I Love School Essay

Sixteen years after a sixteen-year-old wrote this book, Francis Ford Coppola turned this novel into a movie. The book is a coming-of-age novel, but the movie focuses on the characters’ loss of innocence. The movie follows the story line very closely. The reader is only told that this story takes place in the southwest, but the movie places it in Tulsa, Oklahoma, in the year 1966. It also changes the conflict from the East Side versus the West side to the northside versus the southside. This minor directional change was probably made due to the relative time proximity to the musical West Side Story, which won the best picture Academy Award in l961. However, as with all movies, character insight that is critical to understanding the story is lost when the format goes from the written word to the screen. Ponyboy is telling us the story, the same as in the book, but the 91-minute film only glosses over many character relationships. With the exception of Ponyboy, the viewer misses out on knowing most of the novel’s characters. Darry and Soda are relatively minor characters in the movie, and the viewer is given little insight into their lives. The same is true for the rest of the gang, even Dally. Dally’s death loses much of its impact because viewers aren’t able to get to know him. Only the reader is aware of the fact that Dally’s gun is unloaded, and the symbolic death of Dally in the spotlight is gone. Johnny’s character is also weaker in the movie than the book. Viewers don’t see the growth in his character, because they don’t know Johnny. Johnny’s appreciation for life at the end of his own is barely noted, but it has great impact on Pony in the novel. The whole point of the telling of Ponyboy’s story is to give meaning to Johnny’s death. Johnny had wanted Ponyboy to tell Dally certain truths, and given that Dally is dead, Pony writes this story down for all of the Dallys in the world: â€Å"Someone should tell their side of the story, and maybe people would understand then and wouldn’t be so quick to judge a boy by the amount of hair oil he wore.† The movie and book do begin and end with the same lines, the difference being, only readers understand the meaning behind them.

Memo and Notice of Meeting Example Essay

Please be reminded that prompt and efficient service is the key to a successful business. The clients you serve are the business’ future and maintaining a good relationship with them is very important. A good relationship with clients can only be maintained through Prompt and Efficient Service. Delivering, collecting and repairing machines promptly is vital to the survival of a company. Therefore, you are reminded to act promptly. It is also important that there be proper communication with clients if there is a problem. We almost lost a client as a result of improper behaviour. TES VOLUNTARY CARERS ASSOCIATION NOTICE OF MEETING The TES Voluntary Carers Association, Manchester Division, Monthly meeting will be held on Tuesday, March 27 2011 at 9:00 am in Room 803 on the 3rd floor of the Technical Ed. Building St Hews College, 252 Manchester Road Mandeville AGENDA 1Call to Order 2Invocation 3Welcome/ Apologies 4Minutes of last Meeting 5Matter arising from Minutes 6Correspondence 7Reports (a)Director of Social and inter clubbing (b)Treasurer’s report 8New Business 9Any Other Business 10Date of next Meeting 11Adjournment extra words The field slaves had the most difficult time among the different slaves. They had to work longer than any other kind of slave. They usually worked from sunrise to sunset in comparison to the house slaves who only worked a few hours. House slaves were treated far better than the field slaves as some were treated like the slave-owner’s children. The House slaves were kept clean, well dressed, and were allowed to speak much more often because they served the food to the owners and their guests. In fact the house slaves were allowed to eat in the house, not at the table but usually in a back room. As for the FS, they usually ate out in the barn with the animals and were only fed enough to keep them strong enough to work. Field slaves were often whipped, sometimes for without a reason. Their jobs included hoeing, harvesting, ploughing, mowing etc. However, all the slaves whether domestic, factory or field had some things in common in terms of their lifestyle. Most of the slaves were illiterate and the masters did what they could to keep them this way for various reasons. Slaves were allocated a region of the plantation for their living quarters. Slaves houses were usually wooden shacks with dirt floors, but sometimes houses were made of boards nailed up with cracks stuffed with rags. The beds were collected pieces of straw or grass, and old rags, and only one blanket for a covering. A single room could have up to a dozen people-men, women, and children. Another similarity they shared was that they all had a master who they had to obey. They would be punished for murder, robbery, arson or assault upon a white person. Slaves could be killed for murder, burglary, arson, and assault upon a white person. Plantation owners believed that this severe discipline would make the slaves too scared to rebel. Slaves were also whipped.

