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Planning functions Essay

Planning is a decision making process. It helps one to decide on what to do and how to do it. There are six steps to follow when planning. First and foremost, one has to analyze the situation. Two constraints are very important at this stage and they are time and resources. Gathering of information and interpreting is done at this stage. Also, a summary of all the relevant information is done. Identification and diagnosing planning assumptions is done. In addition issues and problems are identified. The second step is having alternative goals and plans. Alternative goals that can be implemented later are provided. It also gives plans used to implement the goals. Thirdly, evaluation of goals and plans is done. Advantages and disadvantages on alternative goals and plans are evaluated. Also, the possible effects of the goals and plans are evaluated at this stage. Fourthly, selection of the goals and plans is carried out. The most appropriate and feasible goals and plans are selected. Right judgment is crucial at this stage. In the fifth step, implementation of the designed plans takes place. This helps one to achieve the set goals. To implement a plan, the manager must understand it well. Also, resources to implement the plan must be available. Finally, monitoring and controlling are important. These help one to know whether his/ her plan is succeeding. Continuous monitoring of the actual performance against unit’s goal should be done. Implementation is the most important step in planning. The reason behind this is that implementation of plans helps in achieving the set goals (Darlkir, 7). There are three types of plans that can be used in different organizations. These include, single used plans, standing plan, and contingency plan. Single-use plans are used in activities that are done only once. They are one time-time use plans. They also have specific goals. They may be used for duration of few days. In addition, they may last for a number of years. Projects and programs are good examples of single-use plans. Also, budgets can be considered as single-use plans. The activities involved are like the special sales program. Programs cover ‘who’ and ‘what’ in an activity. It also covers ‘where’, and ‘how’ the activity will be done (Ingram, para.3). Standing plans are applied in activities that take a long time to complete. In some cases it might be indefinite time. They can be adjusted so as to cater for the changing situations. Mostly they are created from information from different sources over a longer period. They also cover several departments in an organization. Get your 100% original paper on any topic done in as little as 3 hours Learn More Examples of standing plans are policies, a procedure and rules (Ingram, para.4). Contingency plans are meant for specific situations. This is incase things don’t move as expected. Contingency planning involves flexibility and adaptation. Also, mastery is needed due to the changing conditions. They include planning for marketing. The reason behind is to get support from the stakeholders. In addition, they allow for understanding from the stakeholders (Ingram, para.5). In our organization we usually use standing plan. The reason behind is that we usually deal with activities that need much time before completion. Also, in our organization we have many different departments where this kind of planning is more applicable. From the above literature, I have been able to learn that planning is one of the key aspects in any organization. Implementation of a plan is one of the most important steps in any planning. Implementation helps in achieving the already set goals. Without the implementation of a plan, the other work done during the planning process will be of no importance. Different plans can be applied in different organizations. The kind of plan to be used depends on the type of activities taking places in an organization. Works Cited Darlkir, Kimiz. Knowledge management in theory and practice. New York: Technology partner. 2011. Print. Ingram, David. Define single use, contingency
Grand Canyon University Multiculturalism Questions.

Write a 650-1300 word response to the following questions: Explain multicultural communication and its origins.Compare and contrast culture, ethnicity, and acculturation.Explain how cultural and religious differences affect the health care professional and the issues that can arise in cross-cultural communications.Discuss family culture and its effect on patient education.List some approaches the health care professional can use to address religious and cultural diversity.List the types of illiteracy.Discuss illiteracy as a disability.Give examples of some myths about illiteracy.Explain how to assess literacy skills and evaluate written material for readability.Identify ways a health care professional may establish effective communication.Suggest ways the health care professional can help a patient remember instructions.This assignment is to be submitted as a Microsoft Word document.
Grand Canyon University Multiculturalism Questions

