Love, Speech Pathologist Treatment of Dementia Patients with Disruptive Behaviors - Research Paper Example

Love, Speech Pathologist Treatment of Dementia Patients with Disruptive Behaviors Due Introduction Dementia is the main reason for the placement of nursing homes, and the behavioral symptoms are the main factors precipitating decisions. Some of the disruptive behaviors include agitation, sleep disturbance, psychosis, depression and aggression. Such behaviors have the potential of challenging the ability of the family members to care for the loved ones within the illness age. In addition, working with families to bring change in dementia management strategies may lead to delayed institutionalization (Bob & Gia, 2002). As a result, in this paper, the aim is to outline strategies used to identify and treat patients with speech disorders due to dementia. This aims at determining how to ensure the quality of patients and family members’ lives in situations of dementia can be improved. Discussion According to pathologists, despite the fact that memory loss has been a prominent finding lately in most dementia patients, the main issue that contributes to institutionalization is the disruptive behavior, such as unnecessary speech associated with the disease. Some of the main symptoms associated with the disease include sleep disturbance, unnecessary speeches, aggression, depression, agitation and psychotic-related features. In addition, behavioral symptoms may be a result of dementia illness, Iatrogeneric causes and other concomitant illness. However, the main error made by a majority in managing behavioral disturbances is that treatment commences without identification of the symptom precipitant. It is essential to ensure that before anyone commences treatment the identification of the disruptive behaviors and causes is done (Teri, Logsdon, Uomoto, & McCurry, 2012). To ensure that treatment of a sick person is satisfactory, the patient’s family and pathologist should have a sound understanding of the issue under treatment. Depression is one of the symptoms and the disruptive behavior of dementia that affects up to 20% of most patients. Depression can be in the form of unnecessary speeches because of the disease-related neuronal loss and, less frequently, reaction to a disease process. For patients suffering from vascular dementia, depression mostly follows the left cerebral hemisphere stroke. Dementia-related diseases, such as Parkinson’s disease, have many patients showing symptoms of depression through their speeches. In most cases it is difficult to diagnose patients with depression due to dementia because apathy is common in both disorders (Teri, Logsdon, Uomoto, & McCurry, 1997). Frequently, patients with dementia give irrelevant speeches and have impaired insight making. In most cases during the treatment of depressed patients that give irrelevant speeches pathologists recommend psychotherapy. However, they also state that it is possible to reduce unnecessary speech depression using mental and physical activities. In situations where drug therapy is essential, selective serotonin, reuptake inhibitor is most preferred. To ensure that treatment of speech depression becomes successful, patients should undergo treatment for at least six months. After some time it is essential to taper the dosage slowly. However, in situations where patients become inadequate, it could be so because the dosage is inadequate. As a result, it important to continue with the dose for one or two weeks until it is clear that symptoms are over or until the maximum allowed dose is reached. If the symptoms continue to show, it is necessary to use antidepressants from different classes. At times symptoms may stop or continue. If the symptoms do not stop, a patient should visit a speech pathologist for explanation regarding the next action to take (Burke & Morgenlander, 1999). Pathologists state that speech and sleep disorder are other symptoms and, thus, disruptive behavior is associated with dementia. In most cases, family members of patients suffering from dementia may tolerate delusion, agitation only if nighttime sleep remains uninterrupted. However, in situations where behavioral disturbances are constant and occur during the day and at night, family members will find it necessary to resort institutionalization and express love to the patients. At times it is necessary for the pathologists to educate families on the relevant strategies necessary to correct and prevent sleeping problems other than nursing home placement. It is worth noting that there are factors contributing to the poor sleeping habits by persons with dementia. Some of these factors include alterations in the circadian system, unnecessary speeches, frequent urination, frequent napping and use of sedating medication. It should be mentioned that the main cause of sleep disruption is a high expectation of sleep needs and frequent napping. Family members of the patients often claim that patients wake up as early as 3.00 a.m. to get ready for morning activities. In addition, they state that most of the patients like napping during the day as they watch television and in most cases go to bed as early as 8.00 p.m. (Rosenblatt et al., 2004). Cases of dementia are common and on further questioning of the family members they stated that when they see their sick relatives waking up exceptionally early in the morning they are not surprised. In normal life, as an individual grows old, sleep requirements begin to decrease and at times he/she starts delivering so-called speeches of wisdom. However, an individual suffering from dementia may sleep for more than normal 7 or 8 hours. According to the requirements of the caregivers and pathologists, the time used by patients for napping is an appropriate time to fulfill tasks within the house. This is so because, most people at first may not know that such persons are sick and need attention. Some of the possible strategies used to re-establish the normal sleep pattern and avoid unnecessary speeches