Learning Disability? There Are Many Resources for You

All people learn differently. But while all students have naturally variable approaches to learning (read more about different learning styles here ), others have difficulties with specific skills that generally come more easily to their peers. A learning disability is a neurologically-based processing disorder that makes it difficult for people to learn basic skills such as reading, writing, and math, or higher level skills such as organization, time planning, abstract reasoning, long or short term memory and attention. Some people have a learning disability in a specific area, in which case the individual’s performance would be significantly lower in that subject compared with every other area. Do you suspect you have a learning disability? If you, your parents, or your teachers think that might be the case, it’s important to have a psychologist or other certified tester diagnose it through formal testing. Once you have a diagnosis, there are many resources to help you succeed.   Also remember that having a learning disability doesn’t mean you’re not smart or won’t have a bright future. On the contrary, many successful people have learning disabilities, such as Steven Spielberg, Keira Knightley, Anderson Cooper, and Tommy Hilfiger, who all have dyslexia. They didn’t let it hold them back, and there’s no reason why you need to, either! Read on for more for more information about resources for students with learning disabilities. There are different types of learning disabilities. Here are a few of the more common ones. Our Early Advising Program helps students in 9th and 10th grade discover their passions and build strong academic and extracurricular profiles to succeed in high school. Some disorders, such as ADHD (Attention Deficit/Hyperactivity Disorder) and Dyspraxia, are not technically learning disorders, although they can still affect and impact students’ learning abilities. Many of the accommodations we describe below may also apply to students with these disorders. If you have a learning disability and are concerned with how it’s impacting your schoolwork and other areas of learning, your first step is to get it diagnosed and make sure your high school has all the necessary documentation. Ask your parents to set up a meeting with your guidance counselor or other school administrators to discuss the situation and describe what accommodations you will need, if you know. You will probably need a letter or confirmation from your psychologist or whomever gave you the diagnosis explaining your disability and how it affects your ability to complete you schoolwork. There are other types of support available to you. For instance, the SAT , ACT , and AP exams offer special accommodations for people with different types of learning disabilities, such as extra time. To learn more about how they can support you, check out our post, 2017 Welcomes New Testing Policies for Accommodations on the SAT . Additionally, many schools will give you extra time, assign you to a school therapist, allow you to type your assessments if need be, and make other accommodations depending on your needs. If you have a learning disability, remember that you’re not alone. Millions of other students have one too. Because there are so many people with learning differences, there are numerous organizations and associations that are dedicated to supporting these individuals and their parents. There are several unique resources for students with specific learning disabilities. You’ll likely find that your high school and the other people with whom you learn and interact are more than willing to help and support you. Still, you should make an effort to seek out services that can assist you. If you’d like a tutor to help you with your schoolwork or standardized test preparation, make sure you look for one who is specifically trained to work with students with your learning disability. You can often find tutors with this type of training through local learning centers, colleges, or your high school. Document your learning disability on your college applications. For tips on how to address it, check out How to Address a Mental Health Issue or Disability on Your College Application . When touring, visiting, or speaking with representatives at prospective colleges, ask if they have resources and accommodations for your learning disability. Many schools have dedicated learning centers that can assist you. In addition, check out the Mentorship Program . Our mentors drive significant personal and professional development for their high school mentees, and can provide insight on unique circumstances like navigating high school with a learning disability.   Combining mentorship with engaging content, insider strategies, and personalized analyses, our program provides students with the tools to succeed. As students learn from successful older peers, they develop confidence, autonomy, and critical thinking skills to help maximize their chances of success in college, business, and life.

The Impact of (items choose from the requirement) on the culture of an Essay

The Impact of (items choose from the requirement) on the culture of an organisation 2232 - Essay Example The current paper analyses the importance of power, politics, conflicts and negotiations and how they impact organizational culture and the employees. Power can be essentially described as the ability to make someone do something as per ones will. It is the ability to make things happen as one desires and as they direct others. Power can essentially be described as the influential mechanism one has over others. If an organization lets employees work as they wish without exercising power, they might escape from responsibilities and remain less serious about work. In order to make employees work, it becomes essential to exercise a certain degree of power. It is generally observed that power implemented legitimately is most beneficial. Frequent and over exercising of power may lead to employees feeling over dominated and pressurized (Lawrence, et al., 2005). This might negatively impact performance (Mumby, 2001). Power in an organization should always be directed towards enhancing organizational productivity. Mangers must ensure that while exercising power, they must not display rudeness, anger or ego. Power should be exhibited in a motivating and directive manner. Managers must ensure that power does not induce fear and resentment amongst employees. This would prevent them from sharing their problems and issues with the superiors. The power to direct and guide employees must be vested in the hands of able leaders who understand the needs of both the organization and the employees (Mumby, 2001). Threatening employees, with job loss or severe actions to make them to do their work is not an effective way to exercise power (Lawrence, et al., 2005). Organizational politics can be described as the act of giving more importance to one’s own interest without giving much consideration to the needs of others. Political influences are common in

