Introduction
Alzheimer’s disease is a disease that affects the brain of elderly individuals. This disease doesn’t have any cure and is expected to worsen as it progresses (Alzheimer’s Association, 2013). It may eventually lead to death. Despite the fact that there is no cure, the disease should be managed well so that the patient leads a healthy life. Since some of the early signs of the disease are similar to those experienced by a healthy individual in old age, it is important for family members to have enough information about it. Living with an individual with the disease can also be difficult due to the changes in behaviour. Individuals with the disease also need special care since they may be unable to perform some of the simple tasks. For this reason, social workers are required to intervene and provide the necessary assistance. This paper provides a vivid description of the disease and discusses the important role social workers play in their life.
Alzheimer’s disease
This disease affects a person’s brain and interferes with the normal functioning of the brain. It usually affects the ability of an individual to think soundly. It is a form of dementia that affects the individual’s ability to effectively perform the day-to-day activities. About seventy-five percent of cases of dementia are found in the form of Alzheimer’s disease (Gould, 2013). This disease has no cure and is likely to cause death as it deteriorates (Brookmeyer, Johnson, Ziegler-Graham, & Arrighi, 2008). The disease was named after Alois Alzheimer. He described it first in 1906. This disease is prevalent among individuals at the age of 65 and above, though, it may occur at an early stage of life.
The disease does not necessarily follow the same pattern as it develops in individual. However, there are common symptoms associated with it. During the initial stages of the disease, it is easy to mistake the symptoms for those associated with aging or the effects of stress. Short-term memory loss is common for such individuals and this may be common for healthy and aging individuals. When Alzheimer’s disease is suspected in an individual, it is important to perform certain tests in order to confirm its presence. Such tests evaluate the individual’s thinking ability and behaviours. To determine the disease, brain scans are sometimes used. For conclusive results, the brain tissue needs to be examined. At later stages, the individual may become irritable and aggressive. The individuals may start avoiding family and friends. Normal body functions may also be lost and the individual may eventually die.
The causes of the disease and reasons for deterioration are still not well understood but research has suggested several factors that cause the disease. The medicines available are used only to manage the symptoms. Other activities also help delay cognitive symptoms in the elderly. Such activities include performing exercise, mental stimulations and adopting a balanced diet.
Causes of Alzheimer’s disease
The cause of the disease is still a matter of debate. However, studies have tried to explain some of the causes. One of the causes suggested by research is genetics. It is suggested that a few cases of Alzheimer’s disease are inherited. These cases may occur before an individual reaches the age of 65 (early onset). This type is said to develop when mutation occurs on one of the three genes. These cases exhibit autosomal-dominant inheritance. However, most forms of the disease do not come about in this way. When this happens, it is referred to as sporadic Alzheimer’s disease. This occurs with exposure to such risks as genetic and environmental differences. The inheritance of a particular allele causes the disease.
Research has proposed the cholinergic hypothesis. It suggests that the disease is caused by reduced production of the neurotransmitter acetylcholine. However, many have not supported this proposal because interventions to restore the levels of the chemical have not bore much fruit. The amyloid hypothesis was also proposed. It suggests that the main issue was the presence of extracellular beta-amyloid deposit. When it appears in chromosome 21, Down syndrome occurs. Individuals with this disease are highly likely to exhibit Alzheimer’s disease by the time they turn 40.
Symptoms of the Disease
The symptoms of the disease are thought to follow a course that may be divided into four stages. These stages include the pre-dementia, early, moderate and advanced levels. In the different stages, there is progressive deterioration of cognitive functions and impairment of other functions of the body (Caplan & Rabinowitz, 2010). The symptoms detected during the initial stages (pre-dementia) of the disease may be mistakenly taken for factors associated with the individual’s old age. Such symptoms may be present as early as eight years before diagnosis of the disease. However, this may negatively affect the person’s ability to perform daily activities. For example, an individual may experience short-term memory loss and may be unable to acquire new information. An individual may also be unable to pay attention, plan or perform abstract thinking.
The early stage of the disease is characterised by significant impairments in learning capabilities. Some may experience challenges with language, memory and execution of movement. In terms of language, the person may become less fluent and experience vocabulary loss. This may affect both written and verbal communication. However, individuals at this stage may still be able to perform tasks independently. They may only need help when it comes to cognitively demanding activities.
The moderate stage of the disease is characterised by inability to perform most of the common day-to-day activities. Such individuals may be unable to recall vocabulary. For this reason, they may be unable to make meaningful speech. They may also experience problems when writing and reading. Performing complex motor sequences may lead to some difficulties. Memory loss may be severe at this stage and the individual may fail to recognize some of the close relatives (Doraiswamy, Gwyther, & Adler, 2008). Major neuropsychiatric and behavioural changes occur during this stage. This may be seen as the individual becomes irritable, aggressive and starts to resist care giving. The individuals may also lose bladder control. For this reason, family members may find it difficult to handle such an individual. They may then decide to move them to healthcare facilities where they can get specialized care from social workers.
