The Elderly And Mental Health

The Elderly And Mental Health This assignment will look issues around older peoples mental health, in particular, dementia and abuse; this will include demographics of older people, statistics, the history, definitions and causes of dementia, and finally the lack of legislation to protect vulnerable people from harm and the implications for social work practice. The population surge at the end of world war 2 has gave rise to an unprecedented population explosion and to what we now call the baby boomers, these people are now in their retirement years'(Summers Et al, 2006), and our population now contains larger percentage of older people that ever. In society today elder people are becoming the fastest increasing population in the UK, National Statistics (2009) states that the population of the UK is ageing. Over the last 25 years the percentage of the population aged 65 and over increased from 15 per cent in 1983 to 16 per cent in 2008, an increase of 1.5 million people in this age group. Due to the increase of the ageing population we are now seeing emerging health and social care issues in our society. Many older people will be active, involved within the community, and independent of others. However, as you get older it is natural to experience pain, a decline in mobility or mental awareness. Mind (2010) states that the most common mental health problems in older people are depression and dementia. There is a widespread belief that these problems are a natural part of the ageing process, but this not the case; it can start as early 40 but is more common in older people (Royal college of Psychiatrists, 2009), however, there only 20 per cent of people over 85, and 5 per cent over 65, have dementia; 10-15 per cent of people over 65 have depression (Mind, 2010). It is important to remember that the majority of older people remain in good mental health. Dementia mainly affects older people, although it can affect younger people; there are 15,000 people in the UK under the age of 65 who have dementia (Alzheimers society, 2010). However, currently 700,000 or one person in every 88 in the UK have dementia, incurring a yearly cost of  £17bn, and the London School of Economics and Institute of Psychiatry research calculated that more that 1.7 million people will have dementia b y 2051 reported by BBC news (2007). The word dementia comes from the Latin demens meaning without a mind. References to dementia can be found in Roman medical texts and in the philosophical works of Cicero. The term dementia came into common usage from the 18th Century when it had both clinical and legal connotations. Dementia implied a lack of competence and an inability to manage ones own affairs. Medical use of the term dementia evolved throughout the 19th century and was used to describe people whose mental disabilities were secondary to acquired brain damage, usually degenerative and often associated with old age (Kennard 2006). From the 20th century onwards scientific knowledge was supplemented through the examination of the brain and brain tissue which was founded and performed by a physician Alois Alzheimer (Plontz, 2010). The National service framework (Department of Health, 2001, p96) now defines dementia as a clinical syndrome characterised by a widespread loss of mental function. The term dementia is used to describe the symptoms that occur in a group of diseases that affect the normal working functions of the brain. This can lead to a decline of mental ability, affecting memory, thinking, problem solving, concentration and perception, also problems with speech and understanding (Mind, 2010). Dementia is progressive, which means the symptoms will gradually get worse. How fast dementia progresses will depend on the individual. Each person is unique and will experience dementia in their own way (Alzheimers society, 2010). Symptoms of dementia include: Loss of memory, Mood changes, and Communication problems. In the later stages of dementia, the person affected will have problems carrying out everyday tasks, and will become increasingly dependent on other people, two thirds of people with dementia live in the community while one third live in a care home (Alzheimers society, 2010). There are many types of dementia, and some of the causes of dementia are rarer th an others, Alzheimers disease is the most common cause, damaged tissue builds up in the brain to form deposits called plaques and tangles, these cause the brain cells around them to die (Royal college of Psychiatrists, 2009). Other most commonly known is vascular disease, Dementia with Lewy bodies, Fronto-temporal dementia. Mostly, patients themselves do not present to the clinician with dementia, owing to gradual onset and denial of the problem. There is no cure for dementia but there is medication that will help to slow down the progression of the disease. When finding help for dementia it is usually the primary carers, caregivers, supporters, partners or family members who initiate asking help and a diagnosis (Brodaty, 1990). Depression may be misdiagnosed as dementia the difference being that people who have depression are more likely to be aware of