Living Will Essay Example | Topics and Well Written Essays - 750 words

Living Will - Essay Example Life preserving technologies have shifted the dynamics of the perceived role of health professionals as they are now increasingly being viewed as persons most suited to care for the patients sustaining prolonged diseases. Those patients who suffer from diseases which virtually force them to live terminally ill lives may require assistance in the form of help to end their lives to end the suffering and pain inflicted on them through different diseases. In such cases patients may be willing to end their lives mostly with the help of their physicians. (Sunstein, 1997). The case of Terri Schiavo is one such example which raised a lot of ethical as well as professional questions regarding the supposed role of health professionals in providing assistance to end their lives. The above mentioned situation have also gave rise to the discussion of whether the patients, who are lucid as well as competent, to decide whether to accept or decline life sustaining treatments. These discussions has also lead to the culmination of Patient Self Determination Act during 1990 which made mandatory for hospitals and nursing homes to inform their patients, in advance, regarding the type of treatment they may receive and if patients are unaware of such things, they must be informed regarding the advance directives.(Bernal,2008) This legislation also gave rise to the concept of living will which allowed patients of lucid and competent mind to decide upon the type of life prolonging treatments to be administrated to them thus ethically upholding the patient autonomy. (Valente, 2004). As discussed above that patients with terminal illness often seek the help of their physicians to end their lives gives rise to another dimension to the whole argument that whether other health professionals especially nurses should also have a role in assisting patients to write their living will in order to decide upon choosing the life prolonging treatments. Authorization to Nurses The argument of whether to allow nurses to assist patients in writing their will to accept or reject certain life prolonging treatments need to be viewed in multiple perspectives of ethical, legal as well as professional standards. It is often argued that ending one' life either through a living will or otherwise gives rise to the question of the moral beliefs held by the society (McMahan, 1993). This question alone put a certain ethical restrictions on the more responsible institutions not to be a part of something which has strong moral as well as ethical consequences. Though, living will may be a legal document which spells out "the types of medical treatments and life-sustaining measures you do and don't want" (Mayo , 2007) however, it does not necessarily means that hospitals and other health service providers deliberately attempt to assist patients to write their will to live let alone allowing nurses to be part of that. Though the assistance of nurses may be of technical nature however, given the low level of

The effects of Globalization Essay Example | Topics and Well Written Essays - 1000 words

The effects of Globalization - Essay Example In economic sphere, globalization brings new opportunities to developing countries through capital injections, new technology and innovative ways of production. After all, the total value of world trade exploded from $57 billion in 1947 to an astonishing $6 trillion in the late 1990s (Easterly 43). In the last few years, the public debate over the alleged benefits and drawbacks of free trade reached a feverish pitch as wealthy Northern countries have increased their efforts to establish a single global market through regional and international trade-liberalization agreements such NAFTA and GATT. Free trade proponents assure the public that the elimination or reduction of existing trade barriers among nations will enhance consumer choice, increase global wealth, secure peaceful international relations, and spread new technologies around the world (Easterly 2001). Following Bhagwati (2001): "Economic globalization constitutes integration of national economies into the international eco nomy through trade, direct foreign investment, short-term capital flows, international flows of workers and humanity generally" (1). There is evidence that some national economies have increased their productivity as a result of free trade. Moreover, there are some benefits that accrue to societies through specialization, competition, and the spread of technology. But it is less clear whether the profits resulting from free trade have been distributed fairly within and among countries. Most studies show that the gap between rich and poor countries is widening at a fast pace (Easterly 34). Free trade proponents have encountered severe criticism from labour unions and environmental groups who claim that the elimination of social control mechanisms has resulted in a lowering of global labour standards, severe forms of ecological degradation, and the growing indebtedness of the global South to the North. The internationalization of trade has gone hand in hand with the liberalization of financial transactions (Webber and Fort, 62). Globalization of financial trading allows for increased mobility among different segments of the financial industry, with fewer restrictions and greater investment opportunities. TNCs (transnational corporations) have consolidated their global operations in an increasingly deregulated global labour market. The availability of cheap labour, resources, and favourable production conditions in the global South has enhanced corporate mobility and profitability. Globalization boosts productivity and improves production processes in LDCs (less developed countries) like China, India, Korea and Singapore. Today, these countries become the core of global production and economic activities (Bhagwat 72). TNCs and new technology bring new cultural patterns and western style of life changing traditions and values of isolated regions. Cultural globalization refers to the intensification and expansion of cultural flows across the globe. Obviously, 'culture' is a very broad concept; it is frequently used to describe the whole of human experience. In order to avoid the ensuing problem of overgeneralization, it is important to make analytical distinctions between aspects of

