This guide will help you answer the NCFE CACHE Level 2 Award in Awareness of Dementia Unit 2.1. Outline the medical model of dementia.

Dementia is a debilitating condition affecting millions worldwide, including many in the UK. To understand dementia better, you must explore various approaches, including the medical model. Understanding dementia symptoms is crucial in providing proper care and support for individuals living with the condition. Symptoms can vary widely, but common signs include memory loss, difficulty with daily tasks, confusion, and changes in mood or personality. By applying a medical model approach, healthcare professionals can better diagnose and manage the symptoms of dementia, ultimately improving the quality of life for those affected by the condition.

This detailed explanation will help you grasp what the medical model of dementia entails.

What is the Medical Model?

The medical model is an approach used in healthcare to understand and treat illnesses or conditions. It focuses on diagnosis, treatment, and cure. When applied to dementia, this model examines the biological and physical aspects of the disease.

Key Principles of the Medical Model

• Biological Focus: The medical model zeroes in on the biological factors causing dementia. It looks into genetics, biochemistry, and physical changes in the brain.
• Diagnosis and Classification: It categorises dementia into various types, like Alzheimer’s disease, vascular dementia, Lewy body dementia, and frontotemporal dementia.
• Treatment: The model prioritises treatments that focus on slowing the disease’s progression or easing symptoms, usually through medication.
• Research and Evidence-Based: Treatments and understandings in the medical model rely heavily on scientific research and clinical trials.

Biological Focus

Brain Changes

Dementia involves several changes in the brain. Some common changes include:

• Plaques and Tangles: In Alzheimer’s disease, abnormal protein deposits (plaques) and twisted fibres (tangles) accumulate in the brain.
• Vascular Damage: In vascular dementia, damage to blood vessels in the brain leads to diminished blood flow and subsequent brain cell death.
• Lewy Bodies: In Lewy body dementia, abnormal protein deposits called Lewy bodies develop in nerve cells.
• Neuron Loss: Progressive loss of neurons (nerve cells) is a hallmark of many types of dementia.

Genetics

Some types of dementia are influenced by genetics. For example:

• Familial Alzheimer’s Disease (FAD): A rare form caused by mutations in specific genes.
• Huntington’s Disease: A genetic disorder that often leads to dementia in later stages.

Diagnosis and Classification

Exact diagnosis is important. The medical model uses various diagnostic tools, such as:

• Clinical Assessment: A thorough evaluation by a healthcare professional, including medical history and cognitive testing.
• Imaging Tests: Techniques like MRI or CT scans to detect brain changes.
• Blood Tests: To rule out other conditions that might cause similar symptoms.

Types of Dementia

The main types include:

• Alzheimer’s Disease: The most common type, characterised by memory loss and cognitive decline.
• Vascular Dementia: Resulting from impaired blood flow to the brain.
• Lewy Body Dementia: Associated with abnormal protein deposits.
• Frontotemporal Dementia (FTD): Involving damage to the frontal and temporal lobes of the brain.

Treatment Approaches

Medication

The cornerstone of the medical model involves medication, such as:

• Cholinesterase Inhibitors: Like donepezil, to increase levels of a neurotransmitter (acetylcholine) in the brain.
• Memantine: For moderate to severe Alzheimer’s, reduces symptoms by regulating another neurotransmitter (glutamate).

Non-Pharmacological Interventions

Alongside medications, other treatments include:

• Cognitive Stimulation Therapy (CST): Activities designed to improve mental abilities.
• Exercise and Nutrition: Encouraging physical activity and a balanced diet to enhance overall health.

Managing Symptoms

The model focuses on managing specific symptoms, such as:

• Behavioural Changes: Using antipsychotic drugs to manage agitation or hallucinations.
• Sleep Disorders: Medications to aid sleep and improve restfulness.

Research and Evidence-Based Practices

The Need for Clinical Trials

Clinical trials are really important. They reveal the effectiveness of new treatments. For example, recent trials on drugs like aducanumab (Aduhelm) offer hope for Alzheimer’s treatment.

Ongoing Studies

Researchers continuously explore:

• Genetic Therapies: Techniques to alter genes responsible for dementia.
• New Medications: Developing drugs that target different aspects of brain pathology.
• Prevention Strategies: Identifying lifestyle factors that might reduce the risk of dementia.

Criticisms of the Medical Model

Though widely used, the medical model has faced criticisms:

• Reductionist Approach: Critics argue it reduces dementia to mere biological anomalies, ignoring social, psychological, and environmental factors.
• Overemphasis on Medication: Some believe it focuses too much on drugs, rather than holistic care.
• Limited View of Personhood: This model might treat people as patients defined by their illness, rather than addressing their individuality and personhood.

Alternative Models

Some advocate for:

• Biopsychosocial Model: Integrates biological, psychological, and social factors.
• Person-Centred Approach: Emphasises understanding the individual’s unique experience and needs.

