Saturday, August 31, 2019

Perspectives on Abortion

Otis Latin ENGL1301. 17 Mrs. Marcom Abortion Title: Perspectives on Abortion: Pro-Choice, Pro-Life, and What Lies in between Author: Raquel Lopez This essay is a very deep and descriptive essay about abortions and the history behind it. There are two different perspectives discussed in this essay and they are, Pro-Life, and Pro-Choice. The essay talks about the historical perspectives of abortion, pro-life perspectives, moral relativism, philosophical considerations, the church’s views on abortion, pro-choice perspectives, abortion relationship with crime, and the politics of abortion.The author’s main idea is that pro-life and pro-choice perspectives are all based on the person’s emotions and often fail to make logical sense. As the author states, Pro-Life has two main approaches: moral perspectives and religious perspectives. Sometimes these two perspectives intertwine and have some similarities but in many ways they do the complete opposite. â€Å"The religio us perspective has very little to be debated considering it embraces the belief in a supernatural almighty entity; and there is, in fact, very little literature discussing the logics of religion†(512).The author is saying that the religious perspective is saying abortion is wrong based on their beliefs of the importance of a life. â€Å"Critics of abortion attack the fact that despite cultural background, abortion is wrong just as killing is wrong and stealing is wrong in any society, regardless of cultural values†(513). The moral perspective is saying that abortion is wrong just like stealing and killing is wrong. The author disagrees because everything people say is right isn’t necessarily right. This helps prove the author’s thesis that your perspective is based off of emotion and not fact.On the other hand there is the Pro-choice perspective of abortion. This means that the people believe in having the choice to have an abortion or not. This essay disc usses the history of women as caregivers and nurturers. In these roles they were very close to their children and highly unlikeable for them to think of abortion. Now that times have changed the essay talks about how the change in behavior of women affects the children mentally and physically. For example the article says lack of attention can lead to: low self-esteem, anger problems, attention deficit behavioral issues, child molestation, and verbal abuse (514).The author’s intended audience was to everyone who has debates or assumptions on abortions. The author addresses pro-life and pro-choice perspective by comparing and contrasting all arguments and backing it up with facts. The author does not make any assumptions, and he clearly backed up his argument. While the author’s thesis focused on the use of emotion and abortion perspective, he ends by showing his own personal view. In his conclusion, the author discusses how unfair it is for many children to be forced i nto poor homes.The author believes that this is a result decision based on emotion. Why Abortion is Immoral Don Marquis This essay is telling the reasons why abortion is considered immoral. The author suggests that abortion is in the same moral category as killing a human being. The author also states that he does not want to base the article off of religion like most anti-abortionist point of views. He does however want to base it on morality and ethics. By doing this the author will cover the non religious people’s perspective of abortion. In an essay like this writing strategies are really important.With this being said his writing strategies help him prove a point that isn’t very popular. The author uses several writing strategies to get his point achieve this goal. He starts by comparing and contrasting anti abortionist and pro-choice perspectives. In his compare and contrast he gives examples of typical pro-choice and anti abortionist views. The author states tha t â€Å"Passions in the abortion debate run high. There are both plausibilities and difficulties with the standard positions†(188). After comparing and contrasting the two perspectives, the author points out the issues of each point of view.For every point the author makes he list several examples to support his main idea. Basically this entire essay is the author’s argument that abortion is equal to killing a young child. One of the most persuasive strategies is that the author describes opposite viewpoints, and then says why they are wrong. This is why the author talks a lot about â€Å"symmetry between the accounts†(197). One example of this symmetry is when the author talks about some beliefs that â€Å"fetuses lack of property that is essential for the value-of-a-future †(198). Many people might disagree with this point.In fact, this point goes against the author’s perspective that abortion is immoral. He still talks about this in his essay th ough because it gives him an opportunity to say why the person that holds this belief is wrong. The author believes that people that hold this view are wrong because if a fetus lacks value and doesn’t deserve to live then the same must be said for plants and people in comas (199). Overall the author does a good job of getting his point across. He uses compare and contrast, he describes different examples of different viewpoints and he makes a strong case that abortion is immoral.His purpose was to show an anti abortion view that was based on morality and ethics and not â€Å"irrational religious dogma† (183) or a â€Å"confused philosophical argument† (183) and he succeeded. This essay shows that religion is not the only reason why people might be opposed to abortion. Not looking at religion some people may still believe that abortion is similar to killing an innocent man or woman who didn’t deserve to die. Bibliography Lopez, Raquel. Perspectives on Abor tion: Pro-Choice, Pro-Life, and What Lies in between: EuroJournals Publishing, Inc. 2012 Marquis, Don. Why Abortion is Immoral: Journal of Philosophy, Inc. 1989

