Home Health Care Services for Alzheimer's Patients and Their Caregivers - Research Paper Example

? Home Health Care Services for Alzheimer's Patients and Their Caregivers Alzheimer disease is incurable diseases that worsen with age and eventually lead to death. Alzheimer sufferers in 2006 were 26.6 million. It is predicted that, by 2050, it will affect 1 in every 85 people worldwide. Alzheimer disease symptoms can easily be confused with other age related diseases. The first, early symptoms of Alzheimer are trouble in remembering events that may have occurred recently. It is confirmed using behavioral evaluations, thinking abilities and brain scan tests. At an advanced stage, symptoms include irritability, confusion, aggression, trouble with language mood swings, long term memory loss, withdrawal from family and society, loss of body functions, which leads to eventual death. Researchers infer that the life expectancy after diagnosis relatively seven years with three percent of patients living for more than fourteen years (14) after diagnosis. There are several possible, suggested ways that can be used to delay symptoms in older individuals. These ways include a balanced diet, exercise and mental stimulation. These ways can effectively manage the symptoms, therefore, making the patient more comfortable. Since Alzheimer disease is incurable and degenerative, the patient depends on care given by other people. In most cases, the role of the caregiver is usually taken by taken a close relative or the spouse. Alzheimer disease places a massive burden on the caregivers. This places pressure on the caregiver’s life involving psychological, social, economic and physical aspects of his or her life. It is also extremely expensive disease to the family and society. United States and other countries are carrying out research on Alzheimer disease seeking its treatment and prevention. Professional home health agencies give support to the care givers. If the caregiver knows the services rendered by the agencies and know the right time to transit from home to palliative care, gives the caregiver respite and peace. Prevention as the basis for effective home care There is no absolute evidence that supports measures as effective in preventing Alzheimer disease. Studies conducted globally regarding delaying and prevention of the disease show inconsistent results. However, there have been proposed relationships between some factors such as diet, pharmaceutical products and cardiovascular risks in relation to developing the disease. Cardiovascular risks factors like diabetes, hypertension, hypercholesterolemia and smoking are associated with a risk of Alzheimer disease. It is proposed that Mediterranean diet that includes fruits and vegetables, wheat, cereals, fish, red wine and olive oil reduces the risk of this disease. However, there is little evidence to prove that moderate use of alcohol specifically red wine lowers the risk of Alzheimer disease. Non-steroidal anti-inflammatory drugs reduce inflammation associated with amyloidal plaques, which increases the chances to be affected by Alzheimer disease. Research as also shown that people who get involved in intellectual activities, for example, playing board games, reading, completing crossword puzzles, regular social involvement and playing musical instruments are at a lower risk of getting Alzheimer disease. Medical marijuana has been found to hinder the progress of the disease. It prevents by hindering formation of deposits associated with brain disease. However, cannabinoids have not been found to improve or treat the disease. Environmental factors such as metal intake especially aluminum and exposure to solvents increases the risk of Alzheimer although these studies have been criticized based on credibility and accuracy. Management and home based care for Alzheimer patients As explained earlier, there is no absolute cure for Alzheimer disease. The medication available offers small symptomatic help but remains in palliative in nature. The current treatment they can be given to Alzheimer patients can be divided into psychosocial, pharmaceutical, and care giving Pharmaceutical treatment- denopezil which is an acetyl cholinesterase inhibitor is usually used in the treatment of Alzheimer disease symptoms. Memantine medication is also approved for advanced stages of Alzheimer symptoms. Other medications can be put in use; these includes tacrine and rivastigmine. All these medications are approved by U.S. Food and Drug Administration, and also the European Medicines Agency regulatory agencies to treat the cognitive manifestations of the disease. The common side effects of these treatments are vomiting and nausea. In most cases, ten to twenty percent of patients faces these side effects. Thee other unlikely side effects include decreased heart rate, muscle cramps, decreased weight and appetite and increased production of gastric acid. Psychosocial intervention- snoezelen is room designed for Alzheimer patients for sensory integration therapy. Psychosocial intervention is an emotion oriented intervention. These interventions are used in addiction to the pharmaceutical treatment. It is usually ranked as emotion, behavior, cognition and stimulation oriented approaches. This intervention attempts to recognize and lower consequences of behavior problems caused by the disease. Although, this approach may not show success in improving or curing the disease pi assists in reducing behavioral problems such as incontinence. Other emotion related interventions that comprise snoezelen include validation therapy, reminiscence therapy, sensory integration and supportive psychotherapy. Reminiscence therapy comprises of discussions with the patient's experiences as a group or individual to check if they remember past occurrences. The material aids they use includes household items, photographs, sound recordings, music and other familiar objects from the past. This therapy helps in the mood and cognition.Simulated presence therapy is conducted by playing recordings with voices of familiar and the closest relatives of the patient with Alzheimer's disease. There is little evidence indicating that this