A Care of Alzheimer Patient Issues in the Family - Research Paper Example

 Information Planning and Evaluation in Human Services Introduction There are growing concerns that most if not all families that have a patient suffering from Alzheimer’s disease most often do not know how to early identify the signs of the condition, deal with the situations and obtain help for the patient. The patient often more than not ends up with an abnormally increasingly deteriorating condition with the family members left feeling overwhelmed and equally hurting to see their loved ones in such states. In this very vein, the goal of this assessment was to determine whether families have the potential and ability to identify the early symptoms of the disease so that early intervention regimes can be implemented, whether they were able to cope with the increasing demands of caring for an Alzheimer’s patient and how they themselves often coped under the rather peculiar circumstances. I strongly hypothesize that most families and members of the society in general do not have the potential and ability to identify the early symptoms of the disease so that early intervention regimes can be implemented, are unable to cope with the increasing demands of caring for an Alzheimer’s patient and themselves often coped poorly under the circumstances of having an Alzheimer’s patient within the house hold. I also hypothesize that some families do not pay due care and attention that is demanded by these patients. If so, my question is what these clients/ families and the community in general needs most from the human service provider and organization. Literature Review/ Research Alzheimer’s disease, thought to be a consequence of the increase in the production/ accumulation of a specific protein (beta-amyloidal protein) which causes nerve cell damage, is a progressive disease of the brain featuring memory retardation and disturbances in other cognitive/ mental functions such as language and perception of reality. On average, symptoms of Alzheimer’s are noticed by families three years before conclusive diagnosis is done. While not an inevitable part of ageing, Alzheimer prevalence increases significantly after the age of 65 years (Zarka, 2011). The disease develops when the toxic protein, beta amyloidal, accumulates in the brain in the form of plaques which are thought to be in turn toxic to neurons, disrupting messages within the brain by damaging connections between brain cells. The brain cells finally die and information recalling or assimilation disrupted hence. There is currently no treatment available for the disease and the disease cannot be diagnosed until clear symptoms present themselves – by which time there has been irredeemable death to brain cells and damage to the brain. The main challenge remains the early detection of the disease in its early stages before the symptoms manifest so that effective interventions can be delivered. Yet still, available medication can only minimize the symptoms and improve quality of life but they cannot halt disease progress or be effective in all cases/ patients (Gidley & Shears, 1987). The main signs and symptoms include dyspraxia (retarded ability to perform simple tasks), difficulty learning new things or recalling previously learnt information, impaired planning, organizing and sequencing complex tasks, impaired language functions such as difficulty naming things or comprehending conversations, depression, wandering, agitation and aggression. Other common Alzheimer signs and symptoms are anxiety, helplessness, sleep pattern disturbances, lethargy, impaired motor skills, feeling melting, hypertensions, history of cerebral vascular disease (systemic), loss of ability to chew, lack of appetite, historical episodes of hypoglycemia, weight loss, lack of personal habits, history of serious head trauma/ accident trauma and loss of social control (Zarka, 2011). Statistics indicate there are currently more than 25 million people living with dementia worldwide with Alzheimer’s disease the most common type of dementia accounting for 50-70% of the cases. It occurs most commonly in the elderly with women slightly at a higher risk of developing the disease than men. The number of dementia patients is predicted to increase by one-third in the next decade and without a medical breakthrough, it is expected that by 2016, dementia will be the leading cause of disease burden in most parts of the world, while by 2050, a whopping 2.8% of the global population will be dementia patients. In the same year, it is expected that there will be over 2 million new cases diagnosed. There are close to a million people in the world with onset dementia (younger than 65, even at age 30). Surveys demonstrate that three in ten people over the age of 85 and almost one in ten people over 65 have dementia in with an approximated 63 million people involved in care of persons with dementia (Stevens, 2004). Dementia is easily one of the single greatest causes of disability in people aged 65 and over and the third leading cause of disability burden overall. As a result, by 2029, the entire globe faces a shortage of more than 40 million paid and unpaid care givers for people with dementia. Between 2009 and 2010 alone, America, for example, spent at least 4.9 billion dollars on health care for people with dementia and in future, dementia is predicted to become the third greatest source of health and residential aged care spending covering about 1% of GDP (by the 2060s, spending on dementia is set to outdo that of any other health condition). According to a recent assessment, more than half of the residents in government subsidized aged care facilities had dementia. Basically, the world is facing a looming Alzheimer’s disease epidemic with serious economic and social challenges (Zarka, 2011). Most of the views from the assessment point towards a people that are ill at ease with the escalating phenomenon of Alzheimer’s disease and that cannot cope well with the disease and its considerable demands. Most people also do not know about the condition and so when most of their relatives get sick, they are baffled and in the end assume that it is merely one of the normal episodes that accompany aging that will often go away on its own. Even those who have some slight knowledge of the ailment, when they come across it, often fail to provide sufficient care for themselves and the patient. Generally, there exist a plethora of issues that surround Alzheimer’s disease both in the family set-up, the patient, the care-givers and the society at large that need to be effectively addressed in order that we realize a mentally, physically and spiritually stable and healthy community. The onset and the escalation of Alzheimer’s have since time immemorial ravaged many families and even left some asunder in the aftermath. There is an urgent need to