Friday, August 30, 2019

Cleopatra Leader

Cleopatra VII was a remarkably intelligent woman with great charisma and political astuteness. The ancient historian, Plutarch, stated that â€Å"to know her was to be touched with an irresistible charm. Her delightful manner of speaking was such as to win the heart. † (Bradford 14). She utilized these assets to win over the favor of two of the most powerful man of Ancient Rome, Julius Caesar and Marc Antony. Cleopatra is portrayed as being manipulative, conniving; and accused of utilizing her relationships for the advancement for power and the expansion of her empire.Although this is true, there were stark differences in the two relationships Cleopatra had with each man. She reached out to Caesar in her time of no power and continued to be submissive to him throughout their relationship. Even though there was a speculated love connection between the two, Caesar never lost sight of his priority as a politician and did not concede to every one of his mistresses’ requests .While a reversal of roles occurred with Marc Antony, she had the upper hand and he eventually became fiscally and emotionally dependent on her. In addition, he was easily manipulated, thus Cleopatra frequently got her way. Overall, the territorial gain and the power she had over him proved that Cleopatra’s relationship with Marc Antony was more politically beneficial than with Julius Caesar. Firstly, Cleopatra’s submissiveness and political dependency on Julius Caesar proved to be less beneficial in contrast to her relationship Marc Antony.In 48BC, she was a young 22 year old trying to regain her Ptolemaic throne from her brother, she knew he was the most powerful in the world and understood that that the Roman Consul was the only one who could aid her. Bradford noted that Cleopatra realized the â€Å"only one weapon that her brother, back by his powerful advisers, did not have [was]-her sex. † (70) The speculation that she was sneakily presented to him rolled up in a carpet displayed her submissiveness to his authority and beckoning for his help in regaining her throne.Caesar managed to initially appease Cleopatra’s desire for power by reading her father’s will and forcing her brother, Ptolemy XIII, and herself to rule together. Later he gained managed to gain more power for her by commanding her to â€Å"marry† her younger brother, Ptolemy XIV, for she would hold all of the power due to his age. This pretense was set up in order to make her complacent but still remained a superior force with his diplomatic choice. By having both the siblings rule he abided to Egyptian law and did not panic the people and cause them to rebel.

Thursday, August 29, 2019

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

Wednesday, August 28, 2019

The Power of Brand Essay Example | Topics and Well Written Essays - 3500 words

The Power of Brand - Essay Example Today, a brand is made out of not one, but a host of cultural ideas. Branding as a strategy involves a multitude of elements such as symbols, words and images; experiences and feelings, patterns of belonging, allegiance and identity; values, belief systems and knowledge; and many, many, many more. (Grant, 2006, p. 90) This study concerns the power of international brands of consumer goods to foster consumer loyalty to the brand. The dissertation proposes to explore the phenomenon of brand communities of international brands in local society, to describe and document how these brand communities distinguish themselves from one another in terms of their common viewpoints, attitudes towards their product brand, their rituals and traditions. It shall thereafter be verified whether this same set of values, representations, behaviour patterns and rituals are replicated in similar brand communities in other parts of the world. In particular, the study shall focus on the existence of brand communities as an element of the market strategy that seeks to foster what may be almost described as a â€Å"cult following† – a phenomenon more persistent than a fad and which has every indication of a subculture that goes beyond merely repeatedly purchasing the product. The study shall examine those brands for which the phenomenon has entrenched itself, such as the following suggested brands: One may argue that â€Å"Harry Potter† or â€Å"Star Wars† may be classified as â€Å"brands† for the purpose of this study, despite both being concoctions of literature and cinema. It cannot be denied that what was one book and one movie have spawned not only into a series of books and movies (commercially successful, one might add), but also several other product lines that have proved profitably franchises because they carried the names â€Å"Harry Potter† and â€Å"Star Wars†. In this manner, it may be said that â€Å"Harry Potter† and â€Å"Star Wars† have evolved into

