Is dementia a diagnosis or a syndrome

Sue J

Registered User
Dec 9, 2009
8,032
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Longer term care and support at home, in the community is what is needed and more and better homes providing good respite and or longer term care. Joined up care not, fractured resources that the over stressed carer or confused sufferer has to wade their way through.

Good care systems should go and find those where there is need, not wait for those in need to come knocking on the door.
 
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LYN T

Registered User
Aug 30, 2012
6,958
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Brixham Devon
Listening, is how you keep people at the centre of services. Once people are listened to and then understood then the theories can be written, not the other way around.

Thank you for what you have written, my poor cognition, since the start of my own symptoms makes it difficult to follow but in my view the Professionals are making life more difficult for themselves and those they care for with theories.. The others, who are forced to work to a tick box computer screen make me feel less of a person, individual, make me angry and frustrated.

.

I totally agree with Sue J-and that's from a Carers point of view. When my late Husband needed help I came face to face with people who ticked boxes and did little else. I didn't need theories -I needed practical help. Whether Pete had a syndrome or a diagnosis wouldn't have mattered. I needed professionals to LISTEN. I also needed professionals to BELIEVE me when I said that my poor Husband was violent. (they did eventually as he violently attacked so many people). I digress-

''The theories that we have thought about is the social model of disability, which basically sees society as disabling people and not the person. So looking at ways of how to make it people friendly for people who have dementia and also looking at disengagement theory again how society may have made people feel that they need to isolate themselves from society and what ways we can prevent people from disengaging or feeling isolated.''


Re your theory (bolded above) Up to a certain point whilst Society may go some way to disable a Dementia sufferer-it's the actual Dementia that slowly isolates both sufferer and Carer. I don't think that people disengage themselves knowingly but the disease can get to a certain point when due to possible behaviour problems and physical difficulties engaging in society is very difficult. My OH didn't even want to go out; you see he was scared of the 'bad people who were out to get him' and noise and a whole list of things he couldn't understand anymore. So, however much 'prevention' is talked about, in practice (at least in Pete's case) nothing would have helped him. He was lost in his own world and I'm afraid theories and models of isolation would have been lost on him-me too! All I ever wanted was HELP (bathing etc) and a sympathetic ear from professionals who had experience of the demands of Dementia.

SueJ is quite correct when she states that 'when you have seen one person with Dementia. you have seen one person with dementia'. It's never 'one size fits all'-so I don't know how sufferers can be pigeon holed into one working model.

' I think it is important from a professional point of view to understand the difference especially when discussing with someone who has dementia and to also show that you have knowledge around it (I am sure you would not want someone turning up who has no knowledge).'

Re your statement (my Bolding). Does Dementia need a 'label' as such? Whether a professional calls Dementia a 'syndrome' or a 'diagnosis' bears no weight with me. It certainly wouldn't indicate to me that the person had 'knowledge'- and such 'jargon' can be slightly irritating. Much more important would be a person who really has hands on experience with Dementia and can understand the emotional trauma that this terrible disease can bring to sufferers, their families and Carers.

As always, just my opinion.

Lyn T
 
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larzst

Registered User
Feb 16, 2015
13
0
They do not start charging straight away it is mean tested. If you are staying on reablment and are not being tranferred then we will support you in finding private carers and if a financial assessment is needed and you have savings over a certain amount of money then you may have to pay some amount towards the care but in most cases people do not have up to the financial threshold.

If it is transferred to long term services, during that there will be carers still in place.
People providing the service (Carers) will not be the ones to determine whether a person is back to baseline that is what a reablement social worker or a CMO is there for and they will reassess and ask the service user what their feelings are and what they would like us to do now and in agreement they will come to a decision.

I think we are slyly coming off topic now though.

"Reablement will never leave you without any services unless you have returned back to baseline."

After 6 weeks they just start charging you according to the local implementation of

Also how do the people providing the service always know the baseline, the person concerned may not have been on their radar before admission to hospital, or is baseline really defined 'Now OK, no more help needed'?
 

nitram

Registered User
Apr 6, 2011
30,248
0
Bury
"They do not start charging straight away it is mean tested."