The Quality of Work Life Is More Important Than Ever Research Paper

Table of Contents Introduction Work Life: A Brief History How Work Life Affects Organizational performance How to Improve Work Life Balance Discussion Conclusion Works Cited Introduction Quality of Work Life has become an extremely important issue in organizations today. This is because it has been recognized that work-life balance has a direct bearing on the productivity of employees. While organizations could afford to disregard work-life issues in the past with little consequences, they cannot afford to do that today since the business environment is characterized by many competing demands between work and home. These demands have been increased further by demographic changes in the workplace, an ageing population, and the presence of sophisticated communications technologies. As a result, there is a significant increase in the conflict between work and non-work responsibilities for the employee today. When these conflicts are not resolved, the productivity of the employee reduces significantly. To counter these changes and the conflict they bring about, organizations have had to come up with strategies that are aimed at facilitating the employee’s effort to perform optimally at they job while at the same time fulfilling their personal responsibilities. This paper will set out to discuss quality of work life programs provided by organizations. A brief history of work life and how work life affects the corporation’s performance will be given. The paper will also discuss ways through which work-life balance can be improved for the benefit of the employee and the entire organization. Work Life: A Brief History While work-life balance issues have become increasingly important for executive and human resource professionals today, these issues have been in existent for decades. Work-life began to be given relevance by organizations as far back as the 1960s. However, the focus in these early years was on working mothers who were struggling to balance their work demands with those of raising children (Bird 2). By the 1980s, major organizations had begun to make changes to their internal workplace policies so as to address the family needs of women. These changes included maternity leaves, flexible work hours, home-based work programs, and child-care services. By the end of the decade, men also began to voice concerns over their work-life issues. This resulted in work-life balance became viewed as an issue that affected both genders and not only women. Bird declares that in the 1990s, there was unanimous recognition that work-life balance was a vital issue for all employees regardless of their gender, marital status or parenthood (2). The growing awareness of the importance of the issue led to many attempts being made to come up with work-life solutions. Get your 100% original paper on any topic done in as little as 3 hours Learn More Numerous studies were carried out and it was discovered that prospective workers were making job decisions based on work-life issues (Perry-Smith and Blum 1113). Bird notes that despite the adoption of family-friendly policies by organizations, employees and managers were not implementing them and many people continued to report feeling overworked and out of touch with their non-work lives (2). A general consensus on work-life balance strategies at the beginning of the twenty-first century was that work-life programs had not achieved their intended effects. Stress and overwork were becoming even more prevalent among workers with negative impact on productivity being experienced as a result of this (Bird 3). Today’s organizations are characterized by increased pressure to achieve profitability which translates to greater demands being made of the workforce. These pressures, if not properly dealt with, can have a detrimental effect on the life of the individual. It is therefore imperative that the steps be undertaken to ensure that work-life balance is maintained. How Work Life Affects Organizational performance Conflicts between work and non-work responsibilities result in many negative outcomes for both the employee and the organization. Work-life conflicts have been associated with an increase in stress and burnout which results in cognitive difficulties such as staying awake, decreased concentration, and reduced alertness (Anderson et al. 791). Stress and burnout result in decreased performance from the employee which will translate to less productivity for the organization. It is a well established fact that high levels of stress also result in lower job satisfaction by the employee and he/she is therefore less likely to work towards achieving organizational goals. Organizations aim to achieve a cohesive culture which helps to focus the organization’s workforce on the goals and objectives that are important. This focus results in higher performance in the areas that interest the organization (Matthew 690). The number of conflicts is also reduced in a cohesive environment since the employees share objectives. Work-life conflicts may result in weak organizational cultures which are characterized by a lack of a common culture throughout the organization. Matthew asserts that such a culture results in employee’s exhibiting reduced levels of commitment to the organization (679). We will write a custom Research Paper on The Quality of Work Life Is More Important Than Ever specifically for you! Get your first paper with 15% OFF Learn More Provision of work-life practices has the potential to generate positive attitudes towards the organization by the employee. Social exchange theory explains why the presence of work-life practices results in favorable organization outcomes. When the employees are treated favorably by their organization, they feel obligated to respond in a similar manner by adopting a positive attitude and engaging in behavior that benefits the source of this good treatment (Allen 429). This improved attitudinal and behavioral outcome will result with greater willingness of the employee to achieve set organizational goals. By offering work-life balance practices, the organization is able to attract new members while at the same time reducing the levels of work-life conflict among its current workforce. This results in an enhanced organizational effectiveness. Organizations which offer career paths which include family supportive policies and allow the employee to balance career and family are perceived as significantly more attractive that those that only offer traditional career paths (Carless and Wintle 400). This is because people are today keen to integrate their work lives with their family lives (Secret 410). Work-life practices give an organization a competitive advantage in an environment where such practices are limited. Yeandle et al associate the presence of voluntary reduced hours to an increase in recruitment and retention by an organization (34). For example, the presence of onsite childcare centers is associated with lower turnover rates among employees. A qualitative study by McDonald et al on employed women with dependent children found out that many of the participants would not continue working it they did not have access to flexible working hours and family-responsive policies (480). How to Improve Work Life Balance Bearing in mind that a quality work-life balance results in increased organizational effectiveness, it makes sense for an organization to seek ways to improve work-life balance among its employees. Work-life balance practices are presumed to assist the employee to balance their work and family demands which in turn brings about enhanced employee productivity and hence higher business performance. There are a number of strategies which can be implemented to ensure that a work-family balance is achieved in his life. One approach is the boundary-spanning strategy which involves an individual taking action to reduce the forces that interfere with their plans at home or at work (Vydanoff 135). Not sure if you can write a paper on The Quality of Work Life Is More Important Than Ever by yourself? We can help you for only $16.05 $11/page Learn More This approach requires