September 27, 2008
The family and the health care professional involved in the care of the person with Alzheimer’s disease encounter many daily situations in which they must make ethical decisions. These decisions frequently are difficult and may often involve genuine ethical dilemmas. Discussion of the issues can remove some of the perplexity and at the same time illustrate the underlying values, together with practical courses of action that are most appropriate in the care of a person with Alzheimer’s disease.Respect for the person’s right to self-determination is the best guarantor of maintaining personal dignity in the early stages of Alzheimer’s disease. The ability and the right of such a person to participate in decisions pertaining to present and future care have been presented in the previous section. The willingness of family and health care professionals to guarantee such a right, while assessing and evaluating the person’s declining cognitive abilities as the disease progresses, is a difficult task. The advent of incompetence, realizing that a precise definition of such a state does not exist, raises many ethical questions for the caregivers.
The ethical wisdom derived from ongoing discussion about the values and principles that should direct the care of the seriously ill in competent person is difficult to apply in practice to caregiving situations. Much of the legal and ethical discussion, which often centers on the extreme and ambiguous cases of controversial medical decision making, has an academic flavor that seems incongruent with the human anguish that occurs as a result of such difficult decisions. A humane understanding of the issues necessarily includes an analysis of the ethical and legal principles involved; but it must also include descriptions of how these principles are translated into humane care. George Bateson writes that in the attainment of grace, the reasons of the heart must be integrated with the reason of the reason. A purely rational, intellectual, and ethical approach to the needs of the person with Alzheimer’s disease will not work of itself; neither will a purely emotional approach.
The attitudes of caregivers toward caring for persons with advanced dementing disease are determined in part by the caregivers’ views of the personhood of the demented individual. For many caregivers, caring for the body of the Alzheimer patient often stands as a metaphor for taking care of the mind and the spirit of the whole person. For these individuals an essential value is acknowledged by providing even the most basic care for victims of this disease. Another approach that might be espoused by caregivers would emphasize the loss of personhood, identity, and selfÂreflection by the person with Alzheimer’s disease. Advocates of this position argue that to recognize the diminished personhood of the patient reduces guilt and frustration in the family and in caregivers, which ultimately results in reduced stress and, paradoxically, produces more effective care. Viewing victims of Alzheimer’s disease as less than persons, however, can quickly lead to their total devaluation as nonpersons. The status of nonperson is perilous because such a being does not enjoy the privileges and rights of human beings and, as such, is easily discounted.
The value system of the caregiver serves as the ultimate basis for the care provided to the Alzheimer patient. The ethical perspectives of caregivers determine in real life their reactions to routine and emergency situations. The manner in which a caregiver defines a “problem” will determine the clinical interventions. A person’s beliefs about the patient, the disease, and dying will often decide the treatment or procedure that is instituted. The desirability of tube feeding as opposed to the trouble of more normal feeding is strongly influenced by the value system of the caregiver and of the institution. The dignity of the dying person is best assured by caregivers who know how to comfort such patients. This calls for skill, compassion, honesty, and humility. The practical application of compassion is a powerful determinant of the quality of care enjoyed by those patients experiencing the later stages of the disease and, ultimately, in their final act of dying.
Compassion and mercy in caregivers are the qualities that are best suited to meeting the needs of demented persons in all phases of their disease. Little has been written about the practical application of such qualities to the care of the seriously ill. Scant attention is paid to these concepts in the training of health care professionals. The overwhelming emphasis in professional schools is on the technical aspects of patient care. Caring for the demented person in the late and final stages of illness is a high human and professional calling that fully challenges the art and science of the caregiver. Mind and heart are wedded in the care of critically ill demented persons whose most basic human satisfaction may be derived from such basic activities as sucking on a thumb. The sounds, the touch, the smells, the food, the drink, the sensory stimulation that comÂfort or give pleasure to the severely demented are the human components that constitute the practice of mercy and compassion in the care of perÂsons undergoing the late and final stages of Alzheimer’s disease. The human qualities that enable caregivers to deliver such care merit serious attention. People who are comfortable with the unusual, who have basic physical, emotional, and spiritual resilience together with warmth and a sense of humor, may be best suited for the challenging role of caregiver. Those who provide care create the human environment in which concern, fairness, compassion, and mercy translate into effective, humane care for persons in the later and final stages of Alzheimer’s disease.
