What is worth noting here is the fact that behavior disturbances, ranging in severity from repeated questioning to physical violence, are common (National Institute of Mental Health, 1989).
It is unclear whether Alzheimer's disease represents a single entity or several variants. Some experts believe that there are distinct subtypes of Alzheimer's disease, such as Lewy body disease (in which the signs of Parkinson's disease, visual hallucinations or alterations in alertness or attention, or all of these symptoms, are conspicuous) and frontotemporal dementia (in which disinhibition, misconduct or apathy, or all of these signs, are prominent). The well-established risk factors for Alzheimer's disease are age, a family history of the disease and Down syndrome (National Institute of Mental Health, 1989).
Confusions about Alzheimer's Disease and the Need for Alternative Actions
There have been numerous studies conducted in relation to Alzheimer's disease. At the same time, there are a number of reports which revealed about the symptoms, treatments and/or prevention approaches that can be done for the disease. but, it cannot be denied that there are also a number of different disorders and illnesses which are closely related or are significantly similar to the qualities and symptoms of Alzheimer's disease. This is the very reason why it is perceived that Alzheimer's can normally be confused with other related diseases (Advisory Panel, 1992).
Because of the rising number of confusions, there is a call to have more and comprehensive clinical examinations to clearly differentiate Alzheimer's disease from the others. The three major components of the clinical evaluations must include at least (Advisory Panel, 1992):
thorough general medical workup neurological examination psychiatric evaluation that may include psychological or psychometric testing
Although the exact causes of Alzheimer's are not yet known, new diagnostic tools and criteria make it possible to obtain a diagnosis of probable Alzheimer's with an accuracy of 85 to 90%. Scientists are continuously researching new, more effective diagnostic tests in an effort to make it easier to diagnose Alzheimer's disease in the early stages. Being able to recognize symptoms early and obtain an accurate diagnosis gives affected individuals a greater chance of benefiting from existing treatments and preparing for the future (Alzheimer's Association, 1994).
While there is no direct medicine to cure the disease, there are several approaches suggesting how people can handle and/or take care of the people suffering from Alzheimer's disease. Progressively more, social and behavioral scientists are nowadays turning their attention to discovering the most effective methods of providing dementia-capable care, and family care research is becoming more rigorous and focused (Alzheimer's Association, 1994).
The Alzheimer's Association has developed training opportunities for care professionals, including nurses and activity directors due to the increasing research on the benefits of care-giving,. The Association has also developed a unique document called Key Elements of Dementia Care, which defines, describes and illustrates dementia-capable care throughout the range of residential care settings (Alzheimer's Association, 1994).
Caregivers who understand these behaviors and who receive appropriate training in Alzheimer's care are better able to effectively respond and redirect the resident in a compassionate and respectful manner. Communication skills become increasingly important as the disease progresses and residents resort to physical behaviors rather than words to express themselves (AM J. Psychiatry, 1997).
Basic to training is a clear understanding of the effect of Alzheimer's disease on communication. Imagine living in a strange land where you do not speak the language, people don't understand what you are saying and you don't understand what they are saying. Would you perhaps feel frustrated, sad or lonely? A resident with Alzheimer's disease lives in a land like this. It falls to the caregiver to find ways to improve communication verbally and nonverbally (AM J. Psychiatry, 1997).
When a resident's behavior becomes challenging, it could be a result of declining brain function, or it could be an expression of a need or feeling. The challenge to caregivers is to "enter the resident's world," by trying to understand the situation from the patient's point-of-view and figure out what he/she is attempting to communicate (AM J. Psychiatry, 1997).
Skill-based training for managing these behaviors allows the caregiver to minimize residents' discomfort and make their challenging behaviors less of a problem. This then implies that caregivers should be given strategies that help them cope effectively with such behaviors as wandering, agitation, aggression, paranoia and repetitive actions (AM J. Psychiatry, 1997).
References
Advisory Panel on Alzheimer's Disease. Advisory Panel on Alzheimer's Disease. DHHS Pub. No. (ADM) 89-1644, Washington, DC: Supt. Of Docs., U.S. Govt. Print. Off. 1989. (Available from the Superintendent of Documents, Government Printing Office, Washington, DC 20402-9325, GPO S/N -1, $2.25.)
Advisory Panel on Alzheimer's Disease. Second Report of the Advisory Panel on Alzheimer's Disease, 1990. DHHS Pub. No. (ADM) 91-1791, Washington, DC: Supt. Of Docs., U.S. Govt. Print....
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