Wednesday, September 23, 2009

The College Of Physicians of Philadelphia

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Wednesday, September 16, 2009

Aging with Alzheimer's and mental illness

This was a Tutorial training presented by Dr. Fenibo Braide, about Alzheimer's and mental health in Aging population at Greater Metropolitan Institute, Baltimore, MD (September, 2009)

THE CARE GIVER

Caring for a person with Alzheimer’s disease is a difficult task and can become overwhelming at times. Each day brings new challenges as the caregiver copes with changing levels of ability and new patterns of behavior. Example: dealing with the dx, communication, bathing, dressing, eating, sleep pattern, driving, visiting a doctor, and wandering.

You probably never thought this would happen to you. But now that your loved one has been diagnosed with mild to moderate Alzheimer’s disease (or you are now providing care to someone with Alzheimer’s disease) you want to do everything you can to help that patient.

DEFINITION

DEMENTIA: is a word used to describe the progressive loss of cognitive function. It is a disorder of the brain that affects the arrears that allows one to think, speak, remember, and function.

Alzheimer’s disease: is progressive degenerative disorder that attacks the brain’s nerve cells or neurons causing loss of memory, thinking, language skills, and behavioral changes. It is progressive and degenerative which means that the illness gets worse over time.

Alzheimer’s patient commonly experience behavioral problems including aggression, refusal to take medication, hostility, nighttime wandering and sometimes exhibits sexually inappropriate behavior. Diagnosis: Prosopanosis /Alzheimer’s

PART-I Early Stage: Independent (mild memory loss, confusion, forgetful, frustration)

PART-II Middle Stage: Independent/dependent (Poor Judgment, increased memory loss, AV hallucinations, delusion, speech problem)

PART-III Late Stage: Fully dependent, loss of control, flat affect--no facial response, wandering and elopement, cannot recognize, may put everything in mouth or touch every thing around them.

COMMUNICATION

Communicating with a person with dementing illness, such as Alzheimer’s disease can be a terrible difficult task.
YOU SET THE TONE. Be pleasant, begin your conversations with orienting information, repeat what you said, demonstrate visually if necessary, don’t argue, and listen to the patient.

EXPECTATION---The Caregiver

1. Set standards of excellence by providing optimal care in your facility.
2. Be professional in your services including confidentiality.
3. Support other professionals as they support those in need.
4. Caregivers are highly recommended to be physically, mentally and emotionally stable while caring for the Alzheimer’s patient.
5. Adhere to cultural sensitivity.

RESPONSIBILITY-----The Caregiver

1. Documentation (maintain daily assessment each shift).
2. Observe and report changes in mood or behavior, example: rapid mood swings from being calm to tearful or anger for no reason.
3. Ensure safety and pleasant environment (avoid noisy environment) remove medication and hazardous materials out of reach.
4. Collaborate with family and doctors for continuing treatment
5. Utilize care giver resource network as needed.

MODALITY / APPLICATION

Always apply Validation “communication” therapy
Simplify your language
Maintain eye contact
Repeat your statement more than once if necessary
Demonstrate your action if necessary
Communication: Words 7%, Voice 38%, Body language 55% (93% is conveyed NON VERBAL)
Medication

INDIVIDUALIZED CARE PLAN---continues

OTHER RELATED DISEASES

HUNTINGTON’S DISEASE
Is a devastating degenerative brain disorder that slowly diminishes an individual’s ability to walk, think, talk, or reason.

LEWY BODY DEMENTIA (Progressive brain disease)
It is the second leading cause of degenerative dementia in the elderly = symptoms vary but hallucinations and fluctuating cognitive impairment is usually present.

PARKINSON’S DISEASE
Is a progressive disorder of the central nervous system that affects more than 1.5 million people in the United States = symptoms: motor (movement), tremor, gait difficulty
Non motor: diminished sense of smell.

DELIRIUM
Is defined as temporary confusion caused by underlying medical problems—Example Drug and Alcohol abuse.