The Use of DNA in Crime Investigations Research Paper

The Use of DNA in Crime Investigations - Research Paper Example It also depends to a great extent on the far-sightedness of a person in looking at the long-term effects of the changes incorporated into the lives of people due to technological changes. There may be many negatives that can be found in the introduction of these changes. However, that does not justify a rejection of those changes without an analysis of the positive effects that they may have. The use of DNA in the analysis of crime and the investigations of this issue is one such area. In the United States of America, only twenty five states follow a system whereby the use of DNA is done in an efficient manner. This involves the collection of DNA samples right at the time of the arrest of a criminal. In the other states, collection of these samples is conducted following the conviction of a criminal, and this causes a lot of delay. These delays may result in a change in the very outcome of the cases where the said changes are made. This paper will discuss these delays and the changes that can be made in the legislative structures that govern crime investigation in the United States of America. DNA (deoxyribonucleic acid) has the makeup of a person encoded within it. It is a unique code that helps identify a person. It can be used to distinguish between persons. Samples of DNA can be collected from a person’s saliva, hair and other parts of that person’s body. Such information can be later used to verify the identity of the criminal and can be used for matching with the samples that are collected from him or her (â€Å"Use of DNA in Criminal Investigations†, n.d.). While these can be collected from the suspects later on during the time of the conviction, the samples that are to be collected from the crime scene need to be collected at the time of the arrest itself. If this is not done, there may be difficulties in locating the position of the body fluids in question and it may also be difficult to isolate them so that the matching of the DNA may be conducted. In the context of the legislations that currently exist, stress is laid on the use of DNA samples for the solving of crimes; however, as mentioned earlier in this paper, only twenty five states in America have a provision for the collection of DNA samples at the time of the arrest of a suspect. Various arguments have been advanced in favour of collecting the DNA samples at the time of the arrest. One of these is the quick analysis possible as a result of the quick collection of the data. This prevents many problems that would otherwise be present in the process of the investigation of the crime. To understand this fully, one needs to also understand the benefits of DNA analysis in the process. This would help one locate the areas where the problems are present. One of the major advantages of the use of DNA samples in crime investigations is the creation of databases that can be then used to track the activities of people who are known to be offenders. While allowi ng every person who has committed an offence a chance to improve their own characters and lots in life, this system ensures the safety of the society where such convicts are present. Having such a database would mean that people who have committed an offence may be caught in an easier fashion. This would also mean that people who are innocent may have a better chance to stay free and engage in activities that are useful for the society in which they live and are a part of. Statistics

Tuesday, August 27, 2019

Summary and opinion Essay Example | Topics and Well Written Essays - 750 words - 1

Summary and opinion - Essay Example As soon as they finally overcame its effects, they could not help but realize that the numerous effects of globalization had all of a sudden taken place. Thirdly, the article talks about the invention of the broadband connections and email software such as search engines like Google that made the effects of globalization even more evident and made way for the world to become even flatter. Also, the email system and internet brought about a great change in the way people communicated and worked from then onwards. Moreover, ‘It’s a flat world after all’ talks about how the globalization system has allowed all the knowledge pools around the world to connect together over the years. These knowledge pools when combined will lead to brand new innovations and developments and these will emerge not from one specific area but will be a combination of the North, South, East, and the West. The article further states that there are various key factors that led to globalization or to the world becoming a flat one. The first factor of these took place on 9 November in 1989 when the Berlin wall came down. Then the second of these took place on September 08, 1995 when Netscape went public and the internet emerged and the dot com boom was triggered around that point. Furthermore, one observed a breakthrough in person-to-person and application-to-application connectivity that further produced six more world flatteners. One of them was ‘outsourcing’. With further passage of time came the concept of ‘off-shoring’, which referred to sending an entire factory from one country to another. This was followed by ‘open sourcing’ which was further followed by ‘in sourcing’ and then by ‘supply chaining’. After this, came the world flattener that was ‘informing’ which took place when Google and other such search engines came as inventions. The

