Symptoms, Mechanism of Development, and Therapy Disease of Alzheimer - Essay Example

? An explanation of how a worker in the social or health care sector could apply psychological perspectives to protect and enhance the well-being of an older adult being diagnosed with Alzheimer’s disease BY YOU YOUR SCHOOL INFO HERE DATE HERE Alzheimer’s disease Introduction Alzheimer’s disease is commonly referred to as a type of dementia, generally occurring in most sufferers after age 65. The disease is a progressive neurological problem which slowly destroys cognitive and memory capacity in the victim, eventually leading to a complete inability to perform basic tasks associated with daily life. Advanced stage physical symptoms include incontinence, loss of verbal communications skills, an even an inability to walk independently. Emotional outcomes of Alzheimer’s can often include depression, paranoia, inability to recognise family members and friends, and a variety of serious behavioural problems. Aggression and large-scale mood swings often also accompany the disease (Tabert et al. 2005). Of all potential symptoms, which are largely unique to the sufferer, depression is the most common outcome of the disease, occurring in 40 percent of all afflicted (Thompson 2013). During the earlier stages of the disease, before the ultimate and irreversible breakdown of all major cognitive functions, the patient will oftentimes have difficulty coming to grips with their memory losses and contemplate the ultimate end-of-life emotions common in patients with terminal illnesses. In the role of social caregiver or in health care, there are strategies available for assisting the elderly individual more effectively cope and adjust to their illness. Such strategies include reminiscence therapy, validation therapy, simulated presence therapy, or simply utilising common principles of hope that might be linked with spirituality. All of the aforementioned strategies for assisting in improving the well-being of a sufferer of Alzheimer’s could be utilised by a social care or health care worker, both cognitively and emotionally. The impact of Alzheimer’s on the person’s well-being As previously stated, depression is one of the most common symptoms of the disease. This generally occurs during the earlier stages of Alzheimer’s whilst the individual is beginning to realise they are rapidly losing their cognitive and memory functionality. Symptoms of this Alzheimer’s-induced depression range from a variety of somatic complaints, such as digestion problems, heartburn, headaches and even backaches which are brought on by the stress reactions associated with knowledge of the irreversibility of the disease. Somatic complaints are some of the most common symptoms of the disease as it is a recognised phenomenon in psychology that physical health complaints are strongly correlated to stress and frustration. Anhedonia is another significant symptom of Alzheimer’s, which is characterised as an inability to experience enjoyment from certain activities that once brought pleasure to the sufferer such as exercise, sexual activity, or attendance of social engagements (Blanchard, Mueser and Bellack 1998). Some social and health caregivers have attempted to utilise cognitive behavioural therapy as a means of improving anhedonic responses, however by the time an individual has reached an advanced age, the sufferer already maintains long-standing views of the self and can be resistant to attempts to alter established and enduring behaviours (Bienenfeld 2009). Oftentimes, the anhedonic problems are permanent, making it difficult to establish a methodology of imposing treatment on the individual to improve their well-being. However, the commonality of anhedonia for Alzheimer’s sufferers makes it an imperative for the caregiver to re-inject the motivation to engage in activities that provide delight and contentment with the frustrated disease victim. As illustrated, the emotional and cognitive outcomes of attempting to cope, during earlier stages of the disease where cognition is still partially intact, are quite difficult to manage. As cognition, emotion and memory begins to regress further, the individual will often withdraw from their family members or other caregivers as they succumb to the complexities of emotional responses and ultimately lose their mental capabilities. This is why it is vital for a social or health care practitioner to engage the Alzheimer’s victim during earlier stages of the disease if there are to be any long-lasting, positive outcomes of attempting to improve their mental health. There are strategies available to the caregiver that can not only achieve the aforementioned positive effects, but also to potentially improve the tangible cognition of the patient which can enhance the sufferer’s ability to cope effectively with this terminal disease. Potential interventions to improve well-being A once fully-functioning elderly person that is suddenly finding problems with maintaining short-term memories can easily become frustrated or depressed. One method of improving the individual’s memory recall is to engage in reminiscence therapy, a method that can be easily utilised by a social or health caregiver. In reminiscence therapy, the Alzheimer’s victim is actively engaged to discuss their own past experiences (sometimes occurring in group settings). These discussions are often accompanied with supplementary usage of personal photographs, known favourite musical recordings or a variety of treasured personal items that speak testament to the individual’s short- and long-term histories (Webster 2002). This type of therapy allows the individual to not only attempt to improve their memory skills, but also find personal satisfaction through discussion of important