therapy reduces challenging behaviors. Validation therapy is usually based on accepting the reality and personal truth of another's experience with regard to the patient, while sensory integration involves exercises aimed to stimulate senses although there is insufficient evidence to support the use of the therapies. Cognition-oriented treatments include reality orientation and cognitive retraining and aims in the reduction of cognitive deficits where as Reality orientation involving the presentation of information regarding place, time or person so as to ease the understanding of the people and surroundings. Care giving- It is the essential treatment after the onset of the disease. This is because Alzheimer makes people incapable of taking care of their needs. At the early stages of the disease, changes can be done on the environment to increase the safety of the person and reduce overdependence on the caregiver. These modifications include simplified routines, labeling of items so as the person remembers the use and the placing of safety locks. As this disease advances, the patient may be incapable of feeding themselves, therefore, requiring food in smaller pieces. Even when swallowing, difficulties may arise necessitating the use of feeding tubes. At this stage, the medical efficiency and ethics of continuing feeding of the person is a paramount concern of the caregivers and other family members. There is little or no use of physical restraints any stage of this disease, although there are certain instances when they are used to prevent harm to themselves and caregivers. As the stages of the disease progresses, complicated medical issues may appear, these include oral and dental disease, malnutrition, pressure ulcers, hygiene problems, eye or skin infections and respiratory. If, careful management is given it can prevent them. Professional treatment is also needed when problems regarding the patients arise. During the final or last stages of Alzheimer disease, treatment is focused on relieving pain and discomfort until death. Alzheimer caregiver and home based care With the increasing number of Alzheimer patients, it is paramount that there should be almost equal number of caregivers. Caregivers should also be given compassion, love and support similar to the patients they care for. The disease has different effects on the caregivers. The work of caregivers may cause them emotional, physical and psychological problems (Gubruim, 2002). As the disease advances, the caregiver dedicates most of his or her time to the patient which leads to him or her being cut off from society and friends. The caregivers get frustrated and struggle as they cope with the patient change in behavior. Caregivers are deeply faced with financial constraints as they will have to be absent from their jobs. Others will be forced to quit their jobs due to demanding care needed by these patients. Early disease detection is one of the most valuable guides to the caregiver. This is crucial because the patient can also contribute substantially on the strategies of care giving. Such contributions are financial deals, drawing a will and also in therapy participation to name but few. This early diagnosis will make caregiver a lighter burden. Patients on early or middle illness stage can be taken care of at their homes reliving the burden of nursing homes (http://www.thehomecaredirectory.com, Feb 2012). They depend on friends and family for the care. Training is particularly salient for anybody to be a caregiver to Alzheimer’s patient. With adequate training, the caregiver will be performing his/her duties with a lot of professionalism and, therefore, will experience minimal stress or difficulties during care giving. Caregiver needs to have a support service such as respite care, support groups, day care among others (Houlihan, 2001). The caregivers feel healthier and more rewarded compared to those caregivers lacking the support services. Sometimes home care is not enough for the patient. There are options for these patients like nursing homes, facilities like independent living and also assisted living. These will come in once the home care gets deemed not enough for the patient. Caregivers are getting more and more recognition attention and support for their selfless work to humanity. It is suggested that former caregivers be incorporated in health care networks, to share their expertise with newly inducted caregivers. Caregivers should always go prepared with all information regarding the patient when they go to visit a doctor. This normally makes patient-doctor dialogue more effective. When the physician gets key issues earlier he or she will offer excellent services to the patient. All family caregivers should be present when the Alzheimer patient visits a doctor (Schneider, 1999). They should have a strong partnership with the physicians dealing with patients. All activities of concern like approaching new symptoms should be communicated to the physician prior to the visit. This eases the physician’s agony and helps dedication of appropriate measures to keep patient at ease. Caregivers should have a list of specialists of Alzheimer so that they may make referrals quickly and ensure no delays on service delivery. Skilled home care agencies These agencies are licensed and certified to provide medical care services. They major in providing skilled health care or rehabilitation to those Alzheimer patients bound at homes. The agencies always have to adhere to a care approved by the physician which is necessary for a mutual benefit. They offer services such as psychological, medical, disease management, physical therapy and also nursing to the Alzheimer patients. They deliver these services through social workers, nurses, home makers, therapists amongst others. The agencies usually set a team to ensure that all Alzheimer patients meet with a specialist who suits them most. These agencies are extremely reliable because they operate 24 hrs 7 days basis. The agencies may offer their services on private schedule requiring direct due payments. We have gotten also hospice care agencies that provide compassionate, end of life services to the elderly