Ethical Issues in Dealing with Alzheimers - Essay Example

Juliette Garcia Ivan Ruiz ENC 1101 Ethical Issues in Dealing with Alzheimer’s Alzheimer’s disease (AD) is a very common form of dementia that is very complex as well. It starts with a physical problem of brain functioning, thus manifesting as a physical temporary illness. However, with the progression of the physical brain damage, Alzheimer’s later causes mental and behavioral disorders that result from reduced mental intellectual abilities. In other words, a person with Alzheimer’s experiences significant changes in personality during the period of the illness and the ability to make decisions about one’s life is impaired. Alzheimer’s symptoms are usually similar to normal aging, thus making it difficult to notice and it mostly appears when treating and taking care of an ill person. In order to differentiate the symptoms of Alzheimer’s and those of normal aging process, clinical institutions such as Alzheimer’s Association and Alzheimer’s Society have provided an explicit definition of AD. They are based on the physical brain changes. Alzheimer’s is difficult disease to treat in a proper manner, and its management presents serious ethical challenges to the care providers including the family members and health professionals due to alterations in behavior. Thus, this discussion would explore some of the ethical concerns of the caregivers while dealing with patients with Alzheimer’s. At early stages, the similarity of the symptoms of Alzheimer’s and normal aging makes it hard to distinguish AD from old age. As a result, socio-cultural factors play a significant role in AD treatment with an utmost concern for the ethical issues (Dillman129). Moreover, what might be considered as an elderly absent-mindedness might be a symptom of Alzheimer’s or dementia (Alzheimer’s Association 1). Therefore, a proper identification of AD would first require differentiation from the normal aging by observing the physical symptoms in relation to the changes in a person’s mental ability. In addition, a socio-cultural context of the treatment arises as a person with later stage Alzheimer’s demonstrates impaired decision-making skills (Hughes 381). The development of AD involves numerous complex processes. As seen in other dementias, the first symptom of Alzheimer’s is memory loss because the disease begins with physical brain damage. The proteins build up in the brain during the course of the disease resulting in the formation of structures called plaques and tangles (Alzheimer’s Society 1). The nerve cells also lose their connections, and the brain tissue is damaged. The disease specifically affects the cortex, which is responsible for thinking functions. It, therefore, damages the brain areas that are responsible for the intellectual activity. (Alzheimer’s Association 1). It also affects the hippocampus that plays a central role in day-to-day memory (Alzheimer’s Society 2). A person with AD has a problem recalling recent events, and they ask the same information many times. Even though the healthy elderly persons mostly forget, they remember much of the information later (Alzheimer’s Association 1). Contrarily, people with AD experience memory loss (Alzheimer’s Association 2). The elderly may also have occasional errors with numbers while people with AD lose the ability to solve problems and plan due to the destruction of their cortex. Moreover, loss of memory in AD patients causes inability to complete familiar tasks while the elderly may only experience challenges of understanding new devices or some new activities. The later symptoms of AD are less peculiar to normal aging. As the disease spreads to the cortex, a person’s vision and understanding of his surrounding deteriorate. Conversely, the elderly may have difficulty in recalling a day of a week or a date and their vision problems are usually caused by cataracts (Alzheimer’s Association 1). Both the elderly and people with AD may sometimes misplace things. However, the old can retrace steps or a recent chain of events, and remember how an item has appeared in a new place. Since remembering is connected with planning, people with AD cannot remember recent information. In addition, they do not know what they were recently doing, and it is at this stage that the behavioral problems start to appear (Alzheimer’s Association 2). On later stages, AD spreads further in the cortex areas that are responsible for linguistic activities and reasoning; thus a person starts experiencing problems with making a logical conversation. He or she also makes poor judgments because his decision-making capability is affected (Alzheimer’s Association 2). While the elderly may naturally feel tired of family obligations and some social activities, a person with AD tends to detach himself from most of their favorite social activities and hobbies. These are clear examples of personality changes that demonstrate mental and behavioral disorders (Alzheimer’s Association 2). Some of the most common changes in AD are failure to recognize the family members, well-known, and familiar environment due to confusion. In addition, inability to perform essential daily living activities like eating, bathing or walking results (Alzheimer’s Society 5). The changes that occur during the development of the disease make people with AD mostly to experience depression and mood changes (Alzheimer’s Association 1). Later, mental disorders become more severe as more brain areas are damaged. Consequently, people with AD often experience hallucinations and sleeping problems as well as demonstrating aggressive behavior, during which, they may hurt themselves or a person who takes care of them (Alzheimer’s Society 4). Thus, management of AD is a complex process that involves both medical (directed at relief of physical symptoms) and psychological (primary talking therapies for mental disorders) approaches. It means that drug and non-drug care, as well as support activities, are involved at every stage of disease development (Alzheimer’s Society 8). On very later stages, a person with AD may need special care and more often they are hospitalized. In reference to the above specific disease symptoms, it is clear that a person with Alzheimer’s regularly experiences a decrease in intellectual activity during the development of the disease. As a result, diagnosis is usually based on the physical body analysis using techniques such as MRI and other methods of brain scanning that reveal a spreading damage within the cortex. With time, the brain shrinks dramatically and loses its functions (Alzheimer’s Association 2). However, a possibility of diagnosing the disease on the basis of only the apparent clinical or pathological manifestations during the development process has been a subject of debate (Dillman137). This argument has risen because of the obvious similarities of AD with normal aging. Thus, it has widely been compared to normal aging even in the present times (Dillman 137). The statistics have also caused further ambiguity in distinguishing AD from old age since they state that the disease mainly affects people over 65 years of age with the risk increasing with age. Moreover, statistics indicates that one in six people over 80 years old have dementia (Alzheimer’s Society 2). From a clinical perspective, there are rare cases of early Alzheimer’s disease (Alzheimer’s Society 2). Since the brain damage caused by AD is irreversible with drugs bringing only a relief and delay of symptoms, finally it leads to complete inability to make decisions. Therefore, in later stages, doctors and family usually treat a person with AD without his participation in the treatment process. In this context, the caregivers deal with a serious ethical challenge of making a decision on the behalf of the patients. Despite, the modern health care and social tendency recognize the patient autonomy as a priority in the process of providing care (Hughes381). It implies that a person with a dementia should be treated, and if he wishes not to take drugs nor adhere to the therapies, then his decision should be respected. However, a decision that promotes the benefit of the patient must be made (Hughes 381). In addition, persons with late stage Alzheimer’s cannot make decisions about their personal lives and allow others to make decisions on their behalf (Hughes381). The debilitating effects of AD limit the patients of their social and individual rights as human beings. Some philosophers define a personhood in terms of consciousness and, in particular, memory. Thus, as the intellectual activity decreases, and memory loss occurs due to AD, the personality of a person vanishes and the autonomy also decreases (Hughes 383). It affects a once healthy person who had some moral obligations to the family and participated in the process of decision-making. For example, children find themselves in a terrible dilemma when their mother who was well, develops dementia and starts wandering in the streets almost naked (Hughes 381). In conclusions, Alzheimer’s disease presents itself as a quite ambiguous illness. The similarities of its symptoms with normal aging make it associated with the elderly. Alzheimers is defined as an abnormal form of aging that requires an elaborate treatment. Since this definition is primarily based on the clinical evidence, AD’s abnormality may be questioned. The treatment of Alzheimer’s also presents ethical challenges. The society and clinical practice tend to justify disregard of the patient’s autonomy basing their argument on the irreversible decreasing personality. Therefore, the discussion about moral concerns when dealing with Alzheimer’s disease can remain open. Works Cited Alzheimer’s Association. “Inside the Brain: An Interactive Tour”. 21 March, 2015 Alzheimer’s Association. “10 Early Signs and Symptoms of Alzheimer’s”. 21 March, 2015 Alzheimer’s Society. “What is Alzheimer’s disease?” 21 March, 2015 Dillman, Rob JM. "Alzheimer Disease. Epistemological lessons from history." PJ Whitehouse, K Maurer & JF Ballenger (red.), Concepts of Alzheimer Disease.Biological, Clinical and Cultural Perspectives. The Johns Hopkins University Press, Baltimore/London (2000): 129-157 Hughes, J. C. “Ethical Issues and Patterns of Practice”. In Weiner, M. F. and Lipton A. M. (Eds.) The American Psychiatric Publishing Textbook of Alzheimer Disease and Other Dementias, Chapter 22, pp. 379-407. American Psychiatric Publishing, 2009 Read More