the worker to reduce the stressors in their life so as to enhance productivity as well as social capabilities. The employee is required to set guard limits (boundaries) to ensure that his schedule is protected against any interfering forces. Undoubtedly, this strategy can only work with the support of the organization since if the organization does not respect the employee’s boundaries; it is unlikely that the employee can effectively carry out this strategy. Another strategy that can be adopted is fostering an open environment where the employees are allowed to discuss their non-work lives with their colleagues. A survey by Poelmans revealed that employees who discussed their family situations with their co-workers were more satisfied and exhibited superior performance compared to those who kept their home issues compartmentalized (67). Talking about home life is beneficial to work-life balance since the employee can be assisted to fulfill his work goals by the other employees if they understand his/her home responsibilities. The work demands and the resources available in an organization affect the ability of an individual to maintain a healthy work-family balance. Crane explains what then the work demands are great and the resources available are limited, the employee is forced to put in extra effort so as to meet the set organizational goals (159). Such conditions directly influence the work-life balance by escalating conflicts through an over commitment to work at the expense of the family. Research indicates that the use of flexible working hours is associated with lower levels of work-to-life conflicts (Hill et al. 54). The reason for this is that flexible working hours give the employee a sense of control. This perceived control serves as a mediating mechanism for family supportive policies (Rogier and Padgett 94) When the worker is satisfied with work schedule flexibility, there will be a positive job attitude which will bring about increased organizational commitment. A major concern for employees with families is the welfare of their children. The organization can assist to reduce this concern by offering facilities such as childcare centers, referral services and other family-supportive practices that will reduce the inconvenience that the parents might face while at the same time reducing their financial burden (Lewis 19). A study by Grover and Crooker demonstrated that these supportive practices had the advantage of increasing the levels of commitment to the organization by the employee (280). Work life can be improved by adopting an organizational culture that is accommodating and which does not victimize the employee for wanting to spend time with his/her family. Kodz et al. reveal that many workers are de-motivated by the perception that using work-life balance practices will impact negatively on their career prospects (34). This perception is valid in organizations which have cultures that are unsupportive of work-life balance such as deeply entrenched long-hours culture and an unaccommodating attitude among managers and co-workers. Managers should know that time spent at the workplace is not necessarily an indicator of an employee’s contribution and commitment to the organization. Discussion There is no universal approach to achieving a work-life balance and no one solution can work for every employee. Work-life balance programs should therefore be viewed as on-going process which requires the commitment of the individual and the organization. Workers have different preferences and as such, certain work-life balance strategies may reduce conflict for some while increasing it in others. For example, arrangements to work from home through telework may benefit some workers while others may resent it since it may appear to blur the boundary between work and home. Bird denotes work-life balance as an “individual issue that affects the organization than it is an organizational issue that affects the individual” (3). The individual should therefore be involved when coming up with a work-life program for him/her. Organizations should ensure that work-life practices are not only present but are also used. Research indicates that while organizational acknowledge the importance of work-life balance and the impact it has on productivity, most of them do not come up with measures to help employees cope with work-life conflicts (Halpern and Murphy 33). In other cases, employees remain unaware of their work-life entitlements. This situation results in work-life practices failing to achieve their intended aims in the organization. Conclusion This paper set out to discuss quality of work life programs in organizations and show how work life programs affect organizational performance. From the discussions contained herein, it is evident that the quality of work life is today more important than it was in the past. It has been demonstrated that work-life conflicts have negative repercussions for employee performance which translates to decreased organizational productivity. Organizations should therefore ensure that they have effective work-life programs in place and that these programs are utilized. By doing this, the organization will nurture satisfied employees who will bring about increased productivity. Works Cited Allen, Tammy. “Family-supportive work environments: The role of organizational perceptions.” Journal of Vocational Behavior 58.1 (2001): 414-435. Anderson, Stella, Coffey Betty, and Byerly Robin. “Formal organizational initiatives and informal workplace practices: Links to work-life conflict and job-related outcomes.” Journal of Management 28.6 (2002): 787-810. Bird, Jim. “Work-life balance doing it right and avoiding the pitfalls.” Employment Relations Today 33.3 (2006) 1-9. Carless, Sally, and Wintle Josephine. “Applicant attraction: The role of recruiter function, work-life balance policies and career salience.” International Journal of Selection and Assessment 15.4 (2007): 394-404. Crane, Russell. Handbook of families and work: interdisciplinary perspectives. USA: University Press of America, 2009. Print. Grover, Samantha and Crooker Jake. “Who appreciates family-responsive human resource policies: The impact of family-friendly policies on the organizational attachment of parents and non-parents.” Personnel Psychology 48.1 (1995): 271-288. Halpern, Diane and Susan Murphy. From work-family balance to work-family interaction: changing the metaphor. Sydney: Routledge, 2005. Print. Hill, Edward, Hawkins Adams, Ferris, Mill, and Weitzman Morris. “Finding an extra day a week: The positive influence of perceived job flexibility on work and family life balance.” Family Relations 50.1 (2001): 49-58. Kodz, James, Harper Henry, and Dench Susan. Work-life balance: Beyond the rhetoric. Institute for Employment Studies Report 384. London: IES. Lewis, Sandra. “‘Family Friendly’ employment policies: A route to changing organizational culture or playing about at the margins?” Gender, Work and Organization 4.1 (1997): 13-24. Matthew, Jack. “The relationship of organizational culture with productivity and quality.” Employee Relations 29.6 (2007): 677-695. McDonald, Paula, Guthrie Diane, Bradley Lisa, and Shakespeare-Finch Jane. “Investigating work-family policy aims and employee experiences.” Employee Relations 27.5 (2005): 478-494. Perry-Smith, Jill, and Blum Terry. “Work-life human resource bundles and perceived organizational performance.” Academy of Management Journal 43.6 (2000): 1107-1117. Poelmans, Steven. Work and family: an international research perspective. Sidney: Routledge, 2005. Print. Rogier, Sarah, and Padgett Marie. “The impact of utilizing a flexible work schedule on the perceived career advancement potential of women.” Human Resource Development Quarterly 15.1 (2004): 89-106. Secret, Morris. “Integrating paid work and family work.” Community, Work and Family 9.4 (2006): 407-427. Voydanoff, Patricia. Work, family, and community: exploring interconnections. New York: Routledge, 2007. Print. Yeandle, Silas, Crompton Rein, Wigfield Andrea, and Dennett Jean. Employed careers and family-friendly employment policies. London: Joseph Rowntree Foundation Policy Press, 2002. Print.