are enforced by reducing the daytime napping. This means that it is essential to take relevant steps to ensure that a dementia patient is not sitting in front of television for a long time. This can be possible if caregivers engage patients in events tailored dementia degree. Such events include regular physical exercises, household tasks and easy handcrafts. It is possible to have patients engaged in these activities at home but families have benefited due to available day care facilities for adults (Doody et al., 2001). It is worth commenting that once the sleep disturbance behavior and unnecessary speeches is established, it can be difficult to eradicate completely. However, pathologists recommend that the first step in the correction process should be taken by setting an appropriate sleeping time and preventing patients from occasional napping. Instead, the activity level of a patient should be increased and attempts should be made to reduce fluid intake by patients around sleeping time. On correction of such issues patients will have a few difficult nights but at some point they will start having long sleeping time. In families that do not accept the possibility of the problem becoming worse before recording improvements they may find necessary to use sedating or hypotonic drugs (Bob & Gia, 2002). However, speech pathologists state that overreliance on sleeping medication may become unsuccessful in the long run. To some people lighting is one of the main reasons contributing to sleep disturbance and unnecessary speeches. It is worth noting that light is a significant moderator of the circadian rhythms in dementia disruption. Some people claim that the increase in light in the evening and afternoon is likely to improve the sleeping patterns. At some point pathologists commenced a research to outline the effect of increased daytime illumination among 22 patients suffering from dementia. Results showed the increase in rest activity rhythm of patients with intact vision. For those with visual impairment there was no much change in their behavior. This was a clear indication that the prolonged exposure to light contributes towards correction of sleep disturbance and unnecessary speeches by patients with dementia. As it appears, some people may think that it is easy to correct sleep disturbance (Cohen-Mansfield, 2001). However, there are difficulties; for instance, the need to adhere to the rigid schedule. At some point family members may have trouble in adjusting themselves to tight or restricted schedules. As a result, it is vital for speech pathologists to teach them that periodic disruption of schedules may lead to disrupted or irregular sleep patterns. On the other hand, the use of hypotonic agents in periodic administration is essential and can provide or guarantee families some sense of control. Moreover, loving people who take care of the patients with dementia have come up with intervention strategies to solve their problems. It is worth noting that most of the patients with dementia suffer from sleep disturbance and prolonged unnecessary speeches. In addition, such patients have a common issue of agitation. As a result, attempts are made to reduce agitation by increasing patients’ sleeping time. Some of the pathologists’ suggested strategies include the use of bright light therapy, increasing level of exercises, reducing interruptions at night and the use of melatonin. Patients also deserve to get encouragements to improve on their eating and drinking styles and enhance lighting during the mealtime. As a result, increase in restrictions to agitation is likely to improve patients’ behaviors (Camp, Cohen-Mansfield & Capezuti, 2002). At some point caregivers and pathologists find it necessary to have direct discussions with patients on issues which can have a significant contribution to their behavior. It is from discussion that patients may express themselves, thus, enabling caregivers and pathologists to determine a suitable strategy of handling them. According to research, intervention is one of the most appropriate strategies to use while dealing patients with dementia. Conclusion It is worth noting that sleep disturbance and unnecessary speeches by patients with dementia are related somehow. However, something positive regarding it is that, according to pathologists, pharmacologic and non-pharmacologic therapies in most cases are effective and can help dramatically improve patient’s and family member’s quality of life. Nevertheless, the main challenge associated with this method is that treatment may not get successful immediately. As a result, it is mandatory for the parties involved to consider strategies capable of solving sleep disturbance and unnecessary speeches in patients with dementia. This is so because some issues that happen are often caused by patients or family members’ actions. Therefore, where possible family members and patients should correct their mistakes if necessary; for instance, napping in the late evening and watching television for a long time should be avoided. References Bob, K.G., & Gia, S.R. (2002). Cognitive-behavioral therapy. Encyclopedia of Aging. Retrieved on February 22, 2012 from http://www.encyclopedia.com/topic/Cognitive-behavioral_therapy.aspx Burke, J.R., & Morgenlander, J.C. (1999). Managing common behavioral problems in dementia- How to improve quality of life for patients and families. Behavior Management. Vol. 106, No. 5. Retrieved on February 22, 2012 from http://endoflifecare.tripod.com/juvenilehuntingtonsdisease/id138.html Camp, C.J., Cohen-Mansfield, J., & Capezuti, E.A. (2002). Mental health services in nursing homes: Use of non-pharmacologic interventions among nursing home residents with dementia. Psychiatric Services. Vol. 53, No. 11. Retrieved on February 22, 2012 from http://ps.psychiatryonline.org/article.aspx?Volume=53&page=1397&journalID=18 Cohen-Mansfield, J. (2001). Managing agitation in elderly patients with dementia. Geriatric Times. Vol. 2, No. 3. 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