Monday, August 26, 2019

Residency Change Essay Example | Topics and Well Written Essays - 250 words

Residency Change - Essay Example I wish to change my resident student status as my parents have now moved to West Virginia and would prefer me to stay with them. We are very close knit family and my mother, being of delicate health, would be mentally relaxed if I could continue my education from local academic college or University. The multicultural environment of the state is also strong motivating factor that I believe would help me and my family to acculturize more easily within the mainstream society. I also believe that the University of West Virginia promotes the concept of constructive ideologies and proactive participation of the students from diverse backgrounds, in forging better understanding of evolving socio-economic and environmental dynamics. Indeed, it not only offers excellent academic programs but also huge opportunities for personal growth. Hence, change of student residency would considerably help me to be with my family and also help me achieve state of the art

Sunday, August 25, 2019

Benito Mussolini Research Paper Example | Topics and Well Written Essays - 1250 words

Benito Mussolini - Research Paper Example While going to school, Benito rebelled against various issues. Rosa, his mother had insisted he go to this school which was operated by Catholic Monks. However, Benito’s behavior ridiculed the school’s rules and as such he was expelled. Benito’s father believed that the Roman Catholic Church was Italy’s biggest enemy, and he embedded this belief into his son which he solely agreed with. Benito showed improvements at his other school and continued on this pathway and became a teacher. Despite this, Benito’s passion was in politics. At the tender age of 19, Benito fled Italy for Switzerland to avoid military service. There in Switzerland, he met other Italian socialists and gained employment as a bricklayer and became a member of the Trade Union. Just one year later, at the age of 20, in 1903, Benito was expelled from Switzerland for suggesting a general strike. Benito then travelled to France but eventually went back to Italy to complete his military service. To be more precise, he went to Trentino north of Italy which was ruled by the Austrians. However, sooner than later, Benito’s beliefs caused him to be kicked out of Trentino in 1909. Austrian authorities described him as a trouble maker because he encouraged trade unions and launched attacks on the Catholic Church. Afterwards, Mussolini travelled south to Po Valley, where he advocated for farmers to get better salaries. He was appointed Secretary of the local Socialist Party in Forli and Editor of the socialist newspaper â€Å"La Lotta di Classe†. Since his return from Switzerland, Mussolini worked extensively as a journalist and a social activist at the same time. Later he became an Editor for the Avanti. Mussolini resigned his post as Secretary for the Socialist Party in Forli because they advocated support for the allies in World War I. Benito served in the Italian Military when Italy entered the First World War and Benito held the rank of Corporal in the Army. Mussolini was injured during the war and immediately upon his return to Milan; he decided to edit the right-wing â€Å"Popolo d’Italia†. It is probably safe to assume that the effects of the war transformed him from a socialist to a ruthless fascist. He was hungry for power and he was going to get by freewill or by force. Following the war, Mussolini carried out a myriad of activities influenced by Fascism and his many other beliefs. â€Å"The defining features of fascism are nationalism (including economic nationalism), corporatism (including economic planning), totalitarianism (including dictatorship and social interventionism), and militarism†. 1 He attacked Vittorio Orlando (Italy’s Prime Minister at the end of World War I) for his futile efforts in pursuing Italy’s objectives at Versailles Peace Treaty and aided in the compilation of the right-winged groups into the Fascist Party. Right-winged political individuals are a form of governme nt who believe that the individuals are more important than the country. â€Å"Right wingers believe in formal equality. They believe that everyone should be treated equally under the law and should be treated equally by government. Examples of right wing formal equality include equal pay for equal work and civil and political rights.† 2 Out of fear for more bloodshed, he was appointed Prime Minister by King Victor Emmanuel III in 1922 after the â€Å"March on Rome†. Mussolini’s fascist party â€Å"Black Shirts† made his rise to power rapid. By the time of Hitler’