their issues therefore are able to discuss them, whereas someone with dementia may not be able to do this due to their symptoms. Nonetheless, the Mental Capacity Act (2005) states that every person has the right to make their own decisions and must be assumed to have capacity unless otherwise proven and people should be supported to make any decisions. Under the MCA, you are required to make an assessment of capacity before carrying out any care or treatment (Office of the public guardian, 2009). The Mental capacity act is an act that protects individual rights and ensures that the persons liberty is not taken. It is based on best practice and creates a single, coherent framework for dealing with mental capacity issues and an improved system for settling disputes, dealing with personal welfare issues and the property and affairs of people who lack capacity. I t puts the individual who lacks capacity at the heart of decision making and places a strong emphasis on supporting and enabling the individual to make their own decisions (Office of the public guardian, 2009). However, even with a structure in place to protect individuals rights and liberties many people who have dementia are more vulnerable to abuse due to their lack of capacity. The University College London research revealed that a third of carers admitted significant abuse, in total 115 carers reported at least some abusive behaviour, and 74 reported more serious levels of mistreatment (Cooper et al, 2009). Caregivers can also be on the receiving end of verbal or physical abuse directed at them by parents or spouses who are confused and angry over declining mental capacities due to stroke and Alzheimers disease. In some cases, Alzheimers disease or other forms of dementia may cause the patient to be uncharacteristically aggressive (Coyne, 1996). It is only in recent years that abuse of the elderly has become more apparent, Crawford Et al (2008, p122) argues that over time it has very slowly come to the attention of people in the last 50 years that abuse does actually exist behind closed doors; in the 1950s older people lived in large families where issues were hidden, and in the 60s to 70s older people started living alone or in residential homes and it was not until the early 80s that abuse had started to be recognised and defined. Penhale and Kingston(1997) argue that over the years it has been difficult to emphasise the issues of abuse due to not finding a sound theoretical base to which an agreement of a standard definition can be made and applied. Action on elder abuse (2006) defines elder abuse as A single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust, which causes harm or distress to an older person. Abuse comes in not just physical abuse it com es also in sexual, psychological, neglect, discrimination and financial as well. Older people may be abused by a wide range of people including family members, friends, professional staff, care workers, volunteers or other service users, abuse can also be perpetrated as a result of deliberate, negligence or ignorance (Royal pharmaceutical society (RCA), 2007). Abuse can occur in a variety of circumstances and places such as, in own home, in a residential or day care setting or hospital and can by more than one person or organisation. Pritchard (2005) asserts that we will never have a true picture of the prevalence of elder abuse due to the unreported cases, and can only count ones that are known to organisations and services. Most abuse is still unreported due to victims being frightened, ashamed and embarrassed to report the abuse, not realising their rights or not being able to due to tier mental health. Summers et al (2006, p7) points out that those statutes that make abuse criminal are often ineffective due to them not being utilised by the victim, and this means that this will be the biggest challenge and barrier for change in getting people to recognise the scale of the problem and raising awareness so that the government agree to change the legislation to protect older people. Abuse of any kind should not be ignored and there should be legislation to protect adults from abuse like there is in child protection, people who recognise the extent of elder abuse argue why should adults be treated as second class to children, is their suffering and deaths any less important? The Alzheimers Society (2010) states that abuse of people with dementia should be considered in the same way as child abuse. Crawford and Walker (2008, p12) state that prejudice refers to an inflexibility of the mind and thought, to values and attitudes that stand in the way of fair and non judgmental practice. Thompson (2006, p13) defines discrimination as the process in which difference is identified and that difference is used as the basis of unfair treatment. A barrier to recognising the abuse of people with dementia and older people is that of social stigma, negative perceptions and connotations of words for mental health, such as confused or senile. Confused is something that we all experience at some time in our lives, whereas senile is a more complex word and the first recording of its usage was neutral meaning pertaining