look into the major concerns of the syndrome that continue to plague the society so. And that is the core aim and goal of this extensively conducted community needs assessment. Method of Needs Assessment There are a number of methods of needs assessment that were available for use in my endeavors, including the existing data approach (where already existing statistical information is utilized to gain knowledge on my particular research topic), the attitude survey approach (where data is collected by personal interviews, telephone surveys or mail questionnaires from a representative sample of community members about the matter with responses representative of the whole population), the key informant approach (which essentially identifies community leaders and decision makers with knowledge about the issue in the community who are interviewed or given questionnaires) (Royse, 2009) and the focus group interview (in which case a group of persons chosen for their particular skills, experience, views or position are asked a series of questions about the topic at hand to obtain their opinions) (Stevens, 2004) but in the end I opted for the community forum technique of performing a needs assessment. In the community forum, a public meeting was conducted where the participants discussed the topic concerning Alzheimer’s disease and its impact on the individual, family, caregiver, healthcare and the community in general and explored the various possible ways to go about the raised concerns. I chose this technique as it allowed for all members of the community to attend the forum and give their views on the deliberations. In the end what I had was a far superior sample representation compared to the other above mentioned techniques, in my scholarly opinion, and therefore extensive coverage of issues pertaining to the matter of discussion (Altschuld & White, 2010). Once it was ascertained that Alzheimer’s was indeed a giant thorn in the flesh of the members, the forum aimed at determining whether the existing services were sufficient and effective, identifying the gaps in the implementation of the deliberations and assessing whether the proposed ideas and services are likely to be effective once they have been implemented. The forum session witnessed close to 200 participants from the community, and included all groups of persons that may have in the end been affected by the planned interventions, including children adults and the mentally ill from both sexes. The forum hosted both those families who have had to contend with the sickness during their lives and those who have not, and equally those who had some knowledge on the matter and those who seemed green. In the end, the session was not only a needs assessment program but also a vital learning experience for many. The main concerns that continue to haunt the society were clear in the end to be the early identification of symptoms, activities that can help alleviate the onset of the disease in the sunset years of life, and care of the affected persons. The community felt ill equipped and prepared to handle the disease to the best of their abilities as they have been often left frustrated and fatigued in the process. A case was cited where a caregiver who was looking after her elderly grandmother committed suicide due to the increased pressures of her schedules. She is said to have left behind a suicide note citing her frustrations with the burdens accorded to her. Prior to her death, many community member reckon that her behavior towards others which was once warm, friendly and welcoming turned rather unpalatably cold and disturbing. In the past half a decade alone, over one-third of the participants have had to deal with cases of Alzheimer’s in their families. Over half of them have heard of similar cases from friends and other areas. The bottom line is that in almost all cases – astonishingly – the families have often been left broken, separated and reeling in unending turmoil (emotionally). It was decided that there was need to educate the society on the disease, how to avoid it, detect it early enough for swift interventions and how to care for the patients (whether at home or have them institutionalized). The gathering also saw it fit to introduce a scheme where families coping with the illness receive financial contributions from other households so that they can sufficiently manage the condition in terms of health care for the loved one and additional counseling sessions and therapy for the remainder of the family. The condition presents dire concerns for the community. Discussion From the passionate deliberations and expert views from healthcare personnel present during the assessment program, one of the major challenges for family members remains whether they should care for the patient themselves or seek help. As the patient’s decline progresses, more support may be required which may prompt relocation of patient to an institutional residence. The common trajectory of this transition begins with day care services, followed by long-term placement, preferably a facility that offers specialized care for individuals with severe dementia. Treatment of Alzheimer’s is patient-centered with therapy focused on maintaining a familiar lifestyle, maximizing quality of life and independence and utilizing the enduring strengths. Pharmacological therapy on the other hand emphasizes on maintaining functions by retarding disease progression, promoting comfort and providing symptom relief. Pharmacological techniques can also be useful in minimizing/ eliminating complications, glucose, blood pressure and cholesterol levels. Cholinesterase inhibitors reduce acetylcholine breakdown while benzodiazepines and anti-antipsychotics are often administered to regulate emotional symptoms. Several other therapies and training techniques are available to assist the patient and caregiver cope with the pressures of the disease, check psychosocial factors, enhance the use of brain plasticity through memory training and enrich the environment. In the end, emphasis must not only be accorded to the Alzheimer’s patient but also to the caregiver who may crumble under pressure and lose the very essence of life. References Altschuld, J. W., & White, J. L. (2010). Needs assessment. Los Angeles: Sage. Gidley, I., & Shears, R. (1987). Alzheimers: what it is, how to cope. Sydney: Allen & Unwin Australia. Perry, G. (2013). Alzheimers disease advances for a new century. Amsterdam: IOS Press. Royse, D. D. (2009). Needs assessment. New York: Oxford University Press. Stevens, A. (1994). Health care needs assessment: the epidemiologically based needs assessment reviews. Oxford: Radcliffe Medical Press. Stevens, A. (2004). Health care needs assessment the epidemiologically based needs assessment reviews (2nd ed.). Oxford: Radcliffe Pub.. Zarka, H. (2011). Alzheimers. Kbh.: Korridor :. Read More