I did not say they did, I allowed for the 6 free weeks that my edit shows are not always honoured.

Also the financial assessment is not national like CRAG, it only has to conform with the link I posted which uses may several times leaving a bit get out out.
 

Beate

Registered User
May 21, 2014
12,179
0
London
Most people get absolutely no help after the initial 6 weeks. We had to ask for assessments and were told at the beginning that he seemed fine so no help was forthcoming until at least a year later. But of course, if reablement waste time debating theories about what dementia is, it shouldn't surprise us. The care system is very complicated, and carers face obstacles at every turn. We have to shout to get help for our loved ones and we are not listened to, instead someone decides for us how reabled or in need of help someone is. Have you any idea how frustrating these box-ticking exercises are? "You say he can make himself a sandwich? He's fine to be left alone then." Maybe once you have worked with carers for a while you will see where the real problem lies. I wish you the best of luck.
 

larzst

Registered User
Feb 16, 2015
13
0
Hi Lyn,

May I start of by saying I am sorry to hear about what you went through and may his soul rest in peace, you seem like a very strong person and my I put my hat up to you and all of you on here. I am greatful for your opinion including Sue J and I will definetly be adding this into my presentation. It also was something I discussed about the tick box assessment and I do believe that it needs to be more person centred and I am happy that I am seeing this now as a student rather than a full time professional.
Unfortunately it is a requirement for us to be able to show our knowledge around laws and theories but, I decided to do something different which is actually why I am using this blog to find out people's responses, going to a few homes especially designed for people who have dementia and also going to a memory clinic again who deal with people who have dementia and this is all so when I do go out on my first visit I can at least put all of that in my pocket as well as listening to the service user.

Once again, thank you as I will be feeding this back into my presentation

I totally agree with Sue J-and that's from a Carers point of view. When my late Husband needed help I came face to face with people who ticked boxes and did little else. I didn't need theories -I needed practical help. Whether Pete had a syndrome or a diagnosis wouldn't have mattered. I needed professionals to LISTEN. I also needed professionals to BELIEVE me when I said that my poor Husband was violent. (they did eventually as he violently attacked so many people). I digress-

''The theories that we have thought about is the social model of disability, which basically sees society as disabling people and not the person. So looking at ways of how to make it people friendly for people who have dementia and also looking at disengagement theory again how society may have made people feel that they need to isolate themselves from society and what ways we can prevent people from disengaging or feeling isolated.''


Re your theory (bolded above) Up to a certain point whilst Society may go some way to disable a Dementia sufferer-it's the actual Dementia that slowly isolates both sufferer and Carer. I don't think that people disengage themselves knowingly but the disease can get to a certain point when due to possible behaviour problems and physical difficulties engaging in society is very difficult. My OH didn't even want to go out; you see he was scared of the 'bad people who were out to get him' and noise and a whole list of things he couldn't understand anymore. So, however much 'prevention' is talked about, in practice (at least in Pete's case) nothing would have helped him. He was lost in his own world and I'm afraid theories and models of isolation would have been lost on him-me too! All I ever wanted was HELP (bathing etc) and a sympathetic ear from professionals who had experience of the demands of Dementia.

SueJ is quite correct when she states that 'when you have seen one person with Dementia. you have seen one person with dementia'. It's never 'one size fits all'-so I don't know how sufferers can be pigeon holed into one working model.

' I think it is important from a professional point of view to understand the difference especially when discussing with someone who has dementia and to also show that you have knowledge around it (I am sure you would not want someone turning up who has no knowledge).'

Re your statement (my Bolding). Does Dementia need a 'label' as such? Whether a professional calls Dementia a 'syndrome' or a 'diagnosis' bears no weight with me. It certainly wouldn't indicate to me that the person had 'knowledge'- and such 'jargon' can be slightly irritating. Much more important would be a person who really has hands on experience with Dementia and can understand the emotional trauma that this terrible disease can bring to sufferers, their families and Carers.

As always, just my opinion.