The development of a Code of Ethics to guide families and caregivers in the application of ethical principles to the care of persons in advanced stages of the disease would be helpful. Policies and guidelines covering many issues of care could be drawn from such a code. Ethics committees would also be a welcome addition because of their ability to provide education, consultation, and case review in difficult decision-making situations. Some have expressed concern about the quality of the decision making that occurs in nursing homes, which are sometimes described as a very troubled and troublesome component of the health care system. The absence of input from physicians and other skilled health care professionals, because of the limited role they play in such institutions, is noted in this respect.
An ethical code, directed toward the specific needs of persons with cancer, has been adopted by M. D. Anderson Hospital in Houston, Texas. The code is intended to give impetus and direction when thinking about moral problems, but it does not attempt to solve them. An impressive statement of institutional concern for the dignity of persons with cancer is found in the use of the term reverence for the patient as the essential determinant of the institution’s approach. A model code, which would provide similar direction for institutions involved in the care of persons with Alzheimer’s disease and for research in the field, could be developed by the Alzheimer’s Disease and Related Disorders Association or some other interested group. The moral values of families and caregivers, which under gird the care given to persons with this disease, need to be incorporated into a code that could benefit all who are touched by Alzheimer’s disease.
The Alzheimer’s Association has developed commendable guidelines which address the needs of persons with Alzheimer’s in longÂterm care facilities. These guidelines call for the creation of “compassionate life-enriching programs and environments.” Likewise, the Ethics Committee of the Alzheimer’s Association is developing a code of ethics which addresses issues of human dignity in caring for persons with Alzheimer’s.
Reflection on the values that surround the care of a person with Alzheimer’s disease can be a rewarding experience for families and careÂgivers: it highlights their heroic efforts to maintain the dignity of the patients in their care. Discussion of humane care in the later and final stages of the disease helps concerned caregivers identify the essential human elements of such care. Ethical reflection also safeguards the rights of seriously demented persons whose welfare is totally determined by others. As we engage in the pain and suffering of the individuals with the disease, and their families, and seek to care for them in their need, we discover within ourselves depths of concern, compassion, and mercy that remind us of our essential human value.
Tags:abut alzhemier disease, Alzhemier Disease, alzhemier disease disorders. alzhemier disease information, health skin disorders
Posted in Alzhemier Disease 
No Comments »
September 18, 2008
As Mr. Jones’s level of understanding and his attention span decreased, it was important to assess self-care abilities. Was Mr. Jones able to bathe himself, properly clean himself after a bowel movement, brush his teeth, or dress himself? Since Mr. Jones’s mental status was altered, Ms. C. needed to offer simple, direct, and concise instructions about how to perform these tasks when necessary. She was advised to break each task down into steps. For example, to brush the teeth -
(l) Get the toothpaste
(2) Take the cap off
(3) Place paste on the brush
(4) Then brush teeth.
It was also important to allow adequate time to perform the tasks.
When dressing Mr. Jones or assisting him to dress himself, Ms. C. was instructed to offer one item of clothing at a time. Loose-fitting clothing was suggested since it would make dressing easier. Another important consideration, resulting from Mr. Jones’s unsteady gait, was to install a f1exible hose shower nozzle that allowed him to sit while showering.
Methods To Improve Hygiene
• Make adjustments in bathroom area (i.e., hand bars, handrails, raised toilet seat, nonslip surfaces).
• Be simple, direct, and concise when speaking, so the person can follow directions.
• Break down tasks into steps.
• Allow time to perform tasks.
• When dressing the person, offer one item of clothing at a time. Loose fitting clothing is easier to put on.
• Include denture care and oral care in daily hygiene.
Tags:alzheimer, alzheimer disease, alzheimer patient, concise instructions, denture care, hygiene, self care Treatment
Posted in Treatment No Comments »
April 22, 2008
The obesity menace is haunting the world. Many people across the globe are trying varied means to reduce that flab that’s making them unshapely and succumbing them to varied diseases. However, why is it so that very few people can turn their New Year resolution of reducing flab into reality and many fail to do so? It is because they fail to apply better weight loss systems. The ???????? ????? ????????diet pills they choose may not be enough to burn their fats effectively.
This makes them vulnerable to the extent that they have to suffice themselves on diet plans and exercise. However, most people loathe exercising heavily and mild exercise may not be sufficient to reduce the accumulated heftiness. What if there is a diet pill that will forgive you for not exercising and still reduce your weight significantly? It would be great, isn’t it? To suffice your needs, here is the Nueslim diet pill that burns your fat so effectively that you reduce weight faster than running.
Moreover, they are the safe diet pills those are safe in all people irrespective of genre. Even women of stout nature can consume pills without any side effects on their natural hormonal cycles etc. That’s why the Nueslim is a miracle product for sedentary people who will like to sit yet like to reduce weight! Experience the magic!