Dallas County Community College What is Poverty Discussion

write my term paper Dallas County Community College What is Poverty Discussion.

Your assignment is to select any ONE of the following three articles from the attached documents I have providedHow and How Not to Love Mankind Ibsen and His Discontents .pdf Ibsen and His Discontents What is PovertyNOTE: THIS IS NOT A RESEARCH PAPER, SO DO NOT USE ANY OUTSIDE SOURCES OTHER THAN THE DALRYMPLE ARTICLE AND YOUR TEXTBOOK, WHICH YOU WILL CITE USING MLA FORMAT. This assignment is designed to test your ability (after several weeks of reading difficult primary sources in philosophy) to comprehend, explain, analyze, and evaluate a philosophic essay of college-level difficulty. It is for this reason that the use of any sources other than your Dalrymple article and our textbook will result in an automatic 50 point deduction. FOR THE ARTICLE YOU CHOOSE TO WRITE ON, you will type a 1000-1500 word response in which you address EACH of the following points IN YOUR OWN WORDS: 1) What is the author’s main argument? 2) How does he support his main argument (evidence, ancillary arguments, etc.)? 3) Do you agree or disagree with him? 4) Why or why not? 5) Apply the insights of at least two of the readings we have studied in this course (in chapters 1-10) to your analysis. Make sure to explain how the philosophers’ insights are relevant to the topic you are discussing.Please use MLA format.I have attatched the a pdf of the articles and a copy of the textbook for chp 1-11.
Dallas County Community College What is Poverty Discussion

College of Wilmington Create a C Program Computer Programming Task

College of Wilmington Create a C Program Computer Programming Task.