MENTAL AND BEHAVIORAL HEALTH IN LATE LIFE

SCHIZOPHRENIA

Schizophrenia is a mental disorder known as split personality; characterized by a social behavior – introversion and lost of touch in one’s environment. Example, false thoughts or misleading state of irrational behavior

ANXIETY

A signal of inner tension evoked by internal or external threat;
Example of internal threat: fantasies, impulses’
Example of external threat: other people or demand of life.

POST TRAUMATIC STRESS DISORDER (PTSD)

Anyone who has gone through a life threatening event can develop PTSD. ------PTSD is an anxiety that can occur after you have been through a traumatic event. A traumatic event is something horrible and scary that you see or happens to you. Over time you may feel afraid of feel that you have no control over what is happening.

DEPRESSION

Everyone feels sad or less interested in activities occasionally. But if you feel sad or empty most of the day or have loss of interest or energy for your favorite hobbies, or if those hobbies don’t give you the satisfaction they used to nearly every day for 2 weeks or more. It could be depression (consider the stage one Alzheimer’s patient).

For Information about Alzheimer’s contact:

Alzheimer’s Foundation of America Alzheimer’s Association
Phone: 1866 AFA (232) 8484 or 1800.272.3900

Dr Fenibo Fenny Braide
Psychotherapist / Lead Clinician @ The Behavioral health center, Philadelphia, PA
drfenibob@gmail.com
www.alzfdn.org

Alzheimer's at 40

Man Suffers From Alzheimer's at 40
POSTED July 7 2009 Mark Priddy was just 36 years old when doctors diagnosed him with early-onset Alzheimer's four years ago.
The devastating disease is extremely rare in someone his age, and his wife, Dione, told London's Daily Mail she wishes doctors had found the cause of his bizarre behavior earlier because she would have been "kinder and more patient."
"Early-onset Alzheimer's is so rare that I can understand why Mark's symptoms went undiagnosed," said Dione, 40. "But if we'd known earlier, we'd all have been saved so much anguish."

The couple, who married in 1997 and live in Britain, have two daughters, ages 11 and 12. Mark's strange behavior started as early as 2002, when he started to panic when his wife left the house, and become forgetful.

His condition worsened, and the once successful real estate agent started to forget business meetings and have terrible mood swings. He was quickly hired and fired from seven different jobs, the Mail reported.

A doctor diagnosed him with depression, but anti-depressants didn't help.
Finally, in 2005, doctors said the problem was Alzheimer's. Two and a half years ago, when he started to take out his frustration with violence, Dione had her husband admitted to a nursing home, where he has lived ever since.

Posted on the web by:

Dr Fenibo Braide
Psychotherapist

Monday, September 14, 2009

Quantitative studies of HIV / AIDS

From: fnn2@aol.comTo KADIFO: THIS IS A QUANTITATIVE STUDIES ABOUT HIV / AIDS AND SEXUALLY TRANSMITTED DISEASES IN KALABARI COMMUNITIES

The concept of this need assessment is to create awareness, explore and make recommendations about the alarming increase of HIV/AIDS and sexually transmitted diseases in Kalabari community.

THE GOAL IS TO DECREASE THE NUMBER OF HIV/AIDS AND STD INFECTION IN KALABARI COMMUNITY AND TO INSTILL SELF CONFIDENCE AND RESPECT IN THE PARTICIPATING POPULATION.

People of Kalabari: We are enquiring about sexual transmitted diseases in our community. We believe abstinence, protective sex, and self respect are the key to avoid HIV/AIDS and sexualy transmitted diseases. Just because you don't notice any changes in your body does not mean that HIV / AIDS is not damaging your immune system. Overtime, if left untreated, HIV can damage your immune system so much that your body is unable to defend against other diseases or infection leading to AIDS and premature death. This is ONE of the reasons why early testing and preventive treatments are so important.

TARGET POPULATION SURVEY PLEASE CIRCLE THE ANSWER THAT BEST APPLIES TO YOU:

TO BE CONTINUED...This is a continuation of Third Revised draft copy respectively submitted to Dr. Tonye V. Erekosima (Moderator KADIFO) by:

Dr. Fenibo Braide 9/5/07

Friday, September 11, 2009

Find a Psychotherapist

To find a mental health consultant in your area is easy, simply blog on or contact Dr Fenibo Braide at drfenibo@gmail.com