Tags:diet pills, diet plans diseases Posted in Health No Comments »
April 2, 2008
Vaporizers are truly among revolutionary technologies that have given mankind a possibility to quit smoking without any after effects. Thus, vaporizers have been in vogue recently by people who have failed to achieve results with other therapies. The vaporizer has made it possible to achieve this by producing tar-free smoke that is not as harmful as burning tobacco. Moreover if the user puts some herbal medicine into it, he avails great benefits of the herb and can quit smoking over a period of time.
Among various vaporizers, volcano vaporizers are the best bets for people who want to have a maintenance free vaporizer at their home. Many people consult doctors regarding which herb to be used for their ailments to get rid of through these vaporizers. If herb like Echinacea is put into the volcano vaporizer and its steam is inhaled, one gets enormous health benefit and a boost in the immunity.
any such herbs have been identified that give better results when smoked than through alimentary system. Through the ingredients heated at low temperatures, the body does not succumb to the hazardous effects of excess heat too. Not only for treatment, but just for adding fragrance to your day to day surroundings, volcano vaporizers can be used. How good it would be if you can add fresh fragrance of herbs beneficial to health in your surrounding air that you breathe!
Tags:health, health benefit, herbal medicine, volcano vaporizer volcano vaporizers Posted in Health No Comments »
April 2, 2008
The most important thing in order to achieve consistent results during your weight loss weans off in an instant. Your taste buds most often deceive you. regime is being consistent! Well, now you may say that you are pretty consistent with your exercise schedule and even diet to some extent, but you are not able to control your appetite! Yes, that’s the culprit in most cases. You see delicious dishes on table and all your enthusiasm for
But if you really want freedom from excess appetite, you have to embark on a fitness regime that involves an appetite suppressant. This way, you will be able to curb your ravenous appetite very well, as the appetite suppressant fools the brain and creates a pseudo sensation of abdominal fullness and dislike for food. Hoodithin utilizes similar principle in fooling the brain and reducing that excess flab. Well, Hoodithin contains 100% natural Hoodia Gordonii and contains it in professionally grade liquid extract drops, because of which you tend to feel full faster.
When you combine your Hoodithin regime with ample exercise and nutrient rich diet, at stipulated times, you will see the results much faster as compared to other brands. Being most natural is what Hoodithin all about. Thus, if you want to achieve consistent results, there is no comparison to Hoodithin. No wonder if after Hoodithin, everyone will enquire about your slim and trim figure and you will just laugh away the compliments!
Tags:appetite suppressant, delicious dishes fitness regime Posted in Health No Comments »
March 31, 2008
You love your wife very much. But is there any lack of charm that existed a few years ago? Are you searching for a cause that has lost the spark in your healthy and happy marriage? Well, if that’s the case, you better contemplate how long did you not surprise your wife? Women love surprises and with quality pearls, you will be giving her the best surprise ever. Start searching for quality pearls today.
No, you need not rack your brains as to where you can get such pearl jewelry! Just go online and you will find numerous variety of pearl jewelry ranging from pearl necklaces and earrings to varied men’s jewelry as well. You can also quench your thirst for pearls along with your wife’s. No commutation to the pearl mall, no hefty bills! Avail fabulous discounts online and embark on a hassle-free transaction. Your jewelry is here to stay. The quality of pearls does not herald frequent maintenance too. You can however avail pearl cleaning technique book here.
When you will present Tahitian pearls to your blonde wife, no doubt, she will be amazed at the luster and glitter of pearls, no, luster and glitter of your love! No wonder if she falls in love with you all over again. The dazzling pearls will be witness to your never-ending love then. The relations are here to stay. Just they need little brush up and rekindling over a period of time. And when this is done with the mesmerizing pearls, nothing can be compared to its sheer beauty and effervescence!
Tags:pearl jewelry, pearl necklaces quality pearls Posted in Articles No Comments »
February 29, 2008
When we speak, listen, read, or write, when we give someone directions to a favorite restaurant; or, when we think about a friend, we are retrieving information from semantic memory. The distinction between episodic and semantic memory was proposed by Endel Tulving in 1972; since then close to a hundred studies have focused specifically on semantic memory in context of aging or dementia. The findings are quite clear: Normal aging does not impair semantic memory, while Alzheimer patient’s ability retrieve (remember) this kind of information deteriorates steadily over the course of the disease.Retrieval from semantic memory can be tested in a number of ways.At most basic level, people are simply asked what day it is, where they are how to spell a word, and the like. Some studies have examined retrieval of general knowledge, such as historical or current events,vocabulary, names of famous people, and geography . Laboratory studies typically employ tasks that yield easily quantifiable results, such as naming items from specified categories (e.g. list all the fruits you can think of, list as many U.S. presidents as you can ) or simply naming specific objects or pictures (e.g., a key, a picture of on airplane).
