Transcript chemo - Personal Web Pages - University of North Carolina at

Language Discourse
with dementia in mind
Presented By:
Joshua DeAngelo Avery
Dr. Boyd Davis
Gerontology 5050
Language, Aging and Health
University of North Carolina at Charlotte
Spring 2006
Topics of Discussion
Aging
Dementia
Chemotherapy
Factors
Issues
Interventions
Introduction
With life, comes aging… a natural process which should
not be deemed as a negative to society. Unfortunately,
many societies pessimistically identify individuals as they
age and as research has shown, this can be detrimental
to an individual’s well being.
For example, in attempt to reject the aging process as
much as possible, many Americans seek plastic surgery
to counterbalance the effects of aging. Yet, as this
project will show, aging should not be rejected, nor
should people feel pressure from society to reject the
natural aging process.
Aging
As aging occurs in each of us, we must all be prepared to handle what I
will call the “side effects” of this process. Here, side effect can mean
any perimeters that the individual or the society create as a
constraining mechanism. In other words, when a person believes
that they are “too old” to participate/do something, then they are
suffering from the side effects of aging. Some research would point
the finger at societal attributes and social ideologies, while it is also
important to understand that this idea of “too old” can be based on
an individuals cultural and ethnic background as well.
In many cases, the side effects of aging are not as detrimental to either
the individual or the society, yet some minimize their place in the
overall scheme of society based on their age. This is sad in a lot of
cases because it is not an absolute. Age should not act as a barrier
or necessarily a bridge, but “ability” rather than age should be
identified as a more accurate factor in ones place in society.
Aging
In America, production is a general key to success, thus the American
society often gauges an individual’s value based on their ability.
Success and productivity are frequently understood to be the
markers of importance and therefore as people age, an inaccurate
correlation can be disproportionately made.
To some, elderly people loose their productive value as they age and
though this may be true to some extent, it is also not an absolute.
Some sociologists would even note that an elderly individuals labor
productivity should not be the sole qualifier of their social worth. For
there are many parts to a successful society, and ironically elderly
individuals metaphorically become the pistons that drive the social
engine.
Dementia
Since health issues are often associated with
aging, it is not unusual for negative health issues
to be viewed as a natural side effect of the aging
process. Though this is not always true for each
individual across the board, it can be the case
for the larger percentage of aging adults.
Along with those who face the ordinary obstacles
of aging, when other severe ailments, such as
dementia are also present in the body, the
challenges in communication and autonomy
both increase.
Dementia
Individuals with dementia face several factors when
considering treatment options that are not as common to
individuals who do not suffer from the disorder. This
becomes particularly important when identifying the use,
effectiveness, and accuracy of communication through
language discourse.
In many instances, language discourse can be the
cornerstone of correct and accurate treatment, therefore
patients with dementia are at high risks when language
becomes a barrier of communication rather than a
bridge.
Dementia
To this end, it is important that when studying individuals
with dementia, factors that encourage correct treatment
are embraced. Though Dementia is seen as a scary
disease with no present cure, that doesn’t mean patients
with dementia deserve to be treated inhumanely.
Unfortunately, along with cognitive skills, language and
communication functions are also affected when
dementia intrudes the human mind. For physicians and
medical professionals, it becomes even that much more
important to accurately assess an individual with
dementia’s needs, particularly when they struggle with
an underlying communication barrier within themselves.
Chemotherapy
This treatment uses powerful drugs to kill cancer cells. In
cases of small cell lung cancer, chemotherapy may be
used to slow the cancer's growth, to prevent it from
spreading further, or to relieve symptoms and make you
more comfortable (palliative care).
A combination of drugs usually is given in a series of
treatments over a period of weeks or months, with
breaks in between so your body can recover. Even so,
because the drugs damage healthy cells along with
malignant ones, they can cause serious side effects. In
fact, for many people, side effects from chemotherapy
are the most disturbing aspect of cancer treatment.
Factors
Fast-growing cells such as those in your digestive tract,
bone marrow and hair are especially likely to be affected.
But although side effects are common, their severity
depends on the drugs used and your response to them.
To elderly patients who also suffer from dementia, the
question becomes, “do the benefits outweigh the costs?”
This becomes an extended issue when communication
may be compromised. Since elderly adults with
dementia often lack recall and recognition, the use of
several drugs, particularly in chemotherapy can offer
additional decision-making challenges that aren’t as
prevalent with those who do not suffer from dementia.
Issues
Studies have shown that when communication between patient and
physician is compromised, treatment practices can also be
questioned. Particularly, in the sensitive area of chemotherapy
treatments for patients with dementia, there are several factors that
can influence the ethical dilemma of this issue.
Mental Issues:
Understanding what the treatments are for
Understanding what the treatments are doing
Understanding the side effects of the treatments
Physical Issues:
Inability to sit still for long periods of time during treatment
Intervention
Ultimately, many studies have developed similar
conclusions. In the area of aging, research has often
shown that individuals who share similar backgrounds or
ethnic identities may find it easier to accurately converse
with each other, rather than with a person from another
cultural background.
As we saw in the metaphor analysis completed earlier this
semester, even the same phrase can be interpreted a
variety of ways by several different individuals. In
medical practices, this should also be considered even in
everyday communication between patient and physician.
Intervention
In accessing language with aging it is also imperative to acknowledge
the loss of memory found with aging adults. It is no secret that
diagnosing treatment options for cancer patients altogether can be
challenging in several ways. However, specifically when these
individuals happen to be riddled by dementia, considering the mere
use of chemotherapy as a treatment option can become a tricky and
potentially problematic decision all to itself.
When faced with these obstacles, people with dementia need the
contributions and support of their family and those who care about
their overall well being. The importance of proactive care through
advanced directives such as advanced care planning becomes all
the more vital when dealing with people who suffer from the ailments
caused by dementia.
Intervention
Even when both autonomy and competency become questioned, legal
procedures such as substituted judgment and Power of Attorney
allow method for the best interest of the individual to be
implemented.
Furthermore, with any aging individual and especially those with
dementia, along with the family and an active support network, they
should all work as a team in taking proactive steps towards
accommodating the specific needs of the person. I believe if the
physicians and medical staff are able to fulfill their roles as the
information providers and caretakers, families should also be able to
act as positive contributors in assisting the person to gain the best
care available. As stated earlier, family involvement and accurate
assessments are the key. When a person’s autonomy and
competency are both in question, it is the family or guardian’s
responsibility to be involved in making sure that the individual’s well
being is satisfied to their own personal standards.
Conclusion
All in all, I believe the question of “should chemotherapy be
used for people with dementia” needs to be reexamined. Instead, I would suggest that chemotherapy
can be used as means to assist cancer patients –
including those with dementia – only if certain strategies
are implemented to affectively contribute an individual’s
well being.
Inclusive measures should be taken so that the individual
still feels like a part of the society and the society still
acknowledges that the individual is a key component that
keeps the societies engine revved up.