Example answers for unit 2.1. Outline the medical model of dementia

Sure, here are some example answers a care worker might write when completing the unit:

2.1. Outline the Medical Model of Dementia

As a care worker, I’m frequently involved in supporting individuals with dementia. Here’s my understanding of the medical model of dementia. The medical model primarily views dementia as a series of cognitive deficits resulting from various medical conditions, emphasizing diagnosis and treatment of the underlying causes. This perspective often focuses on the clinical symptoms and categories of dementia, leading to a dementia definition and explanation that centers on biological and neurological factors. While this approach is essential for developing effective interventions, it is equally important to consider the personhood of those affected and the impact of social and environmental factors on their quality of life.

Introduction to the Medical Model

The medical model of dementia primarily focuses on the biological factors that cause the disease. It looks at dementia from a purely medical perspective, examining how genetics, brain chemistry, and structural changes in the brain contribute to the condition. This model is mostly concerned with diagnosing the specific type of dementia, treating symptoms, and aiming to slow down the progression of the disease.

Biological Focus

Brain Changes

In the medical model, dementia is seen as resulting from physical changes in the brain. For instance, in Alzheimer’s disease, there are protein deposits called plaques and tangles that interfere with brain function. In vascular dementia, it’s the damage caused by problems with blood flow to the brain. Different types of dementia have their unique characteristics, but they all involve significant changes in the brain’s structure and function.

Genetics

Some forms of dementia have a genetic link. For example, familial Alzheimer’s disease is inherited, which means it runs in families. This type of Alzheimer’s is rare but features how genes can influence the onset of dementia.

Diagnosis and Classification

Accurate diagnosis is essential in the medical model. This involves a thorough clinical assessment where healthcare professionals evaluate medical history and conduct cognitive tests. Imaging tests like MRI or CT scans are often used to observe brain changes. Blood tests can also be done to rule out other conditions with similar symptoms.

Types of Dementia

The medical model categorises dementia into several types, each with different underlying causes:

• Alzheimer’s Disease: The most common type, known for affecting memory and cognitive abilities.
• Vascular Dementia: Caused by problems with blood flow to the brain.
• Lewy Body Dementia: Characterised by abnormal protein deposits in the brain.
• Frontotemporal Dementia: Involves damage to specific areas of the brain.

Treatment Approaches

Medication

Treating dementia in the medical model usually involves medication. Common drugs include cholinesterase inhibitors (like donepezil) which increase levels of acetylcholine in the brain. Memantine is another medication used for more severe cases, helping to regulate glutamate, another neurotransmitter.

Non-Pharmacological Interventions

Apart from medication, the medical model also supports non-drug therapies. Cognitive Stimulation Therapy (CST) is an example where activities are designed to improve cognitive functions. Encouraging physical exercise and a balanced diet also plays a role in managing symptoms.

Managing Symptoms

Specific symptoms like behavioural changes and sleep disorders are managed through medications and sometimes behavioural strategies. Antipsychotic drugs might be used to manage severe behavioural problems, although there are concerns about their side effects.

Research and Evidence-Based Practices

Clinical Trials

The medical model is heavily research-oriented. Clinical trials are essential for developing new treatments. For example, recent studies on drugs like aducanumab offer new hope for Alzheimer’s patients.

Ongoing Studies

Researchers continuously work on discovering new treatments. Genetic therapies that can alter specific genes and new drugs that target different brain mechanisms are being investigated. There’s also a focus on prevention methods to reduce the risk of developing dementia.

Criticisms of the Medical Model

The medical model faces some criticisms. It tends to look at dementia strictly as a medical issue, potentially ignoring the social, psychological, and environmental aspects. Some people think it emphasises medication over holistic care. Critics also argue that it could treat people as patients defined by their illness, rather than as individuals with their unique needs and histories.

Final Thoughts

In summary, the medical model of dementia looks at the biological causes and aims to diagnose, classify, and treat the disease. It relies on scientific evidence to guide treatments and improve patient outcomes. As a care worker, while it’s important to understand this model, it’s equally essential to adopt a person-centred approach to provide holistic care. By combining the strengths of the medical model with personalised care, we can better support those living with dementia.

By writing my answers this way, you can demonstrate a good understanding of the medical model of dementia for the NCFE CACHE Level 2 Award.

Final Thoughts

The medical model of dementia is a structured and research-driven approach. It focuses on the biological, physical, and genetic underpinnings of the condition. By categorising types, offering targeted treatments, and employing evidence-based practices, it aims to manage and ideally slow the progression of dementia.

However, while this model offers significant insights and tools, it’s essential to complement it with holistic and person-centred approaches. Understanding dementia fully requires considering all aspects of an individual’s life, beyond just the biological markers.

This thorough understanding of the medical model will aid you in your studies and your work in health and social care. Remember, the ultimate goal is to improve the quality of life for those living with dementia.