Healthy older adults, as a group, rarely do worse than young adults on the foregoing kinds of tasks. In fact, a number of recent studies have found that older adults often perform significantly better than young adults on semantic memory tasks. For instance, in one study we conducted at Southern Methodist University (with Alan Brown, Todd Jones, and Laura Steen-Patterson) with current students (average age 19) and older alumni (average age 74), the older group’s vocabulary scores were nearly 20 percent above those of the young. Other studies have found that memory for facts and world knowledge (e.g. history, entertainment, politics) also tends to actually increase with age.
In contrast, Alzheimer patients typically experience difficulty retrieving information from semantic memory. Early on, patients simply have problems retrieving specific names, a common memory complaint among healthy individuals as well. Frederick Schmitt and I found that relatively mild Alzheimer patients had more tip-of-the-tongues than age-matched healthy adults (e.g., shown a picture of an artichoke, the patients knew what it was, but couldn’t retrieve the name). Another study by Jacob Huff and his colleagues at Massachusetts Institute of Technology also found naming impairments in Alzheimer patients. However, when given a name recognition test, as in “Is this called an x?” where x was the name of the accompanying line drawing, these patients performed as well as healthy control subjects. This suggests that the Alzheimer patients have not lost their semantic memory; rather, their access to information in semantic memory is impaired. There is further evidence of an access problem. Herbert Weingartner and his colleagues reported that more than two years before the onset of Alzheimer’s individuals in the baltimore Longitudinal study of Aging exhibited difficulty generating less common instances from certain categories such as fruits and vegetables. Even reading reflects this phenomenon. Karolyn Patterson and colleagues at the MRC Applied Psychology Unit in Cambridge, England, found impaired pronunciation of words with atypical spelling-sound correspondence.
A number of studies have analyzed the nature of the naming impairment in Alzheimer’s disease. For some time, it was thought that the problem was primarily perceptual; in other words, the Alzheimer patients could not accurately interpret what an object was, which in turn preÂvented them from retrieving the correct name. For example, Howard Kirshner and his colleagues at Vanderbilt University found that Alzheimer patients made more naming errors for photographs of objects than for the actual objects. On the other hand, the healthy control adults actually made more perceptual errors than the Alzheimer patients did.
One problem is that many naming errors are not exclusively perceptual or semantic. For example, when a picture of a pen is called a “pencil” or a chisel is called an “ice pick,” these names share both perceptual (long, thin, sticklike cylinders) and semantic (writing instruments, tools) attributes. Perceptual Horse that have no apparent semantic component are actually quite rare (such as “bucket” for thimble, “wheel” for button). LikeÂwise, semantic errors that have no visual or perceptual component (such as “saxophone” for a picture of a harp) are rare as well. However, pure semantic errors that are very common involve producing category superÂordinate names: “worm” for caterpillar, “vegetable” for asparagus, “bird” for penguin, and “bug” for grasshopper. Similarly, semantic errors recalling the function, but not the name, of the object are very common. For example, when asked to name pictured objects, an Alzheimer patient said that sock was “for a foot,” gun was “pull trigger, say bam with that,” and ashtray was a “cigarette dish.” These functional errors tend to be more prominent and occur more often beyond the mild stages of the disease.
In light of the foregoing distinctions, studies by Kathryn Bayles and Cheryl Tomoeda at the University of Arizona and by myself and Frederick Schmitt have led to the conclusion that the source of the naming errors is semantic rather than perceptual. In other words, Alzheimer patients (at least in the mild to moderate range) can perceive objects, but have trouble accessing the specific name. Some investigators have interpreted the impaired access to semantic memory as involving effortful memory processes. In the next section, we will see evidence that implicit memory seems to be spared in the course of both normal aging and Alzheimer’s disease.
Tags:alzheimer patients, Alzheimers Disease Disorder, episodic and semantic memory, memory tasks southern methodist university Posted in Alzheimer's Disease Disorder No Comments »
February 22, 2008
When the family needs an attorney to help draft a will, pursue involuntary civil commitment, or secure guardianship of an incapacitated family member, locating a member of the bar who is familiar with this area of the law may present some problems. If there is an Alzheimer support group in the community, members may provide a list of attorneys familiar with the issues and who are experienced. If no support group exists, then a call to the mental health association or the local bar association may prove valuable for those needing a referral list of attorneys specializing in family or mental health law. You are buying a service; do not hesitate to shop around to find an attorney who will work easily with you and your family. A scheduled appointment with several attorneys on the list will be of great help in finding the lawyer best suited to your family’s needs.