Saturday, August 24, 2019

The Church of Jesus Christ of Latter Day Saints Essay

The Church of Jesus Christ of Latter Day Saints - Essay Example They believe in the complete Bible plus an open canon that includes the Book of Mormon, the Doctrine and Covenants, and the Pearl of Great Price. These are based largely on the dictates of Joseph Smith, Jr. and are followed in the LDS church as the irrefutable works of God (Mormon, 2009). The group then multiplied and grew. It grew enough to draw attention of the mainline churches as well as the general population. The Mormons effected thousands of conversions in the 1830s, following which the group under Smith Jr. intended building a â€Å"City of Zion† in Missouri. They could not build the city, however, owing to persecutions and charges brought against them. Joseph Smith Jr. and his brother, Hyrum Smith, were assassinated by a mob in the prison on 27 June, 1844 (Mormon, 2009). The teachings of the LDS church are based on the life of Christ but emphasis is laid on the rules and their interpretations by the central and local LDS churches. The tenets of the LDS church are based on the extra material found in the â€Å"open canon†. On the basis of these extra materials, the church relates future events that are again subject to the interpretations of their modern prophets. For instance, before his assassination, Joseph Smith Jr. appointed Brigham Young and the Quorum of Twelve Apostles to oversee the LDS churches affairs. He also gave them the keys of the priesthood. So, it naturally followed that Brigham Young and the Quorum of Twelve Apostles took over the reins of leadership of the church after the death of Joseph Smith, Jr. Others in the church split from the church and followed denominational leaders of their liking (Mormon, 2009). The LDS church claims the natives of ancient America are descendants of Semitic race of Asiatic origin and trace it down to Joseph Smith, Jr. Thus, with the ties of Joseph Smith, Jr. established to a Jewish race, the next step to proclaim his closeness to Jesus Christ and the â€Å"true

Friday, August 23, 2019

The Curriculum and Instruction Case Analysis Assignment

The Curriculum and Instruction Case Analysis - Assignment Example The Principal is far more than the physical head of a school or a person with abundance of knowledge. He is also the role model and a great leader cum visionary, who propels his entire family of teachers and students towards success. In today's world of extreme competition and marketing strategies to attain that sharp edge over the others, Principals, as the head of the institution have a greater role to play. It includes living up to the expected standard of the school, while also catering to the current demands of the market; all this while obliging and adhering to the rules and guidelines prescribed by statutory bodies and boards of education in the area concerned. The case study on GATE is one such example of the number of responsibilities and decision-making abilities that must be realised by the Principal. Assuming that I am the Principal of Monet Middle School located at La Solana, I would deal with the problem, in a tactful and with a more open perspective and outlook. Since the issue deals not only with the educational point of view, but with a broader issue like heterogeneous ethnic backgrounds and the pressure to categorise students, it needs great amount of confidence and strength to chalk out a pathway to satisfy a large number of the people involved, take great care not to hurt the sentiments of the diverse population, and yet adhere to principles and codes of conduct. The case study says that the school has about 23% of the students attaining their education through the Voluntary Ethnic Enrolment Program (VEEP), about 53% of the students consisted of those qualifying for the Gifted and Talented Education (GATE) program and about 5% of the students have been recognised as those with special needs that requires them to attend the Special Education Program. With such diversified population, it is indeed an uphill task to bring and bind all of them together. The Tracking System that segregated the students was initially implemented in the school and then, it was done away with great difficulty but with immense conviction. It brought about great changes for the better and also raised the normal standard of education and results. Most importantly, it bridged the gap between students emerging from various backgrounds and with different levels of intellectual quotients. As the Principal, I am now faced with a challenge---the school board has passed an ordinance that calls for the implementation of the tracking syste

