Transcript AD - Personal Web Pages

Alzheimer’s
By
James Atkinson
Dementia


The topic I will be covering is Alzheimer’s. It is
the most common form of dementia, and is
when there is a progressive decline in mental
functions caused by a group of conditions that
gradually destroy brain cells. Another common
cause is from reduced blood flow to the brain’s
nerve cells.
After losing a Grandmother due to Alzheimer’s, I
find myself wanting to gain as well as share
information about the disease.
What Is Alzheimer’s



When Alzheimer’s disrupts memory, language, thinking and
reasoning, these effects are referred to as “cognitive symptoms” of
the disease. The term “behavioral and psychiatric symptoms”
describes a large group of additional symptoms that occur to at
least some degree in many individuals with Alzheimer’s.
In early stages of the disease, people may experience personality
changes such as irritability, anxiety or depression. In later stages,
other symptoms may occur, including sleep disturbances; agitation;
delusions or hallucinations.
Many individuals with Alzheimer’s and their families find behavioral
and psychiatric symptoms to be the most challenging and
distressing effects of the disease. These symptoms are often a
determining factor in a family’s decision to place a loved one in
residential care. They also often have an enormous impact on care
and quality of life for individuals living in long-term care facilities.
Interventions



Interventions range from the application of 'hi-tech'
computer technology for socially isolated carriers, to the
formation of specialist support groups and respite
services
Moreover, the term 'intervention' in relation to caregivers
of people with Alzheimer's disease is open to wide
variations in interpretation at the level of service
provision.
They include educational support groups, behavioral
skills training programs, family-based interventions,
environmental modifications, and computer-based
information and communication services
Experimental language intervention
study

The language interventions were administered once per week for
10 consecutive weeks in the autumn and spring semesters in 1997
and 1998. The physical fitness sessions were supervised by
students and the interventions used in every session were:
 Free and prompted descriptions of Norman Rockwell pictures
associations to evocative words.





Proverb completion and interpretation.
60-second category fluency exercises.
Advice and opinion questions.
In addition, some of the following activities took place
Category assignment of similar pairs of items- Famous names
completions game.

Required production, in sequence, of a female or male name,
depending on gender of subject, a hypothetical spouse’s name, a
place name, and an object name beginning with a particular letter
of the alphabet within the framework of a ball-bouncing game
jingle.
Non-Drug Interventions


There are two distinct types of treatments for agitation: non-drug
interventions and prescription medications. Non-drug interventions should
be tried first. In general, steps to managing agitation include (1)
identifying the behavior, (2) understanding its cause, and (3) adapting the
care giving environment to remedy the situation.
A key principle of intervention is redirecting the affected individual’s
attention, rather than arguing, disagreeing, or being confrontational with
the person. Additional intervention strategies include the following:
 simplify the environment
 simplify tasks and routines
 allow adequate rest between stimulating events
 use labels to cue or remind the person
 equip doors and gates with safety locks
 remove guns
 use lighting to reduce confusion and restlessness at night
Interventions Studies by Hopper,
Bayles, and Tomoeda

During a few interventions, which measured discourse
production in four AD patients, Hopper, Bayles, and
Tomoeda found an increase in the number of
information units produced. This was only in the
presence of the specific stimuli used. They had used toys
such as dolls and stuffed dogs as stimuli, then they
measured discourse production in four AD subjects
before and after an individualized music intervention.
Caring For a Demented Person


Because of the intensity of care that may be required, it is often
difficult for even a loving family to provide all the "around the clock"
care that a demented relative may need. If friends or family wish to
provide these services it is very important for them to be aware not
only of the demented person’s needs, but also of their own needs.
This is one reason why interventions are so useful. They help the
caretakers better understand what is going on and what needs to be
done in order to care for the demented.
Research has shown that it is easy to lose companionship and
support of a life partner, social isolation and complex financial
problems can end up as a result. Again this is why it is so important
to be fully educated and aware of all aspects of Alzheimer’s. The
burden of caring is financially, emotionally and physically significant.
Interventions For Caregivers


There are several key strategies recommended by NYU. The
approach employs key strategies that can be modified to fit the
many needs and abilities of caregivers.
They include:
1) Education of caregivers and family members about Alzheimer's
disease, as well as its effects on the patient. Also how best to
improve social support for caregivers.
2) Counseling and ongoing support for the caregiver and family
members, which includes both individual and family counseling,
and support for caregivers to join groups.
3) Reducing conflict within the family and improving social
support can help the caregiver withstand the hardships and help
family members understand how to be helpful.

This NYU study is the longest running of its kind and is now in its
seventeenth year.
Insight
When my grandmother was alive, she had a mild case of Alzheimer’s that only got
more severe as she aged. She was very hard to take care of and for a while really
only had her family to take care of her. She would constantly ask what your name
was and what you were doing in her house. It was very hard, but there were times
where she would remember who you were. This is when it became more emotional,
when you would actually be able to talk to her with her knowing exactly what was
going on. You would be able to get her for five minutes and it would be as if she
was healthy again. It was hard on my mom and her brothers and sisters, having their
mother not being able to identify her own children. During the last two years of her
life, we had hired a live in nurse who would take care of her during the day and stay
with her at night. We needed someone to stay with her at night for she would have
night mares and wake up screaming in the middle of the night.
I didn’t have the knowledge of any of the interventions or information that was
presented here back when she was living. I’m sure it would have helped with the
process and would have made everyone a little more aware of what Alzheimer’s
was really all about. Alzheimer’s is a terrible thing to have, not only for the person
but for family and friends as well.
Summary

Dementia is a serious illness that requires much help
from a person’s friends, family and society to manage.
The eldest segment of our population is now the fastest
growing group in the United States. As people live
longer, and as the "baby boom" generation ages,
dementia is increasingly likely to affect us directly or
indirectly at some point in our lives. Could be with a
family member or with a friends relatives. I hope this
has helped provide you with a better understanding of
Alzheimer’s and its interventions as well as a wide range
of information. With research still progressing to better
understand the causes of dementia and to develop more
effective treatments, it remains a significant challenge
for us to deal with.
References



UNCC Course reserves
http://www.ncpamd.com/dementia.htm#Caring%20For%20a%20D
emented%20Person
http://www.alzinfo.org/research/caregiving/default.aspx