Strategic Marketing Case Study Example | Topics and Well Written Essays - 1750 words

Strategic Marketing - Case Study Example It is a democratic country which ensures that the tourism industry enjoys stability and hence the hotel industry will also get benefitted. India has a specific ministry called tourism ministry which formulates strategies to enhance the tourism sector in India. Indian government charges huge amount of taxes from the luxury hotels which will have a huge impact as political scenario changes. The hotel industry in India gets good incentives and the respective state governments also supports development of such hotels and their growth. Though the terrorist attacks on Taj Hotels and Oberoi hotel have led to drop in foreign travellers, Indian government is taking steps to allay such fears (Kachwala and Mukherjee, 2009, p. 158). Economic Factors India is one of the fastest growing economies of the world with the GDP growing almost 4 to 5 % where the rest of the world economies are slowing down. Hence many business meetings and conferences are held in India and the hotel industry tries to cap italize on that. It is seen that many foreign tourist travellers are now willing to spend money to get their value for it. As economy of India is increasing at a good pace, it signifies investments in infrastructure, construction of new avenues for tourist, increase in promotional expenditure, beautification of the cities and towns etc. These give a boost to the hotel industry. With high growth in GDP and a sound financial system, the hotel industry has grabbed the chance of enhancing their profitability (Anand, 1976, p. 43). Socio-Cultural India being a diverse nation has diverse languages, traditions, cultures, cuisines; making it an ideal destination for cultural tourism. India has more 22 languages recognized by constitution and 1600 dialects. Hence cultural tourism in India will rise and so will the growth of the hotel industry. According to Indian culture they always treat guest as God. In Sanskrit there is a popular Shloka â€Å"ATHITHI DEVO BAHVAH†. It gestures the lo ve for their guest that exist in India. Foreigners love this concept and are pleased with the love they get in travelling to India. This also enhances the Hotel Industry (Briggs, 2001, p. 49). Technological In today’s globalised world Information technology plays a critical role in tourism planning and implementation. There are web based platform like makemytrip.com, yatra.com in India which provides tourist booking hotels online. Most of the luxury hotels are now Wi-Fi enabled. More technology means less manpower and chance of lesser complaints. This shows enhancement of the Hotel Industry In India transportation system is not as per the international standard. For any nation to be successful in tourism industry it must be equipped with efficient transportation system which is capable of carrying large volumes of people in a cost efficient way. India is lagging behind in this front. If this improves a foreigner can easily find such luxury hotels and travel there comfortably (Kannan, 2005, p. 39). Environmental In India the environmental forces supports the Hotel Industry in India. Environmental forces like growth of GDP, Political stability in India supports the Hotel industry in India. Legal Indian Legal system is very strong and it doesn’t support any flouting of rules like keeping emergency services ready, keeping the appropriate records of the foreign visitors, paying of appropriate taxes etc. Such

