your practices through research, talking to people who are in the early stages of dementia or family and friends of those who have it. Learning about dementia from those who have firsthand experience is often more beneficial than reading a book, although books have the benefit of being portabl e and accessible at any time. At the end of this unit there 18 3. 3 How myths and stereotypes related to dementia may affect the individual and their carers Dealing with the difficulties that come with the diagnosis of dementia is not going to be made any asier with the myths and stereotypes that society has created. Within society, dementia is often seen as a condition that causes the person to require 24-hour care in a secure environment so they cannot get out and wander aimlessly. People who are newly diagnosed with the condition are sometimes disbelieved because they appear ‘normal’ and are dribbling or babbling. Some myths or falsehoods can create an unrealistic hope within the person or their family. Some of these untruths profess to offer cures or preventions. The following information can help you to identify fact from fiction. Q – Can using aluminium saucepans affect the risk of eveloping Alzheimer’s? A – No, there is no convincing evidence that cooking with aluminium saucepans increases the risk of developing Alzheimer’s. Q – Is it true that people who follow a healthy lifestyle reduce the risk of developing dementia? A – Yes. Research shows that people who enjoy a healthy lifestyle by eating a well-balanced diet, not smoking and taking regular exercise reduce their chances of developing dementia. Recent research has shown that being healthy in mid-life can help lower our risk of developing dementia as we age. Understand dementia Q – Can Ginkgo Biloba help people with dementia? A – No.Unfortunately, the latest evidence shows that Ginkgo Biloba has no benefit for people with dementia. Q – Does eating meat have any connection with developing Alzheimer’s? A – There is no convincing proof that eating meat is linked to developing Alzheimer’s. Q – Do people who have dementia become childlike? A – No; it is very important to remember that people wi th dementia are adults and should be treated with the dignity and respect other adults receive. Many people, quite wrongly, have stereotypes when it comes to dementia. It is these stereotypes that can become the fear of reality for people newly diagnosed ith dementia. Sometimes it is the person’s own stereotyping of dementia that they have to face. Facing and resolving this can only occur with education and acceptance. Unit DEM 301 3. 4 Ways in which individuals and carers can be supported to overcome their fears Research has shown that many people fear the thought of developing a form of dementia. The worry of losing one’s identity, independence and mind for some is a greater fear than the fear of death. Worrying about a condition that you may not develop seems futile. Worrying about a condition which you have developed will not do your health much good.Simply telling somebody who has received a diagnosis of dementia or their family not to worry is insufficient. Advis ing the person and their family to talk about their fears will help towards them overcoming any uncertainties. Ignoring the condition or pretending it is not happening is simply denial. To help all those involved to overcome worries for the future, the person and their family should be supported to learn the truth, what they can expect from the future. Activity 3 Understand the condition What’s in a name? The person and their family should be supported to develop a true understanding of the condition they are acing. Information can be obtained from GPs’ surgeries, health centres, libraries and the Internet. When obtaining information from books or the Internet, you need to ensure it is up to date and reliable. Internet sites run by organisations such as the Alzheimer’s Society or NHS Direct can be seen as reliable sites, as can educational sites such as those ending with . org. Some of the facts relating to dementia do not always make for easy reading; however, the person and family need to know what to expect. Skirting around these issues will not enable the preparation that may be required. This could lead to a bigger shock when it ctually happens, which would not do anybody any favours. Devise a simple questionnaire which you can either send out to colleagues or staff within your organisation, or give to your family and friends. Ask questions such as, ‘Give the first word that comes into your head when you hear the word â€Å"dementia†. ’ Include a few questions that relate to the myths around dementia to see if your colleagues or family know the truth or not. Compile the results from your questionnaire and discuss these with your assessor. People’s inappropriate views or opinions on dementia often arise from ignorance. For many, the only portrayal hey have of dementia is that which they see on television. Storylines shown in films are often of people in the advanced stages of dementia. If this is the only per spective you have, then there is no wonder why society looks at this condition in the way it does. If the individual newly diagnosed with dementia or their family has only ever known of dementia in this way, then their fears will understandably be heightened. Encourage future planning Once the person and their family are aware of how dementia may affect the future, they should be supported to think ahead and be ready for the changes that will follow.The person and their family will need to prepare things not just materially but emotionally as well. At some point the person may require support with toileting and other personal care needs. They may not want their family attending to this sort of personal care, 19 Level 3 Health & Social Care Diploma preferring to have a care worker attend to their needs at home. There may come a point where the person is unable to stay in their own home due to the advancement of their condition. The fear of this eventuality can create a lot of worry f or them. Supporting the person to plan for this can help allay those fears.They and their family could be supported to identify a care home which the person may move into in the future. Simply knowing that this step has been arranged can help them feel a little easier, knowing that they will not be placing a burden on their family. Making life easier The person may have received a diagnosis of dementia because of their current memory difficulties. The family may worry that the person will not be able to cope very well at home, forgetting to take their medication, forgetting to lock doors and windows when going out and so on. These sorts of worries for the family will not necessarily lessen.As each day passes they may worry. As each day passes the person’s condition may increase, making the family worry all the more until it becomes a vicious circle. To help reduce these fears, the person can be supported to remain as independent as possible at home with the use of notes, labe ls, lists – any memory joggers. The environment in which the person lives can be made safer – for example, installing grab rails or an emergency pull cord system. Making these minor changes to the person’s home may reduce the natural worries of the family with regards to their loved one’s safety. Dealing with the diagnosis of dementia is never going to e easy. Some people and their families may benefit from receiving counselling. This can often b