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