Dickens's Treatment of Education and Social Mobility in Great Essay

Dickens's Treatment of Education and Social Mobility in Great Expectations - Essay Example These circumstances call for a story far less comfortable about the separation of good and evil, the imputable and the innocent,........" (Reed, 1995) In Great Expectations, Dickens gives us the story of Pip and the story of Pip's growing into a man is a portrayal of his expectations and aspirations: "Now, I return to this young fellow. And the communication I have got to make is, that he has great expectations". It is also a realistic chronicle of Pip's enormous guilt both deserved and undeserved, his insecure posture as a gentleman, his moderate success at being a gentleman in the worldly sense and his finally ending up as a gentleman of intrinsic value. For it is in the definition of a "gentleman" that the central dichotomy of the novel lies, and being a gentleman is directly related with social mobility and education, not only in the personal story of Pip himself, but in the stories of the gallery of characters that surround him from his childhood to maturity. And the concept of becoming a gentleman is constantly and inextricably related to educational improvement. Not born to gentility like any other gentleman, Pip must strive to acquire all the ways of a gentleman, and for him the only option to do this lies in being better educated and improving his reading and writing: "writing some passages from a book, to improve myself in two ways at once by a sort of stratagem." Education for Pip is therefore vital, and has become the measure of his worth as Harold Bloom has pointed out: "For Pip, writing and reading will become the beginning of his accomplishments. They are the vehicles of his anticipated upward social mobility, and the expectation not only of greater wealth but of moral superiority as well. He recapitulates the historical experience by which oral culture is devalued and writing replaces spoken communication as the transcendent value of western culture. The subsequent plot reveals how Dickens is making an accounting of the costs and benefits of modernization: writing, the production of language, and the manipulation of words and capital have become the new measure of human worth". (Bloom, 2000) 1.3 Dickens as a social climber and Pip's aspirations As in David Copperfield which had definite autobiographical overtones, Dickens uses the first-person narrative style in Great Expectations as well, and if we look back on Dickens' youth, it is not hard to find similarities between his life and Pip's, and the ways in which the fictional Pip dealt with his issues the way his creator did in real life. In The Life of Charles Dickens, and Favorite Stories, Everett H. Rupert relates the dismal beginnings of Dickens' own education: "Such formal schooling as he got during his early childhood was little better than no schooling at all. His tired, over-worked mother taught him his letters, and later the rudiments of English and a little Latin". This can be very easily related to Pip's earliest encounters with education: "Much of my unassisted self, and more by the help of Biddy than of Mr. Wopsle's great-aunt, I struggled through the alphabet as if it had been a bramblebush; getting considerably worried and scratched by every letter. After that I fell among those thieves, the nine figures, who seemed every evening to do something new to disguise themselves and baffle recognition. But at

Corporate Finance Essay Example | Topics and Well Written Essays - 2000 words

Corporate Finance - Essay Example In addition, environmental factors like macro economic conditions and cyclical behaviour of the industry may influence on their performance. The hubris hypotheses formulated by Roll, states that often company managers systematically commit error in evaluating merger opportunities which are due to their excessive self-confidence. So, managerial motives play important role in determining the outcome of the merger and acquisition. In contrast, in some instances even when shareholder wealth is destroyed, executives still seem to gain from mergers and acquisitions, which show that, managers through mergers and acquisition activities may seek to utilise their own utility at the expense of shareholders (Casper Flugt, 2009). Main objectives of merger Companies go for merger and acquisitions to expand their business. By the process they try to develop their companies’ brands. Aim to reduce market competition. Aim to cutting costs by laying off employees, removing management and other r elated actions. To reduce taxes they go for merger. Aim for ‘empire building’ by acquiring managers and other purposes, they may go for acquisition. It is a strategic move by companies to diversify their business away from their resources. Company managers think that joint company will be able to generate more value than the separate firms. There are many options for payment for a company when it goes for acquiring another firm. It can pay in fully cash, or it may buy targeted shares. It can also choose a combination of loan notes, share and equity, deferred payment. Actually, the payment method is important for several reasons. Payment by means of cash and debt will benefit more for a company than stock acquisitions, as it could be used more efficiently... At the time of stock market boom, mergers were more appealing. On the other hand, falling share prices can lead to a company being undervalued, and make it an attractive for acquisition. Mergers and acquisitions can either be value destroyers or value creators that depend on factors like company’s cost of capital, its strategies and decisions and cash flows generated from the business operations The performance is not related to the nature of an industry, instead it was driven by the quality and strategy of management. Good strategy by management can produce good results, on the other hand, poor decision and strategies may end with poor performance. In the present competitive market companies are looking for mergers and acquisitions to expand their business to a newer region. Most of the mergers and acquisitions resulted in value creation. Especially, in case of big companies it is true. There is some perception that nearly 50-70% of mergers fail to deliver shareholder value. In many occasions employees feel the pinch as the new group goes to cut jobs to reduce cost to the company. But, ultimately performance is not related to the nature of an industry, instead it was driven by the quality and strategy of management. Sound financial management along with other favourable factors is necessary for value creation, its survival and growth for any company.