You have two sample files attached to this assignment: one showing how to work with memory sharing and another showing implementing a copy program using open(), read(), and write() methods. Your job here is to convert the copy program to copy one file to another file(with a different name) using memory mapping APIs, not using read() methods. You can use write API.Copy.c#define NULL 0#define BUFFSIZE 512#define PMODE 0644 /* RW for owner, R for group, others */main ( int argc, char *argv[]){ int f1, f2, f3; char buf[BUFFSIZE]; if(argc != 3) error(“Usage: copy from to”, NULL); if(( f1 = open(argv[1], 0)) == -1) error(“copy can’t open %s”, argv[1]); if(( f2 = create(argv[2], PMODE)) == -1) error(“copy: can’t create %s”, argv[2]); while (( f3 = read(f1, buf, BUFFSIZE)) >0) if(write (f2, buf, n) != n) error(“copy: write error”, NULL); exit(0); } void error( char *s1, char *s2){ printf(s1, s2); printf(“n”); exit(1); }MappingSample.c#include <stdio.h>#include <sys/types.h>#include <sys/stat.h>#include <fcntl.h>#include <unistd.h>#include <sys/mman.h>int main(int argc, char *argv[]){ struct stat sb; off_t len; char *p; int fd; if(argc < 2){ fprintf(stderr, “usage: %s <file>n”, argv[0]); return 1; } fd = open(argv[1], O_RDONLY); if(fd == -1){ perror(“open”); return 1; } if(fstat(fd, &sb) == -1){ perror(“fstat”); return 1; } if(!S_ISREG(sb.st_mode)){ fprintf(stderr, “%s is not a filen”, argv[1]); return 1; } p = mmap(0, sb.st_size, PROT_READ, MAP_SHARED, fd, 0); if(p == MAP_FAILED){ perror(“mmap”); return 1; } for(len = 0; len < sb.st_size; len++){ putchar(p[len]); } if(munmap(p, sb.st_size) == -1) { perror(“munmap”); return 1; } if(close(fd) == -1) { perror(“close”); return 1; } return 0; }
College of Wilmington Create a C Program Computer Programming Task