to old age, but now has negative connotations linked to mental decline due to age (Crawford and Walker, 2008). Therefore, challenging peoples perceptions needs to done to change these social constructs to enable a change in legislation and protection of vulnerable adults. In March 2010 the department of health ran a series of campaigns to address poor public understanding of dementia which included TV, radio, press and online advertising featuring real-people with dementia (Department of health, 2009). In 2009 the first ever dementia strategy was launched that hopes to transform the quality of dementia care, It sets out initiatives designed to make the lives of people with dementia, their carers and families better and more fulfilled It will increase awareness of dementia, ensure early diagnosis and intervention and radically improve the quality of care that people with the condition receive. Proposals include the introduction of a dementia specialist into every general hospital and care home and for mental health teams to assess people with dementia (Department of health, 2009). However, this is not legislation it is just a strategy for dealing with people with dementia. The government are recognising that there is little protection for vulnerable adults and that further legislation need to be put in place and stating that dementia care is a priority (BBC news, 2007). At present, there is no one specific legislation which directly protects vulnerable adults, instead the applicable duties and powers to assess and intervene are contained within a range of legislation and frameworks, such as the Mental Capacity Act 2005 and Mental Health Act 2007 and the national service framework for older people. One of the themes for national service framework (NSF) is respecting the individual which was triggered by a concern about widespread infringement of dignity and unfair discrimination in older peoples access to care. The NSF therefore leads plans to tackle age discrimination and to ensure that older people are treated with respect, according to their individual needs, specifically in standard 2 it relates to person centred care (Crawford and Walker, 2008, p8). And expectation of NSF is that there must be systems and processes put in place to enable multi agency working. In 2000 the government published No secrets which is guidance that requires local authorities to set up a multi agency framework which includes health and the police with a lead person (adult social care) to carry out procedures into the allegations of abuse whilst balancing confidentiality and information sharing (Samuel, 2008). No Secrets is only guidance and does not carry the same status as legislation, the LAs compliance is assessed through an inspection process, therefore the LA can with good reason choose to ignore the guidance (Action on elder abuse, 2006). This has concerned agencies who want to see the protection of adults given the same equivalent priorities as child protection and think that legislation is the only way to accomplish this. A review of No Secrets guidance has been carried out in 2008 and consulted with over 12000 people (Department of Health, 2009), the report found that over half (68%) of the respondents were in agreement to new safeguarding legislation and 92% wanted local safeguarding boards to be placed on a statutory footing and still there is no legislation to protect vulnerable adults (Ahmed, 2009). A recent article in community care told the failure of the government to commit to making a policy has only strengthened campaigners fight and given rise to criticism (Ahmed, 2009). The need to protect vulnerable people brought about the protection of vulnerable adults scheme (POVA) which is run by the Department of Health to regulate and monitor the employment of staff in the social care workforce, through this scheme a list of people who are unsuitable to work with vulnerable people is kept. More recently, the Safeguarding of Vulnerable Groups Act 2006 which was launched in 2008 replaced POVA with the Independent Safeguarding Authority (IDeA, 2009). The problem with this is that abusers of dementia sufferers are usually family member or informal carer that are under considerable stress and may not receiving help from within the health and social care system, therefore, an abusive situation can carry on for some time until the situation is found by an outsider. This situation may only be found when a informal carer starts asking for help, and when informed of the situation it is good practice and essential to make sure that carers are getting the help they need which can prevent the abusive situations. Under the 1995 Carers (Recognition and Services) Act carers are entitled their own assessment of need and by doing so this may allow for respite or payments to be made for their services (Parker Et al, 2003). University College London researchers who interviewed people caring for relatives with dementia in their own homes stated within their research that Giving carers access to respite, psychological support and financial security could help end mistreatment (Cooper et al,2009). When working with relatives who are carers it is