Literary Elements in the Scarlet Ibis Essay Example for Free

Literary Elements in the Scarlet Ibis Essay In â€Å"The Scarlet Ibis,† James Hurst uses the aspect of nature in the settings to reflect when the tone transposes from a sorrowful and regretful tone to a more hopeful and joyous tone. Brother reminisces of a summer that has long since passed, as he sits in the house he was raised in: â€Å"It was in the clove of seasons, summer was dead, but autumn had not yet been born, that the ibis lit in the bleeding tree. The flower garden was strained with rotting brown magnolia petals andiron weeds grew rank amid the purple phlox. The last graveyard flowers were blooming, and their smell drifted across the cotton field and through every room of our house, speaking softly the names of our dead. † With this, the author uses the natural scenery of a dying garden in the transition of seasons to set a tone of sadness. He illustrates a garden with rotting flowers, a graveyard’s last flowers blossoming and their smell being carried to where Brother is, reminding him of the dead. Hurst uses the natural elements in the setting to paint a gloomy and dismal setting, he could have expressed what he saw and smelled from his garden in many ways, yet he chose to depict this garden dying. Furthermore, this was done to indicate the tone in this memory, which is one of sadness. Moreover, just as the author uses dying settings to reflect a sorrowful and dreary tone, he also uses beautiful settings to reflect a joyous and hopeful tone. Brother describes his and Doodle’s time shared in Old Women Swamp, a place he refers to as the only beauty he knows: â€Å"I would gather wildflowers, wild violets, honeysuckle, yellow jasmine, snakeflowers, and waterlilies, and with wire grass we’d weave them into necklaces and crowns. We’d bedeck ourselves with our handiwork and loll about thus beautified, beyond the touch of the everyday world. † Furthermore, Old Women Swamp is a place found beautiful to both Doodle and Brother, a place where they go to play and relax. Almost all of the joyous and hopeful times that Doodle and Brother share happen in Old Women Swamp: the first time Doodle stood where they go to lay and tell stories, and where they imagine they will build a house and live in together. The author once again uses the setting to reflect the tone; Hurst uses the abundance of beauty found within Old Women Swamp to show the hope and joy Doddle and Brother sometimes shared. Furthermore, as Brother remembers these times he does so in a joyous and hopeful tone. To them Old women swamp signified beauty and a world of never-ending possibilities. Moreover, all the scenes that take place in Old Women swamp are of happiness and hope, its portrayed as this beautiful place because that’s the way Brother remembers it and that might be because of all the happy moments he shared there with Doodle. Brother remembers all of theses events with a hopeful and joyous tone and all take place in serene, beautiful, and beloved Old Women Swamp. In conclusion, the natural elements of the setting indicate the change in the tone from a sorrowful tone to a joyous tone.