Case Analysis And Problems With Dementia Nursing Essay

Share this: Facebook Twitter Reddit LinkedIn WhatsApp Dementia is a progressive and irreversible decline in mental function1. Lewy Body Dementia (DLB) is a form of degenerative dementia characterised by the presence of “Lewy Bodies” which are clumps of alpha-synuclein and ubiquitin protein in neurons2. These are only detectable in post-mortem brain biopsies2. The manifestations of dementia present themselves clinically as progressive cognitive decline which impairs day-to-day social and motor functioning. This central feature of DLB is essential for the initial diagnosis of the disorder and the initial evaluation of a patient with dementia must establish the presence of cognitive impairment and provide a measure of its severity. Three core features which are significant in the diagnosis of DLB and distinguishing it from these other disorders are2: 1. Fluctuations in both mental cognition and relative levels of attentiveness. The severity and duration of these episodes vary among patients, however, generally, severity increases with time. 2. Visual Hallucinations – characteristically detailed and well-formed; significant in differentiating DLB from Alzheimer’s disease as they are relatively rare in the latter disorder. 3. Spontaneous features of Parkinsonism, such as tremors. At least two of these core features must be present to conclude that there is DLB3. Suggestive features of the disorder include rapid eye movement (REM) sleep behaviour disorder, repeated falls and transient loss in consciousness. In the absence of a core clinical feature the presence of one or more of these suggestive features may help in the diagnosis of DLB. The differential diagnosis for DLB is mainly Alzheimer’s disease, Parkinson’s disease or other dementia syndromes. However, in Catherine’s case the presence of a number of core and suggestive features strongly indicate DLB. In relation to Catherine, there are many indicators present which qualify her for diagnosis with the disease. Not only does she exhibit some of the core features mentioned previously but it is also evident that she is suffering from some of the more suggestive, but equally as debilitating, aspects of the disease. It is evident on examination that Catherine is experiencing fluctuations in cognition as her verbal responses are often difficult to comprehend and are unreliable. These memory lapses, along with aggressive responses, are known symptoms of dementia2. She has had some vivid visual hallucinations previously which may be a mitigating factor in her continuous falls, another suggestive feature of the disorder2. Catherine’s husband faces many challenges as her primary caregiver. Caregiver burden is defined as the high levels of stress and anxiety associated with the provision of care to another person suffering from some kind of illness4. Catherine’s husband is likely to suffer from caregiver burden as he is the sole provider of care and his closest source of relief is his daughter who lives some distance away. He faces challenges in communication and in managing Catherine’s behaviour and struggles with his own physical fitness while also trying to care for his wife. He is likely to suffer emotionally as result of the demands placed upon him as a result of Catherine’s unwillingness to avail of respite care services. Catherine presents many challenges to the healthcare system in that she is aggressive towards members of staff with whom she is unfamiliar. This impedes upon the quality of her care as nursing staff appreciate her condition but are unable to manage it on an acute ward. The problems with her memory make interactions difficult as she does not remember her surgical treatment and becomes aggressive and agitated at times. It is likely that as the disease progresses these factors will become more serious and incapacitating, leaving her husband with no choice but to admit her to a long-term care facility. Societal Context It is difficult to quantify the prevalence of Dementia in Ireland and in various countries due to variances in how we define and ration dementia and also due to methodological variances in conducting studies5. However there remain some factors such as age and gender which show consistencies across studies. It has been found that Alzheimer’s disease is more common in women, and that prevalence of dementia can double with every 5 years of increase in age6. The Alzheimer Society of Ireland (ASI) estimates that there are currently more than 44,000 people suffering from some form of dementia in Ireland7. It is shown that the prevalence is higher in females than males with 20,000 females and 14,000 males found to be suffering in 2002 and the incidence is expected to increase dramatically in the coming years in correspondence with the aging population in Ireland. By the year 2036 the ASI estimates that there will be over 100,000 people with dementia8. Studies have shown there are a number of risk factors associated with dementia. Along with age and gender, genetics and BMI have also been linked closely with dementia. One study found that normal-weight women had a greater risk of developing dementia than women with a higher BMI than them9. It has also been found that those with higher BMI have a decreased risk of cognitive decline10. Cholesterol levels have also been linked to the cause of dementia in that high levels of high density lipoprotein have been associated with a decreased risk of Alzheimer’s disease11. There are a number of known support groups in this country for relatives of patients with dementia7. For example, The Alzheimer Society of Ireland provides a range of services to people with Alzheimer’s disease and other forms of dementia. The Carer and Family Support Groups operate throughout Ireland, usually meeting on a monthly basis7. This support network offers a vital opportunity for carers and family members to share experiences, information and practical advice in a supportive environment and would be of significant benefit in Catherine’s case to provide her husband with an outlet from the constant pressures associated with her disease. The Irish Government does offer some financial support to people suffering from dementia but it appears not to be enough. There are a number of schemes which provide home care to patients, however a new report illustrates that Ireland spends only half the OECD (Organization of Economic Cooperation and Development) average on dementia services12 despite the fact we rival any other European Country in relation to the growth of dementia. According to the report for every 18,500 euro cut, four people with dementia will lose any service provided by the government12. This would be detrimental in Catherine’s case as she may eventually rely heavily on the government for support. Healthcare Quality and Patient Safety The treatment of Dementia is focused towards specific disease manifestations as there are no definitive treatments available. To effectively treat Dementia, patients and families should be involved as soon as the diagnosis is made. The availability of information, good health services, and support should be provided to help patients and their