important to remember who is the service user, although it is important to ascertain the wishes of the relative it should not override the wishes of the service user, this is especially true when there is a break down in the care of the service user and the carer wishes the service user to be placed in care. Many older people with dementia receive care in a residential home; this may be due to family member no longer being able to cope with the care of the person. The local authority has a duty to assess the needs of a person with dementia ensuring that their wishes are heard and adequate care is put in place. Assessment is an ongoing process, in which the client participates, the purpose of which is to understand people in relation to their environment; it is a basis for planning what needs to be done to maintain, improve or bring about change in the person, the environment or both (Anderson Et al, 2005). The trouble with placing people with dementia in care homes is there are not enough care homes specifically for people with dementia and people end up in a home that do not have trained staff to cope with individual needs of someone with dementia, therefore, people s wishes may not be heard. As part of the joint assessment process it is the social workers role to ascertain the wishes of the individual, this is done by assessing their needs in an holistic way which includes and medical and social aspects of the person. If there is doubt as to the mental capacity of the person then a mental capacity assessment will need to be acquired by asking to joint assess with community psychiatric nurses (CPN). Priestley (1998) states that the community care reforms established the principle of joint working between health and social services authorities as a priority for effective care assessment and management with social services taking the lead role. In conclusion there seem to have been many shifts in the direction of how policy and procedures framework and guidance care for people with dementia, although there is still no firm legislation to protect them. However, there seems to be more recognition of the issues that surround dementia and future goals are towards the training of people to understand those issues so that professionals are able to deal with the complex needs of a person with dementia. Word count 2969

Is the Dollar Depreciation Good for the American Economy? Essay

Currency depreciation always affects both sides of the coin. By lowering the dollar, it will enhance the price competitiveness of US product overseas but lower dollar maybe counter productive especially if there is not enough output for further expansion. Thus the move to depreciate or to appreciate the currency is very significant for economy not only to the US but in the global economy as well. Maintaining the dollar at its value therefore is also very important as it provides balance on imports and export commodities. Over the years the dollar has been swinging high and low against some of the worlds leading currencies. The question that might be ask is, was it intentionally depreciated as part of economic strategy or was it a result of economic decline due to domestic or international circumstances that hamper economic growth, such as, the 9/11 tragedy and the US led war and continues occupation in Iraq? In the midst of ever-increasing competitiveness in the world market, dollar depreciation is good for America because it puts them in the economic competitive advantage position in the international market relying on the quality of the US made goods. It is often a deliberate economic action to cope with the stiff international market competition. However, there is a contraindication to this economic action as lowering the dollar would mean lowering the living standard back home. Depreciating the dollar could stimulate strong economic performance but it also poses bad impact because it will be at the expense of cutting American wages. Paul R. Krugman point out â€Å"Depreciating the dollar is a bad way to reduce the trade deficit because it amount to meeting international competition by cutting American wages, thus lowering the living standards of the American workers† (119) In view of the macroeconomic principles, it will be more advantage for the U. S. to depreciate the dollar at a certain level because it will help to settle some of its economic deficits such as unemployment problem and trade deficit. What the US needs to do is expand its market abroad while increasing domestic productions of export goods. If there is enough output for export expansion, the impact of lower dollars maybe minimal as more money will circulate in the market. Japan’s yen is certainly undervalued compared to the dollar and yet the Japanese enjoy a high standard of living comparable to that of the United States. By mass production it will create more jobs, which can ease the problem of unemployment Another thing the U. S. should do is to put a substantive limit on domestic product for domestic consumption in order to maintain the inflation rate at its current level. Because of the lower dollar, imports from other countries will be balanced by the US exports thereby