Thursday, August 22, 2019

Stalins leadership Essay Example for Free

Stalins leadership Essay The great patriotic war was a theatre of war primarily between Russia and the Nazis, although it involved many surrounding countries in Eastern Europe and beyond. This period was notorious for its unprecedented ferocity, destruction, and immense loss of life and was lead under the leadership of Stalin. Yet to what extent was Stalins efforts and actions the reason for the Soviet victory against the axis powers? Politically, there were many aspects that contributed to the war effort. The Communist Party itself worked at the rear of the forces (350,000 members were transferred to the back lines) and also increased membership to ensure that there was sufficient support for the party. The NKVD played a more significant role in the war, most importantly controlling the USSR population through fear. The NKVD were responsible for the labour camps (gulags) where prisoners of war were sent as well as opposition suspects and deserters from the Russian armies. The group had many other roles, including undercover officers within the red army reporting any deficiencies in moral and any anti-communist attitudes. Therefore they created a sense of terror that deterred any resistance against Stalin and the regime from building up effectively as well as maintaining discipline and security within the army. This was obviously a crucial factor in Soviet success, without this the Red Army would not have fought effectively. Although the NKVD were very effective throughout the war and must certainly be credited in the Soviet success, Stalin was in overall control of the body, and therefore could also claim some of this as his own. He also influenced the air of terror, by coining orders like not one step back meaning that any soldiers that tried to retreat would be shout by the NKVD themselves. Britain and America were Russias allies in the war and although they did not send troops directly to the front line, the lend lease programme (begun in March 1941) provided the USSR with essential war supplies $11. 3 billion worth of goods were sent throughout the war. Without these the army would have been less effectively supplied and progress may have been slower, particularly one the offensive move towards Berlin, which may have given the enemy more time to re-organise and build defenses. Additional assistance came from U. S. Russian War Relief (a private, nonprofit organization) and the Red Cross who also sent supplies. Again, it could be suggested that it was Stalins political ability that allowed him to form these alliances that proved to be so vital. However, for the supplies from the Red Cross and Russian war relief he cannot be accredited and it could be argued that the allies did not aid Russia due to Stalins diplomacy but merely in an attempt to defeat Germany. Despite the destruction of the war, the Russian economy managed to keep the front supplied with weapons and other supplies. The move to dismantle factories and rebuild them in the remote Urals once the Germans had begun to infiltrate Russia proved to be very successful. 1500 enterprises and 10 million people were transferred eastwards and the new industrial heartlands began production. The planned economy also meant that industrial plants were converted into military production factories (for example, in Moscow a childrens bicycle factory was converted into a automatic rifles factory). Without this economic planning, the Red Army would not have been supplied tanks, guns ammunition and planes in adequate quantities (in fact, by 1943 the Red Army was achieving this). However, yet again the ideas for the planned economy and the move of the factories were announced by Stalin and therefore their successful results and vital contribution to the war could be said to be a result of cunning planning and economic efficiency. Further than this, Stalin managed to mobilize the entire urban society into production. Similarly to the five year plans, anyone of a working age was forced into labour, including the women. For example, in 1942, women made up 53% of the urban workforce. Without this mobilisation, the factories would not have run to full capacity and production levels would have fallen substantially. Stalin also cleverly ensured that the workers would not resent the regime by increasing wages (wages rose by 75% between 1938 and 1944) and those in regular manual employment were guaranteed survival through the network of Ors (workers provisionary department) shops at their places of work. Obviously the Red Army must be accredited with at least some of the war success. Although it was initially disorganised and was unable to adapt to the defensive tactics now necessary, this was the result of Stalins fierce purges of the Red Army causing military leaders to be wary of taking any initiative or acting without firm orders from the leader himself. The Army was however, heroic in nature and had many successful attacks against the Germans (for example, the Battle of Kursk). Another initial weakness was the dual command of the Politruki, but Stalin did end this when he realised it was a hindrance to the army rather than a help. Stalins choices in military men had both positive and negative effects on the war. He was often seen to give leadership powers to those who were his close friends and allies, often with poor results. An example of this is Kulik who delayed the production of Katyusa rockets and T34 tanks due to a belief that more old fashioned artillery and horsepower were more effective war methods. However, Soviet success was also the result of meticulous planning and military excellence of many other of the Russian leaders, for example Vasilevsky who was responsible for the planning and co-ordination of all decisive offences and Chuikov who commanded in Stalingrad. The man with the most influence militarily however was General Zhukov who oversaw the defence of Leningrad and orchestrated the first breakthrough, commanded in the Battle of Kursk