Lyn T
 

LYN T

Registered User
Aug 30, 2012
6,958
0
Brixham Devon
If it is transferred to long term services, during that there will be carers still in place.
People providing the service (Carers) will not be the ones to determine whether a person is back to baseline that is what a reablement social worker or a CMO is there for and they will reassess and ask the service user what their feelings are and what they would like us to do now and in agreement they will come to a decision.

I think we are slyly coming off topic now though.

Just me being sly;)

Re the bolded section above. One BIG flaw with this:eek: What happens if the 'service user' does not have the ability to communicate their feelings or agree with the proposals? Shouldn't the Carers opinion be taking into account rather than a SW or CMO? The Carer would have more hands on experience and insight regarding the 'service user's' needs.

Lyn T
 

LYN T

Registered User
Aug 30, 2012
6,958
0
Brixham Devon
We were referred to reablement. It was completely useless. Someone came inspecting the house and suggesting such clever things like calendars on the wall and notes on the kitchen cupboards. And asked what hobbies he had. I had to fight to get him referred to longer term services which is where he should have been in the first place.

Ha! See my point entirely Beate. We had a person from OT turn up (after waiting for 7 weeks and my doubly incontinent OH hadn't had a bath/shower during that time:eek:) OT professional bounced in and saw loads of books. ' Oh Mr T! What are you reading? What a lot of books'!

Er hello:eek: Books were there for OH to tear up (just paperbacks)! Yet again one size is meant to fit all:eek: My poor Husband hadn't been able to read for years. However, the professional (who did know that Pete was at severe stage) just assumed something that she shouldn't have. It was a case of retired English lecturer=books=reading:eek:She had absolutely no knowledge IMO-at least she admitted to me that she had no first hand experience of friends/family members with Dementia. Perhaps she should have worked for a while as a CARER.
 

CollegeGirl

Registered User
Jan 19, 2011
9,525
0
North East England
Like Kevinl, I don't understand the question either, I'm afraid.

Did you mean to ask whether it's a disease or a syndrome?

The diagnosis is the act of identifying a condition, not the type of condition itself.

I'm sorry, but I'm confused :confused:.
 

stanleypj

Registered User
Dec 8, 2011
10,712
0
North West
I think that there is far too much emphasis on, and belief in, the validity of labels.

In reality whatever labels are thrown at you (and there's an increasing number of labels that can be thrown) what all the people throwing them and you really need to know is what can the person in question do/not do and how might they be helped to cope with the things they can't do and preserve for as long as possible the ability to do the things they can do.

I feel sorry for you larzt because you obviously asked your question in good faith and this should be a a good place to come and learn about dementia. I hope you'll stick around - and that you develop a thick skin.:) All credit to you for choosing to work in this challenging area.
 

Kevinl

Registered User
Aug 24, 2013
6,306
0
Salford
We our having a debate on whether Dementia should not be classified as a diagnosis and should be classified more as a syndrome. We have decided to present our arguments at my placement and it would be great to recieve some people's opinion. It will be brilliant if some theories and law can be included aswell.

Wow larzst now you can see what a ranty lot we can be sometimes :D
Anyway back to the point, can you explain what you actually mean by your original question. What is the meaning of the 2 options you give of dementia either being a "diagnosis" or a "syndrome". Is there some jargon use of these 2 words that we're all missing, I still can't get my head around what you actually mean.
K
 

Sue J

Registered User
Dec 9, 2009
8,032
0
Wow larzst now you can see what a ranty lot we can be sometimes :D
Anyway back to the point, can you explain what you actually mean by your original question. What is the meaning of the 2 options you give of dementia either being a "diagnosis" or a "syndrome". Is there some jargon use of these 2 words that we're all missing, I still can't get my head around what you actually mean.
K

I understood Larzst to mean 'disease' or 'syndrome' as someone else suggested above, but maybe I'm wrong in that?
 

stanleypj

Registered User
Dec 8, 2011
10,712
0
North West
Being ranty on behalf of the person you care for in a specific situation is one thing.

Being ranty, at times, with the universe is also understandable.