wiping trade imbalances because of the higher dollar. Thus lowering the dollar provides ample economic benefit for America. It maybe a bitter pill to swallow for others but it may cure some of the economy’s diseases. But it cannot be denied that depreciating the dollars have a serious economic implications to some developing countries. As a matter of principle the US should not play the role of a shrewd manager who only cares of its interest at the expense of the weaker countries. Jacob Frenkel Noted â€Å"The U. S. decision on an exchange-rate regime will clearly affect foreign economies, and it is not clear that what is best for America will be best for the rest of the economy, we must reformulate our notion of how a good exchange rate system performs† (158). Frenkel cited that due to dollar depreciation, the corresponding appreciation of foreign currencies against the dollar worsens the situation abroad compared to the fix exchange rate case. Frenkel stated, â€Å"By allowing the U. S. to export some of its unemployment, the dollar’s depreciation has a beggar-thy neighbor effect† (158). Thus, while the dollar depreciation might shield the U. S. economy from the adverse effect of inflation, but it has an opposite effect on U. S. trading collaborates. To explain this further Frenkel said,â€Å"The beggar thy-neighbor effect of dollar depreciation can be thought of as a payment made by the foreign country to the United States in states of the world where U. S. aggregate demand is relatively low. In the opposite situation, the United States, by allowing its currency to appreciate, compensates foreign countries† (Frenkel, 158). Thus the depreciation of the U. S. dollar requires a more sensitive study of the possible implication on other countries particularly on the trading partners of the U. S. if the United States is concern of its trading partners’ economic developments. Not only in the international market that the dollar depreciation had its impact but in domestic economy as well. Allen J. Lenz pointed out that â€Å"contractionary policies could slow U. S. economic growth relative to foreign growth rates† (68). Lenz emphasized that what counts is not just good trade performance but how that performance is achieved. Strong U. S. market performance based on productivity gains contributes to gains in living standards. Strong performance achieved by dollar depreciation can lower living standards. The depreciation therefore is an important economic action of the United States that will have significant impact not only in the U. S. but also to its trading partners. It may be good for the U. S. economy, and bad for the trading partners, but it may also be bad for the U. S. Work Cited icago PressFrenkel, Jacob. Exchange Rate and International Macroeconomics. U. S. A. : University of Chicago. 1988. Krugman, Paul. Diminished Expectations U. S. A. : The Washington Post Company 1994. Lenz, Allen J. Narrowing the U. S. Current Account Deficit: A Sectoral Assessment. U. S. A. : Institute for International Economic. 1992.

ACT Test and Registration Dates for 2019 - 2020

For the 2019-20 admissions cycle, U.S. students have seven ACT testing dates from which to choose. The exam is offered in September, October, December, February, April, June, and July. The July option was new in 2018. Registration deadlines are roughly five weeks before the exam, so be sure to plan ahead. When Is the ACT in the United States? For the 2018  - 19  academic year, the ACT test dates and registration deadlines are presented in the table below. Important ACT Dates —  2019-20 Test Date Registration Deadline Late Registration Deadline September 14, 2019 August 16, 2019 August 30, 2019 October 26, 2019 September 20, 2019 October 4, 2019 December 14, 2019 November 8, 2019 November 22, 2019 February 8, 2020 January 10, 2020 January 17, 2020 April 4, 2020 February 28, 2020 March 13, 2020 June 13, 2020 May 8, 2020 May 22, 2020 July 18, 2020 June 19, 2020 June 26, 2020 Note that the July ACT is not offered in New York State. International test dates are generally the same as those in the United States, but options may be limited. When Is the ACT Offered Outside of the United States? If youre taking the ACT outside of the United States, Canada, Puerto Rico, or U.S. territories, you should register online for the exam. The test dates are the same as for the United States with the exception of February when the exam is not offered at international test locations. There is a $57.50  fee for international testing and late registration is not available. Is the ACT Always on a Saturday? The ACT test dates, like the SAT test dates, are on select Saturdays throughout the year. For some students, however, religious convictions make Saturday testing impossible. For these cases, the ACT is offered at a limited number of testing locations on Sundays. Youll be able to locate these Sunday test centers on the ACT website when you register for the exam.   