suffering from Alzheimer. They provide spiritual, psychological, medical care to the Alzheimer patients since there is no possible cure. They coordinate with the family to deliver the services like palliative care, and psychological/social back up to their loved ones. They ensure that patient wishes are adhered to making the patient feel at home. The patients with Alzheimer disease will need both skilled care agencies as well as home care services for a better living (Homecare.com, 2010). Supporting and caring for the care givers Care givers can do their work effectively if they educated on the care they can give to patients. This gives the caregiver relief if they do not get the results they expect. The support so helps them to know when they need professional help especially when the patient is being moved from home to palatable care. Caregivers should communicate with support groups and people professional help so; their lives are not entirely cut off from the society. The care givers health must be put in consideration. This is because one out of ten caregivers health deteriorates as a result of care giving. Family and society should appreciate the work of the caregivers. When the caregiver is supported socially, his or her well being improves. When caring for the patient it is likely might forget their needs, the family should not forget the needs of care giver. Care givers should not be isolated from the society as this may make them feel depressed. They should also be encouraged to accept care in the support groups. It is advisable for care givers to accept help fro people who wish to help them. This help may be in caring for the patient, finances, emotional and professional help. Some times the care giver feel guilty when relieved of their duties, they feel it is not to have an enjoyable time while their family member is suffering (Schneider, 2007). The care givers should understand they are not perfect and; therefore, they are irresponsible for anything happening to their family members. Care givers should be advised to join groups such as National Alliance of Care givers. They may share their experiences with other care givers and learn from them too. Care givers are advised to connect with the patient through change. This is because this condition keeps changing. When the person is still able to organize activities they can participate, learn to let go the things that the loved ones can not perform and value what they can give at the moment. Observing and experimenting the loved ones favorite activities this way there will be a connection between you and the ailing person. Care givers should be advised to maintain social contacts, peer support, family connections and professional networks in order to safeguard for their wellness and happiness. It is also advisable to the family members to sharing tasks, solve problems, and savoring the humor when caretaking as this lets the family return to a life filled with full of health and cherished memories. When dealing with care giving challenges, the care giver should prevent being burnout and look for assistance when necessary. It is necessary to embrace respite care so as to relieve stress, have balanced life and restore energy. Stress management is also crucial as one learns how to control thoughts, environment, and emotions and how to deal with problems. Exercise and relaxation techniques can be used to improve mental and physical health. Relaxation is also effective in combating stress and ease tension. Conclusion The new methods of diagnosing Alzheimer have made it possible for early diagnosis. This is essential in the sense that, it helps in formulating strategies to help the Alzheimer patients and caregivers. Since it is a progressive and irreversible condition that affects the memory, thinking abilities and body systems long term strategies should be formulated. Care should not only be focused on the ailing family member with Alzheimer condition, but the care giver too needs care so that their health may not deteriorate or suffer from stress. People with this condition may begin to have difficulties in recognizing family members, friends and may also be no longer able to learn or retain new concepts. Family members should understand them and not overwork themselves trying to remind them. Care givers should learn about the Alzheimer disease to be well versed with happenings to their loved one. Knowledge will also guide on the help they can give to maximize their quality life and that of the loved ones. Family members should also be helped to plan and prepare for the outcome of the disease. Care givers should also learn about care giving tips to manage symptoms and problems associated with the behavior of patients. Non-verbal communication skills should also be used in building relationship with the ailing loved one. Alzheimer is an incurable and manageable disease with the right care a patient can live comfortably for the remaining of his or her life. However, the care givers and family should know when to transit from care from care givers to professional help. References Houlihan, J. (2001). Families Caring for Frail and Demented Elderly: A Review of Selected Findings, Family Systems Medicine; vol.5 (3), 344-356. Human Factors Challenges in Home Health Care. December, 2011. Agency for Healthcare Research and Quality http://www.ahrq.gov/research/dec11/1211RA1.htm Gubruim, J. (2002). Family Responsibilities and Care Giving in the Qualitative Analysis of the Alzheimer’s disease Experience. Journal of Marriage and Family; Vol. 9 (3), 497-507. Quayhagen, M, Patterson, T. Irwin, M., and Grant, I (2007). Coping With Dementia: Family Caregiver Burnout and Abuse, Journal of Mental Health and Aging; Vol. 9, (3) 357-364. US Department of Health and Human Services. Alzheimer's Disease Fact Sheet. National Institute on Aging. Retrieved March 11, 2012, from http://www.nia.nih.gov/alzheimers/publication/alzheimers-disease-fact-sheet. Schneider J, Murray J, Banerjee S, Mann A. (1999). A cross-national study of co-resident spouse carers for people with Alzheimer's disease: Factors associated with carer burden. International Journal of Geriatric Psychiatry. Read More