families to cope with dementia. The behavioural and psychological symptoms of dementia have been a difficult management area for neurologists and psychiatrists alike. The key to proper management is the correct identification of each symptom and the underlying precipitating cause. The proper management is not only rewarding in terms of responsiveness in an otherwise incurable and progressive disease, but also improves the quality of life of the patients and the caregivers. The management of dementia begins with a thorough assessment to search for underlying causes of behavioural changes. Non-pharmacological approaches should be used prior to medication use. These interventions include music, light, changes in level of stimulation and specific behavioural techniques. The type of dementia, individual symptom constellation and the tolerability of the patient will help to determine what medication should be used13. Cholinesterase inhibitors treatment for people with DLB is commonly used in clinical practice, especially for patients that exhibit neuropsychiatric symptoms. The use of antipsychotics for agitation and aggression has shown consistent efficacy and it is the most studied pharmacological intervention14. Pharmacotherapy must be monitored closely for both effectiveness and side effects, with consideration of medication withdrawal when appropriate. Studies show that anti-dementia medicine neither cure, arrest nor delay the onset of the disease, but are helpful in symptom relief14. There is an urgent need to develop more efficacious medications for the treatment of dementia15 as in the long-term we know that a diagnosis of dementia is a sentinel event that signifies progressive loss of independence and increasing demands on caregivers. In this case, the biggest barrier to Catherine receiving adequate healthcare is herself and the uncooperative and aggressive nature of her condition. Her husband and family cannot fully support her needs therefore she needs to be admitted to a long-term care facility. Her wishes to continue living in her own home may prevent her from getting the care she needs. Also, the fact that her husband must make the decision could be considered a barrier as he is unwilling to put her into long-term care, where the stability may help her. Individualised rehabilitation approaches targeting relevant and personally-meaningful aspects of everyday functioning have demonstrated significant benefits in single-case and small-group intervention studies16. Cognitive rehabilitation is a relatively new approach to improving well-being for people with dementia and their families, but at present only preliminary evidence regarding efficacy is available16. However, this preliminary evidence suggests that cognitive rehabilitation does have the potential to bring about changes in behaviour, enhance well-being and maintain involvement in daily life. Psychosocial interventions of this kind can be provided alongside pharmacological treatment, and it is possible that these two approaches can complement one another to optimize benefits for the person with dementia17. There are a great many questions still to be answered, but the existing evidence provides a valuable basis for further development of this approach. Ethical Considerations There are a number of ethical issues to address in Catherine’s case. As DLB progresses, it gradually renders people incapable of tending to their own needs, thus their decision-making capacity is compromised and caretakers must step in and make decisions for them. Catherine suffers from dementia and requires constant care. In preventing Catherine from independently getting in and out of bed, several ethical issues are involved. Her caretakers can only effectively tend to her and ensure her safety by compromising her right of autonomy for the sake of beneficence18 i.e. doing this for her own well-being in order to provide her with adequate care. Also non-maleficence18 is a factor in this situation i.e. they must ensure she does not get harmed while moving about unsupervised In Ireland, under the Mental Health Act of 2001, certain conditions must be must be met before someone is involuntarily admitted to a long-term care facility19. Fundamentally The patient must be eligible to be involuntarily admitted The “Person” sending the patient must send in application for the patient That “Person” must fit certain requirements. After application, a registered medical practitioner must do an examination on the patient and if he/she is satisfied, he/she writes a recommendation for the involuntary admittance of the patient in an approved centre. Catherine definitely fits the requirements of the patient to be involuntarily admitted as she is actually suffering from a mental disorder20 and her caretakers may be considered “unfit” to take care of her. While her husband wants to respect her wishes he is physically unable to provide the level of care that she needs, even with his daughter’s weekly assistance. It is obvious that she requires constant monitoring as evident by her repeated falls. Therefore, after a mental health assessment it is likely that she be recommended to live in such a facility with more appropriate care21. Healthcare providers are only able to advise patients and their family members on the best course of treatment and management plan available, suggesting alternatives are still within their boundaries. However, the final choice always resides with the patient and his/her family members22. Disputes which may arise become a tough issue for health care professionals to resolve, as all circumstances need to be taken into consideration before a decision can be reached23. Word Count: 1989 Search Strategy As part of our search strategy we used resources from the library and those online. We found books and journals in the library useful for sourcing background information about Lewy Body Dementia. Online we used medical search database, “Medline” and “PubMed.” We had to tailor our search criteria to suit the particular section of the report we were writing. To further refine our search findings we used the advanced search and used the “limits” option. If our search yielded too few findings, we learnt to change our keywords and to broaden our search area. For example when “Dementia” is searched PubMed reveals 119494 options, however if “dementia AND Ireland” is searched 404 results are revealed. To further refine this search we used “Limits” whereby we limited the findings to trials that had links to the free article online, were in English and were conducted on humans. This searched revealed 60 findings. It is also useful to use sources that have been referenced by other authors and we found that once you found one or two good trials, they usually had referenced some other sources that matched your search criteria. This cut down on the searching through irrelevant articles and proved better use of our time. All in all we found the internet very useful for sourcing our references and in particular we found PubMed and Medline user friendly once we understood how to use them properly. Share this: Facebook Twitter Reddit LinkedIn WhatsApp

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