Impact of Ageing on Psychological Health

Impact of Ageing on Psychological Health It should be noted that all names of individuals and places in this report have been changed in order to protect the patients confidentiality (Nursing midwifery council 2009). Therefore the patient will be known as Mrs.Brown.Mrs Brown is an 86 year old lady who lives with her elderly husband. According to Mrs Brown husband they have two sons together and 3 grandchildren, they both visit occasionally. She used to work as a secretary until she retired in her early 60s. She clearly had a good memory. She enjoyed travelling abroad, with her husband. For many years she had attended services at the local church where she was well known .as a kind, warm-hearted popular lady in her town for the good things she did. Mrs Brown clinical notes written by her community mental health nurse states that she was diagnosed with dementia the Alzheimer disease 12 years ago. Alzheimers is a brain disease that causes problems with memory, thinking and behaviour. Symptoms usually develop slowly and get wo rse over time, becoming severe enough to interfere with daily tasks (online www.alz.org/alzheimers_disease 21/02/11). Her husband has been her main carer ever since. She attends a day centre once a week and has carers coming in twice a week to assist with personal care. The staff at the day centre has also reported that Mrs Brown now showed no interest and was reluctant to comply with activities which showed that she had lost sense of pleasure. Mr Brown stated that before the diagnosis, they were several episodes when she got lost and was picked up by police to be returned at home.Mrs Brown become disorientated about where she was because of her dementia. She became confused about time. She will also miss her doctors appointments .Mrs Brown couldnt even remember her sons names later on recognise her husband and would lose track of conversations.Mr Brown stated that he made an appointment then to see the general practitioner (GP) who then referred them to the memory clinic where she was diagnosed with Alzheimer. In the last year Mrs Browns mental and physical health has deteriorated rapidly. She can no longer do her activities of daily living and she needs support with personal care. Her behaviour has gradually become more and more eccentric that her husband is no longer copying.Mrs Brown was recently admitted to hospital with chest and urinary tract infection, which would also increase her level of confusion and lack of orientation (Adams 2008).Although now discharged from hospital Mrs Browns sleep pattern was disturbed, she now wanders around at night. She has become more physical and verbally aggressive towards her husband, Mr Brown has raised concerns that he can no longer cope with her behaviours to her CPN.The community mental health team have been monitoring Mrs Brown condition for some time now and liaising with the family, GP, social worker and psychiatrist regarding her care and support as required by the Department of health (DOH 2001), in relation to older people (over 65yrs) with mental disorder.Mr Brown was considering looking for permanent placement in a nursing home for his wife. Mrs Brown was prescribed the following for her dementia Donepezil hydrochloride/Aricept 10 mg once daily at bedtime: is a reversible inhibitor of acetylcholinesterase.They are for the adjunctive treatment of moderate Alzheimers disease. Like all other medication donepezil has its side effects which are nausea,vomiting,anorexia,diarrhoea,insomnia,dizziness and agitation just to mention a few.(Source :British National Formulary 2007) There is currently no cure for Alzheimers disease. However, they are some drug treatments are available that can ameliorate the symptoms or slow down the disease progression in some people such as donepezil, Exelon ,reminyl and galantamine these drugs maintain the supplies of the acetylcholine The (National Institute for Health and Clinical Excellence: NICE 2011) available online, states that these drugs are recommended as an option for people in the mild-to-moderate stages of Alzheimers disease. Older person presentation Dementia is the general term used for diseases affecting the brain, including Alzheimers disease it is characterised by progressive cognitive impairment and the emotional and behavioural problems that result from the cognitive decline (Sungaila Crockett,1993 citied in Tappen,R 1997). There are many different types of dementia although some are far more common than others. They are often named according to the condition that has caused the dementia. They are Alzheimer disease which is the most common cause, followed by the vascular dementia, dementia with lewy bodies and fronto temporal dementia these are the common ones. To rule out that someone has dementia test has to be carried out .Winter (et al 2001) states that there are different illnesses that appear to affect the brain in ways that can cause symptoms similar to dementia. Winter (et al 2001) describes these as people with underactive thyroid gland, deficiencies of certain vitamins and general physical illness can give rise to symptoms of dementia, poor concentration and poor memory ln the case study Mrs Brown was diagnosed with Alzheimers below the author describes what Alzheimer is and its features which lead to the diagnosis. Miriam (1994) describes Alzheimers disease as a brain disease accompanied by characteristics microscopic structural changes in the brain tissue leading to the death of brain cells.lt is the most common cause of dementia in the UK. The first signs of Alzheimers disease include lapses in memory and problems with finding the right words (Alzheimer society available on line) .In normal ageing memory lapse are common as we get older. Also the person mood changes: Particularly as the parts of the brain that control emotion becomes affected by disease. Memory loss is the most common potential impact on the psychological ageing. Remembering everyday tasks becomes a chore. People with dementia may also feel sad, frightened or angry about what is happening to them. The person with Alzheimers may start to have communication problems like inability to recall names quickly, decline in co-ordination and control of speech and action. Feeling and becoming lost in familiar surroundings. Some of these symptoms where noticed in Mrs. Brown. Depression is other symptom for dementia (Tappen R, 1997) states that many individuals in the early stages of Alzheimers disease are also clinically depressed. Some of the behavior exhibited by Mrs. Brown may have been caused by that