Tags:guardianship, Legal Consideration, mental health association mental health law Posted in Legal Consideration No Comments »
February 15, 2008
An elderly Hispanic man with Alzheimer’s disease was placed in a nursing home. He was a model resident except for a single quirk that confused his caregivers. Each morning this man would resist having his pajamas exchanged for daytime clothing. The institutional policy called for each resident to be neatly dressed during the day. This typically meek resident resisted the change of clothing and often became physically and verbally abusive.Following an investigation by personnel in the nursing home, an explanation was found for this seemingly paradoxical behavior. This man was a proud individual, who was described as “macho” by his family. Even with dementia, the notion that female caregivers would undress and dress him was entirely unacceptable to him. Once this sensitivity was discovered a male attendant was assigned for purposes of dressing and no further outbursts occurred.
More Facts
One of the greatest burdens for the family caregiver is the lack of knowledge of community resources and the ability to utilize these resources. In reality, the Alzheimer’s disease care system has been a fragmented approach designed to function on a crisis basis. The needs of the patient and the family have been poorly understood and have received little societal attention. To further complicate the situation, confusing eligibility requirements make it difficult to identify available services. Preparation well in advance of need and a careful review of potential nursing homes may save families much grief. Mental health agencies, the Social Security Administration office, state Area Agencies on Aging and local support groups are much needed sources of valuable guidance.
Tags:Alzhemier Disease, institutional policy, Medical Aspects, mental health agencies, nursing home nursing homes Posted in Alzhemier Disease No Comments »
February 5, 2008
The normal aging process does not create major deficits in the intelligibility or the appropriate organization of speech. However, those persons who are afflicted with Alzheimer’s disease are atypical because the undergo brain changes in areas that appear to be highly associated with memory and language. The mechanical components of speech production remain relatively unaffected by Alzheimer’s disease until the final stages of the disorder. It is disturbance in the meaningfulness of language that is most pronounced throughout the progression of the disease.
The major aspects of disrupted communication arising in Alzheimer’s disease are language problems that result from cognitive decline. One of. the first problems to occur involves the forgetting of appropriate words or the use of “pseudowords” in place of the forgotten item. For example. person might use the term pencicle to describe a ballpoint pen, or the term firebugs to describe matches. There is also difficulty naming objects, particularly specific names. The Alzheimer patient, for example, may be able to identify a picture as that of a dog, but not as that of a “collie,” which is a higher order name. The communication problem is not one of articulation but a deficit in generating the appropriate words with which to convey information on a symbolic level.
The Alzheimer patient is generally unaware of these communication problems; his/her speech is frequently characterized by an empty, aimless, quality. Much of this pointless vocalization is the result of verbal wandering characterized by repetitive speech with little comprehensible meaning. The spoken words are produced correctly and with appropriate fluency but with limited ability to communicate meaningfully .
As the disease progresses, problems will occur in generating words. naming objects, and recognizing meaningful relationships. For example - forks, knives, and spoons may no longer have a relationship to one another for a person experiencing the symptoms of Alzheimer’s disease. He or she may begin to engage in echolalia, repeating the same word or phrase over and over. These verbal repetitions will occur with little or no comprehension of what was said. Echolalia may progress to the point where vocalizing deteriorates to repetitious syllables that are unrecogniz able as language.
With Alzheimer’s disease there is also a decreased ability to recognize some of the pragmatic aspects of speech. Pragmatics involve the rules of speech and language as they apply to usage. Adjusting one’s rhetoric to suit the audience, not standing too close to the listener, and using body language to help convey intentions are all part of the pragmatics of communication. Other examples of pragmatics include asking questions by using the appropriate inflection, or greater emphasis being placed on certain statements by the way words are spaced and timed. Lacking awareness of the pragmatics of a certain situation, a person night not respond in the desired or appropriate manner.
In advanced stages of Alzheimer’s disease communication has progressed to such an extent that the individual is essentially mute. Spontaneous speech may all but cease, and echolalic behavior is quite common. At this point the patient may have difficulty even with the physical generation of speech sounds.
Tags:alzheimer patient, Alzheimers Disease Disorder, brain changes intelligibility Posted in Alzheimer's Disease Disorder No Comments »