life events and characters through which the sufferer once or currently maintained psychological attachment. Reminiscence therapy has been found to be an effective early-stage intervention when it is utilised in a group environment, which is why the strategy is widely utilised in the nursing home environment or within a similar geriatric health facility environment (Tadaka and Kanagawa 2007). Reminiscence therapy not only attempts to slow the breakdown of memory capacity, but also improve the self-esteem of the victim which is an important construct in altering depressive symptoms. For those elderly individuals not suffering from Alzheimer’s, but concurrently maintain generic depressive symptoms, establishing a sense of social belonging has been known to reduce anhedonic responses (Henslin 2005). Using reminiscence therapy, the role of the social or health caregiver is to attempt to provide confidence to the sufferer by allowing them to take pride in their memory recall accomplishments. By being allowed to continuously retell important stories with others sharing similar age and cultural characteristics, reminiscence therapy maintains many opportunities for bringing pleasure back into the victim’s life and allowing them to find dignity even in the face of their diminishing mental capacities. This approach also allows the caregiver to change the individual’s propensity to draw on memories that are supportive of dysfunctional or maladjusted depressive views and focus on more positive aspects of their role within the family or in general society. Yet another approach for improving the well-being of the victim is referred to as simulated presence therapy (SPT) which draws on the psychology of adult attachment theories. When the individual reaches a stage in the disease’s life cycle in which they begin to forget important friends and family members (unable to recognize visually), the role of the caregiver is to attempt to simulate their presence with the sufferer. This is usually accomplished by gathering recordings of friends and family voices which are then played in the victim’s presence. SPT has been known to reduce aggressive behaviours with some Alzheimer’s patients, reducing the likelihood that they will challenge others attempting to provide care and support (Peak and Cheston 2002). This is a rather simplistic methodology, however it does allow the social or health caregiver to attempt to improve cognitive recall and also find comfort in familiar voices. Adult attachments are much more complex than child attachments, usually involving very close-knit or intimacy-based affections. Using voices of spouses or endearing social acquaintances can provide the individual with better emotional adjustment and removal of anhedonic responses common with the disease. Because of the relative simplicity of this approach, the role of the caregiver is simply to engage friends and family to provide appropriate voice recordings and then facilitate its instruction. Whether or not a metric of measurement to illustrate observed cognitive or emotional improvements is developed would be within the discretion of the caregiver as research did not uncover any control methodologies that have shown success in measuring effectiveness of this strategy. Another viable strategy for improving mental health and generic well-being is classified as validation therapy. This therapy approach is closely aligned with humanistic psychology in which the disease sufferer is treated with the utmost dignity, respect and where it is reinforced of the absolute value of the individual. Again, usually most effective during earlier stages of the disease, validation therapy is a reciprocal communications strategy where respect is continuously iterated and where the caregiver recurrently acknowledges that the individual’s needs and opinions are heard and where efforts to reduce marginalisation occurs (Neal and Briggs 2003). The role of the social or health caregiver is to simply be a facilitator of discussion, maintaining a type of emotional intelligence to avoid any biases or stereotypes to surface during interventions with the Alzheimer’s patient. The goal is to remain fully focused on the sufferer so enhance their self-esteem, improve their perceptions of social belonging, and attempt to instil a sense of reverence for the individual struggling with coping methods during a difficult disease. Many elderly individuals, whether suffering Alzheimer’s or not, do not have access to adequate and fulfilling social support networks that are critical for improving emotional well-being. The caregiver, therefore, becomes an appropriate medium for social engagement illustrating a genuine love, concern and empathy for the victim. The outcomes of these engagements are to build an effective attachment with the caregiver which has long-run opportunities for improving trust and openness that are necessary for assisting in removing depressive symptoms. Another rather simplistic approach to assisting the Alzheimer’s victim adjust and cope effectively is to link spirituality with hope principles as a means of inspiring optimism and faith, something often required of elderly patients facing a terminal illness. During the end-of-life period, many older individuals begin questioning religious conceptions based on concern over whether life actually ends at the point of death or whether there is a transition period leading to some proverbial hereafter existence. The simplicity of this approach entails a variety of generic strategies that include illustrating a sense of optimism about the quality of life of important family members after the death of the sufferer or assisting in redefining goals whilst the disease continues it progression (Macleod and Carter 1999). The role of the caregiver