she was depressed. Some of these features led to the diagnosis that Mrs Brown was suffering from Alzheimer as she was exhibiting these problems. Once a diagnosis of dementia has been made, the next stage will be to assess its cause.Mrs Brown had a series of tests and examination to exclude disease in the rest of the body and to rule out some other brain conditions. The persons memory will be assessed, initially with questions about recent events and past memories. Given these problems Mrs Brown was exhibiting, and the in-put from the community nurse it was agreed that she required further assessment to determine her level of cognitive impairment. This was done by using the mini mental state examination (MMSE) developed by Folstein et al (1975), with consent; Mrs Brown scored 12, which indicated severe cognitive impairment. According to Miller (1999) to examine specific cognitive impairment a Mini Mental state examination is used .The National institute of health and clinical excellence (2011) recommend s that this tool be used for determining a persons suitability for the anti-dementia drugs such as Aricept which was prescribed to Mrs Brown.Aronson M,k (1994) suggests that it is appropriate to include a short list of complete blood count, vitamin B12 level, thyroid function test and brain scan as MMSE may not offer clues to their presences. A brain scan may be carried out to give some clues about the changes taking place in the persons brain. There are a number of different types of scan, including computerized tomography (CT) and magnetic resonance imaging (MRI). Vascular dementia Alzheimer society (2010) describes vascular dementia as a type of dementia caused by problems in the supply of blood to the brain. There are two main types of vascular dementia: one caused by stroke and one caused by small vessel disease. It is the second most common form of dementia The risk factors associated with Vascular dementia, as indicated ,are those associated with cardiovascular disease and include High blood pressure Diabetes Deficiencies of certain vitamins High cholesterol levels Dieses in arteries elsewhere in the body and rhythm abnormalities (Soucers: Martin 1998, Gould 2002, Taylor 2006). People with Vascular dementia may experience these symptoms problems concentrating and communicating depression accompanying the dementia symptoms of stroke, such as physical weakness or paralysis epileptic seizures Periods of acute confusion hallucinations (seeing things that do not exist) delusions (believing things that are not true) physical or verbal aggression restlessness Incontinence. Dementia with Lewy bodies Dementia with Lewy bodies (DLB) is a form of dementia that shares characteristics with both Alzheimers and Parkinsons diseases Person with lewy bodies may have these symptoms A person with DLB will usually have some of the symptoms of Alzheimers and Parkinsons diseases. fall asleep very easily by day, and have restless, disturbed nights with confusion, nightmares and hallucinations Faint, fall, or have funny turns. (Source: Alzheimer society 2010) Legal and ethical issues surrounding people with dementia Dementia raises difficult ethical issues for people with dementia, for their formal and informal carer and for society in general. Formal carers are paid and trained to perform their caring role; those involved in Mrs Brown care were GP, community mental health nurse, and social worker. Informal carers usually is provided by family and in Mrs Brown case it was her husband and children. Tappen R (1997) states that ethical issues include the often painful decisions that must be made about restrictions on freedom, or end of life decisions and the legal issues include patients rights, abuse, neglect and incapacity. Myron F and Wiener M (2004) suggested that legal issues are best addressed while patients still have the capacity to understand and communicate while ethical issues begin at the time of diagnosis and may include whether to tell patients about their diagnosis. The key pieces of legislation surrounding people with dementia The Mental health Act 1983 amended 2007:-it protects the rights of people who have been assessed as having mental disorder including dementia.lf a person with dementia is behaving in a way that is risking other and his/her health can be detained in hospital using this act. The Mental capacity act 2005 (implemented 2007) designed to protect people who cant make decisions for themselves or lack the mental capacity to do so.Recognised that in some circumstances ,being placed in a hospital or care home may deprive someone of their liberty. Deprivation of liberty safeguards code of practice (2008)-DOLS in practice provide guidance for professionals involved in administering and delivering the safeguards. The Code is also intended to provide information for people who are, or could become, subject to the deprivation of liberty safeguards, and for their families, friends and carers, as well as for anyone who believes that someone is being deprived of their liberty unlawfully (department of health online). Before Mrs Brown dementia became severe, when she still had capacity, they had sat down with his husband .They discussed about future plan on what to do with everything including her care.Mrs Brown choose her husband to be her durable power of attorney for all her health care needs and property. Myron F Weiner, M (2005) states that with appropriate durable power of attorney, Mrs Browns husband can consent to her medical care, but the patients wishes if known, must be respected. Mrs Brown capacity was limited to live independently or make her own choices, inorder to respect her autonomy her husband and family were involved in taking active steps to act as advocates and to try and promote her autonomy. As Mrs Brown diagnosis was early she and her family had time to plan about her preferences on treatment and facilitate support from community organisation.Mrs Brown was treated or care for justly by everyone involved in her care. Everyone worked together to create an environment that is safe, sustaining her dignity and optimizing opportunities for independent decision making and functioning. Ethical problems carers Balancing risks and freedom Avoiding telling the truth to prevent distress How to manage conflict between caring for the person with dementia and other commitments. Those caring for people with dementia face ethical problems in caring out day to day care, these problems are important and stressful, those providing care receive little support and providing such support will improve good dementia care. Conclusion