It is also possible to apply for arranged testing  if there is no Sunday test center near you, you live in a country where the ACT is not offered, or if you are confined to a correctional facility on all of the test dates. Note that non-Saturday testing is not an option for the great majority of high school students, and you should make every effort to sit for the ACT during one of the Saturday exam administrations Is the ACT Offered Near Me? On the ACT website, youll find a tool for finding your nearest test center. The great majority of students should be able to find a test center within an hour of home, and you may even find that your own high school is a test center. Some rural students, however, may find that the exam will require a bit more travel. The situation can be even more challenging for international students. Some countries have just one or two test centers, and a few countries have none at all. Some international students may need to travel long distances or to other countries in order to take the exam. How Does ACT Test Registration Work? To register for the ACT, youll need to create an online account on the ACT website. The process can take about 40 minutes because the registration form will ask you about your personal information, interests, and high school course details. Youll also need to locate the test center where you want to take the exam, and youll need to have a credit card or other form of payment handy to pay the registration fees. Finally, youll need to provide a headshot photo for your registration ticket. This is a security measure to ensure that the person taking the exam is the same person who registered for the exam.   When Is the Best Time to Take the ACT? When you take the ACT is entirely up to you, but some exam strategies work better than others. Because the ACT is an achievement test (rather than an aptitude test), it asks you about information you have learned in high school. The result is that taking the exam in 9th or 10th grade may not be the best idea for the simple reason that you probably havent yet covered all of the material that will appear on the exam. One of the common approaches to the ACT is to take the exam in the second half of your junior year (February, April, May, or June). If you dont get good ACT scores from that test, you have time to prepare further and then retake the exam at the beginning of your senior year (July, September, or October). Be careful with the December test date: youll want to make sure the scores will be available in time to meet all of your application deadlines. It is always an option to take the ACT more than twice, but doing so shouldnt be necessary for the great majority of students. In many cases, in fact, a single testing in the spring of junior year can be more than adequate if you find your scores are in line with your target schools. What Does It Cost to Register for the ACT? At the time of registration, you will need to pay the fees for the ACT. The current fees for some of the most popular exam services are as follows: $52.00 for the basic ACT. This fee includes score results for the student, the students school, and four colleges$68 for the ACT with Writing$30  additional fee if you register late$55.00  additional fee if you register for standby testing (after the late registration deadline)$13  for additional score reports As you plan your college budget, be sure to keep these costs in mind. College expenses arent just about tuition, room, and board. Applying to college is also expensive, and standardized tests are a big part of that cost. If you take the ACT twice and need to send score reports to a dozen colleges, your ACT costs will most likely be several hundred dollars. The good news is that fee waivers are available for qualifying students from low income families. A Final Word About ACT Test Dates and Registration For better or worse, standardized tests are an important part of the college application process. Even if you are applying to test-optional colleges, you may need to take either the ACT or SAT to qualify for scholarships, to be placed into the appropriate classes, or to meet NCAA requirements for athletic participation.   Finally, dont put off thinking about the ACT. Youll want to carefully plan when you take the exam, and youll also need to plan ahead so that you dont miss registration deadlines.

Keeping A Watchful Eye Security Essay - 1545 Words

Keeping a Watchful Eye: Security in the Workplace Times are changing and the threats that businesses face are changing as well. Workplace security and asset protection is vital in order for a company of any size to be successful. Crime is getting more sophisticated and ruthless, and no matter how big or small a company is it needs to be mindful of threats to keep themselves protected. There are countless steps that can be taken to ensure that a company’s assets and employees are kept safe and out of harm’s way. A few of these steps include informing employees of security procedures to prevent dangerous situations, maintaining a competent security staff, and exterior facility defenses. Finally and perhaps the most important aspect, steps that can be taken in the unlikely event that a life threatening situation occurs. Recent Tragedy The world is getting more and more dangerous every day and no company is safe, not even at a holiday party. 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