in this strategy is to role model optimistic behaviours and attitudes to inspire the individual to think positively in relation to their own dignity or by providing sensations of security about the well-being of important figures in the sufferer’s life. Hope strategies can also be linked to spirituality, also designed to inspire positive thoughts and sentiments about end-of-life issues that are often a concern during earlier stages of the disease whilst the victim seeks to cope. The role of the caregiver, when deciding to blend spirituality, is to seek out literature on relevant spiritual sources or religious doctrine to better inform the stricken about potential grief management strategies or potential life continuance after the individual has passed away on Earth. This is also akin to a type of acceptance therapy which assists the individual in coming to grips with the irreversibility of the disease and the inevitability of their death. Many elderly individuals struggle with these issues as they approach advancing age and drawing on psychological theories of grief management strategies can assist in ultimately building acceptance over what is occurring in the sufferer’s life. In this approach, the social or health caregiver seeks to facilitate sanguine or otherwise cheerful discussion about spiritual issues in an effort to remove anhedonic responses that are closely tied with depressive symptoms. Potential limitations to described approaches Unfortunately, there are not empirical results about the concrete effectiveness of all aforementioned strategies for Alzheimer’s patients, though they are often prescribed as a means of enhancing well-being and improving cognition problems associated with the disease. Validation therapy, as one example, has received much criticism in the scientific community with researchers and health practitioners believing there is simply not enough data to support the efficacy of this humanistic-like approach (Neal and Briggs 2003). However, there have been many advancements in utilising humanistic psychology principles to change maladjusted behaviours and attitudes of other individuals in society suffering from a range of problems including anxiety, paranoia or even guilt. Each of the aforementioned prescribed opportunities for improving the well-being of the patient, including validation therapy, simulated presence therapy, hope strategies, and reminiscence therapies do not seem to have a solid set of preferred methodologies which allows some discretion on behalf of the social or health caregiver. It would appear that understanding the basic premise of each approach serves as the appropriate foundation for curriculum development or intervention strategy development, at least until further research on the efficacy and success ratios of each approach can be clearly defined. How to effectively assist an individual whose cognitive and emotional capacities are deteriorating rapidly absolutely requires more research attention in the scientific and social/health services domains. Conclusion It is clear that there are many approaches for the social or health caregiver to assist the Alzheimer’s sufferer in building a better sense of well-being and also improve cognitive functioning. Alzheimer’s is a very difficult and frustrating illness that deeply impacts the mental health of many sufferers especially during the early stages of the disease where many cognitive capacities are only moderately affected. Individuals that are suffering from the disease manifest many unique symptoms, ranging from aggressiveness to anhedonic responses that remove pleasure from the sufferer’s environment, making it difficult to quantify a specific strategy that would be most effective. Whether the aforementioned approaches can be combined or should be utilised disparately is currently unknown as supported by research evidence. Despite the aforementioned complexity of choosing an appropriate strategy to assist the Alzheimer’s patient, it is clear that the role of the social and health caregiver is to assume a position of educator and counsellor, taking a very interactive role in facilitating positive discussions and attempting to open lines of trusting communications. Coupled with strategies to build self-confidence and a sense of social belonging, where appropriate, the caregiver can play an integral role in removing opportunities for the sufferer to fall into deep depression that is common when battling Alzheimer’s disease. By being open, honest, trustworthy, optimistic and blending these attitudes with tested activities to improve cognition capacity, the caregiver can build a sense of efficacy and ultimate value within the victim that facilitates better coping and adjustment during this difficult disease. Whether the individual suffering the disease maintains a loyal and supportive family or social network or has minimal access to these important familial outlets, the role of caregiver should not deviate from attempting to build hope and confidence in the sufferer to make the illness more manageable for the individual. References Bienenfeld, D. (2009). Cognitive therapy with older adults, Psychiatric Annals, 39(9), pp.828-831. Blanchard, J.J., Mueser, K.T. and Bellack, A.S. (1998). Anhedonia, positive and negative effect, and social functioning in schizophrenia, Schizophrenia Bulletin, 24(3), pp.413-424. Henslin, J.M. (2005). Sociology: A Down to Earth Approach, 7th ed. A&B Publishing. Macleod, R. and Carter, H. (1999). Health professionals’ perceptions of hope: understanding its significance in the care of people who are dying, Mortality, 4(3), pp.309-317. Neal, M. and Briggs, M. (2003). Validation therapy for dementia, Cochrane Database of Systematic Reviews, 3(1). 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