and launched the final attack on Germany, including capturing Berlin. Further than this Zhukov was more fearless than many others of the leaders and stood up for his military ideas. It could be suggested that this was the main reason that Stalin eventually accepted that his tactics needed updating and moved away from his previous military ideas. Had the Red Army continued with these they may never have won the war as the outdated tactics were very unsuccessful. The Stavka ended up being a very effective team, some disagreement with Stalin was tolerated and the result was concrete military decisions that resulted in Soviet success. It is possible to completely blame Stalin for the initial Russian failures for a further reason. Previous to Operation Barbarossa, Stalin had been warned of the German attack but simply ignored this and made no defensive military plans. Therefore when under attack, the army only had defensive strategies available. This was particularly a problem due to the lack of initiative that generals were willing to take as explained above. Some debate still remains over why Stalin refused to acknowledge the information but it was probably a combination of Stalins overconfidence in the character of Hitler and other circumstantial information (such as 22nd June was theoretically too late to attack as it was too close to the Russian winter). For these reasons Stalin was certainly a hindrance to the Russian side at times. However, he did change his tactics eventually which was obviously a difficult move for Stalin as it resulted in a loss of face. Another of Stalins failures was his refusal to sign the Geneva Convention for human rights. Therefore when Russian prisoners of war were captured they often ended up in extermination camps in Germany. Many Russian war prisoners ended up fighting for the German side in preference to being killed. An example of this is Andrei Vlasov who set up a Russian Liberation Army who fought for the Germans; he was later used as a figurehead for German propaganda. If Stalin had signed the agreement the Germans wouldnt have had any extra re-enforcements. Another general factor for the Soviet success in the Great Patriotic War is psychological and social. The role of the Russian people undoubtedly contributed to the war effort. Other than the obvious roles they played in the factories, farms and on the battlefront itself, the sheer heroism of many of the people is astounding. For example, within Leningrad the Russian people failed to give in to German terror for 872 days, despite the constant attack from the skies, bitter famines spread throughout the whole city, horrific death rates (in December 1941, 53000 people died in Leningrad (this was as many as the total deaths in 1940)) and rations that were barely enough to survive (bread rations were 400g a day but decreased to 250-125g in December/January 1941). This strength of the nation was seen in other places, such as the partisan units that were set up in the German occupied areas. Often the members were Red Army troops that had not retreated quick enough to stay in front of the Germans, but many were also civilians united in a hatred for the Nazis. They were effective in tying down Germans in certain areas, harassing German soldiers but most importantly showing the opposition that Russian influence was still present in their occupied areas. The sheer hatred that the Russians felt for the Germans was also influential to Soviet success, and the treatment in the camps was certainly a contributing factor to this. Another reason for this was the treatment for the Russians in the German occupied territory. The Germans viewed the war as a war of extermination and used the Slav people as sub-humans. An example is a quote from Hitler if 10,000 females die of exhaustion digging an anti-tank ditch, my only interest is that the ditch is dug for Germany. Only towards the end of the war did the Germans realise that it would be much more effective to try and keep the Russians on side. An example of the earlier brutality is the 34,000 Jews and Soviet citizens massacred at Babi-Yar which was an attempt to cleanse Russia and create living space (lebensraum). This is important for the war as the Russian hatred fuelled their desire to defeat the Germans and individuals would work harder and faster in whatever role they were contributing in. It could be suggested that Stalin did help influence this as his speechs were always hugely anti-German and highlighted the deaths and terrors inflicted upon Russia. He also contributed to the propaganda that was circulated in the war which showed clearly the brutalities of the war to the Russian civilians. This was to influence the Red Army and partisans to fight for motherland, for honour, for freedom and for Stalin. Stalin also managed to mobilise and encourage women into the war effort. Women took on roles within factories, farms and other mens positions such as miners and welders. At the beginning of 1940 women made up 41% of labour front and over 800,000 saw active service on the battlefields (ordered after 1942). Another social change that Stalin made during the war were the religious concessions. For example, in 1942 the labour camps were searched for religious men who were then allowed home and in 1943 they Russians elected a new patriarch and synod. These proved very successful and brought him more support as the religious Russians had previously felt oppressed. Stalin as a war leader was always resolute and determined. It is unquestionable that Stalin was courageous, despite German attack he remained with his family in Moscow rather than fleeing to Kuibyshev. Although he did make some mistakes, particularly during the openings of the war, he did manage to amend many of these. The ways in which Stalin helped make the Soviet war success certainly outweigh his hindrances in both number and significance. Without such a powerful, charismatic and talented leader, Russia would have been much more likely to be defeated in the Great Patriotic war.