Being ranty with someone who is genuinely seeking information from people who might know seems, to me, to be something we should try to avoid.
 

Kevinl

Registered User
Aug 24, 2013
6,306
0
Salford
I understood Larzst to mean 'disease' or 'syndrome' as someone else suggested above, but maybe I'm wrong in that?

I'm just not getting it, I've been to dictionary corner and asked Susie Dent and I can only see that if you come to see Dr Kev with a sore leg and I x-ray it, find a bone in 2 pieces that should be 1 piece then I diagnose that as a broken leg. Alternately you turn up saying you feel bloated, weepy and angry then tell me your period starts in a few days I diagnose it a premenstrual syndrome.
Dementia is a disease, it has physical changes in the brain which can be seen, it is a syndrome in that it has a collection of symptoms which can be tested for and it can be diagnosed based on the results of the test.
The original question is:
We our having a debate on whether Dementia should not be classified as a diagnosis and should be classified more as a syndrome. We have decided to present our arguments at my placement and it would be great to recieve some people's opinion. It will be brilliant if some theories and law can be included aswell.
How can you debate if dementia can be classified as either a diagnosis or a syndrome? It is a syndrome when it has symptoms and a diagnosis when the syndrome are determined by a doctor to be diagnosable as dementia. Am I being stupid I just don't get the question. I also don't get the "theories and law" bit, is that theories on the causes and laws relating the dementia?
K
 

stanleypj

Registered User
Dec 8, 2011
10,712
0
North West
According to the Alzheimer's Association (US) dementia not a disease:

Dementia is not a specific disease. It's an overall term that describes a wide range of symptoms associated with a decline in memory or other thinking skills severe enough to reduce a person's ability to perform everyday activities. Alzheimer's disease accounts for 60 to 80 percent of cases.

Dementia - Alzheimer's Association
www.alz.org/what-is-dementia.asp


But I'm also uncertain how 'syndrome' comes into this.
 

nitram

Registered User
Apr 6, 2011
30,248
0
Bury
I would say that a syndrome is a collection of a number of symptoms and as such can aid diagnosis of a disease.

He has Tourette's means he displays Tourette's syndrome.
She has Korsakoff's means she displays Korsakoff syndrome.

My wife's consultant gave a diagnosis of LDB but referred to problems - hallucinations, gait, cogwheel joints - as parts of the dementing syndrome. The range of symptoms in the syndrome helped with the diagnosis of LDB.

Just my take, hope I've not added further confusion.
 
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Kevinl

Registered User
Aug 24, 2013
6,306
0
Salford
According to the Alzheimer's Association (US) dementia not a disease:

Dementia is not a specific disease.


That's the Americans for you (whoops I forgot there's one or two on here:D

disease
noun
noun: disease; plural noun: diseases; noun: dis-ease; plural noun: dis-eases

a disorder of structure or function in a human, animal, or plant, especially one that produces specific symptoms or that affects a specific location and is not simply a direct result of physical injury.

It actually says "not a specific disease" they're not saying it isn't a disease it can be any one of a number of individual diseases.
K
 

Sue J

Registered User
Dec 9, 2009
8,032
0
I would say that a syndrome is a collection of a number of symptoms and as such can aid diagnosis of a disease.

He has Tourette's means he displays Tourette's syndrome.
She has Korsakoff syndrome means she displays Korsakoff syndrome.j

My wife's consultant gave a diagnosis of LDB but referred to problems - hallucinations, gait, cogwheel joints - as parts of the dementing syndrome. The range of symptoms in the syndrome helped with the diagnosis of LDB.

Just my take, hope I've not added further confusion.

I understand your take completely Nitram and it makes sense to me. Being able to identify specific symptoms from the syndrome can narrow down the diagnosis and potentially target better treatment approaches.
 

nitram

Registered User
Apr 6, 2011
30,248
0
Bury
"Being able to identify specific symptoms from the syndrome can narrow down the diagnosis and potentially target better treatment approaches."

And symptoms from any comorbidity are not part of the syndrome and are ignored in the diagnosis.
 

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