The advanced stage of the disease is characterised by complete dependency of the patient on the caregiver. At this stage, the individual’s language would be greatly affected. The individual may be unable to make complete sentences and may eventually lose the ability to speak. However, it may be possible to understand non-verbal communications and respond using emotional signals. Motor skills are also greatly affected and such individuals may need help in order to perform the simplest activities. Due to reduction in ability, muscle mass deteriorates significantly. This may eventually require the patient to be bedridden and fed. Although death is known to be the result of Alzheimer’s disease, it occurs as a result of external factors rather than the disease itself. Such factors include diseases such as pneumonia and ulcers.
Examples of How Alzheimer is Experienced by People
Alzheimer is experienced differently by people depending on several factors including the stage of the disease. During early stages, the individual would be like any aging individual. For example, the individual may face difficulties trying to perform executive functions. Short-term memory loss may also be experienced by the individuals. As the disease progresses, issues such as decreased fluency may be experienced. Some individuals experience long-term memory loss and may be aggressive. Individuals at advanced stages may be unable to work independently. At this point, they may have experienced complete loss of speech and have deteriorated muscle mass and be unable to move.
Treatment
No cure for the disease has been found so far. Available treatment is usually used for symptomatic benefits only (MNT, 2014). Pharmaceutical interventions may include the use of acetylcholinesterase inhibitors. This group of medications includes rivastigmine and donepezil. In some cases the NMDA Receptor Antagonist may also be used. However, these medications only provide limited benefits.
Another form of treatment of the disease is the use of psychosocial intervention. They may be used together with pharmaceutical treatment. Behaviour-oriented approaches may be used to deal with problem behaviours. Emotion-oriented approaches, on the other hand, may be beneficial for cognition and mood. They include psychotherapy, sensory integration, validation therapies and reminiscence therapies. Cognition-oriented interventions aim at improving cognitive abilities. They may include cognitive retraining and reality orientation. The stimulation-oriented approach may also be useful for ensuring improved behaviour, function and mood.
Care Giving
Social workers may play an important role in care giving since it is a form of treatment for individuals with Alzheimer’s disease. This care should be managed attentively during the course of the disease. During the first three stages of the disease (as described earlier), it is important to adjust the environment and the person’s lifestyle. This is necessary in order to ensure that the individual’s safety is guaranteed and that the caregiver’s burden is reduced. For example, caregivers may help patients to adhere to certain routines. They may also be taught how to place safety locks and use modified objects for daily use. Feeding tubes may be used for individuals having problems while eating. Other issues may arise as the disease progresses. They may include pressure ulcers, skin infection and malnutrition. Proper care is required to manage such issues. In the final stage of the disease, patient care would involve the relieving of pain and discomfort until the patient succumbs to the disease.
Resources Available to Patients and Families Experiencing Alzheimer
Several resources are available for such individuals in Edmonton (Alberta). All these facilities provide various services to ensure that the patients with Alzheimer live comfortable lives away from home. Examples include the following:
- Good Samaritan Wedman Village Homes
- McConnell Place North
- McConnell Place West
- Strathcona Alzheimer Care Center
- Rutherford Heights Retirement Residence
- Home Instead Senior Care
- Bluegrass Assisted Living
- Elizabethtown
- Elmcroft of Lebanon
- Clare Bridge of Goodlettsville
- Atria Stony Brook
These facilities strive to ensure that the surroundings are aware of the disease. They also put in place measures to ensure that the family members are encouraged to cope with the challenges of the disease. Most of these facilities encourage the engagement of social interaction among the patients. They also provide mind-stimulating activities in order to help with cognitive development. Since a healthy diet is required for these individuals, these facilities aim at providing nutritious meals. The professionals working within the facilities also manage the changing behaviours of the individuals as the disease progresses. The social workers also strive to enhance and restore the simple pleasures of live. For example, they may retrain the individuals to make walks in the park. The individuals may also be taught to make their way to the garden and enjoy their time there. This is usually meant to maximize their abilities and ensure independence. The social workers in the facilities also help support the families of the patients (Pearce, 2010).
Role of social Work Relating to Alzheimer’s disease
Social workers play an important role when it comes to managing cases of Alzheimer’s disease. They may be helpful during all stages including before diagnosis, during the process of diagnosis and after diagnosis (treatment and management of the disease) (Waldemar, 2007). They may help by offering information, providing advice, care and treatment to the affected individuals. One of their important roles includes helping individuals and families understand some of the signs and symptoms of the disease and when visiting the doctor. Most individuals do not understand the difference between typical aging and the disease. For this reason, social workers may come in handy. Social workers also play an important role in educating the family members of their role in the diagnostic process. This is mainly due to the fact that they know the individual (with the disease) well enough to tell when this or that change may happen. Such changes may include forgetfulness, avoidance of social activities and decreased interest in some of the fun activities. The doctor might not be in a position to tell it if such changes have occurred over time since this would require having knowledge of the person’s abilities. Social workers may get this information by performing family interviews.
After diagnosis of the disease, the social worker may also be helpful in guiding the individual and family on how the individual may live with the disease. For example, the social worker can encourage the individual with the disease to begin daily physical exercise and adopt a healthy diet. They may also encourage the patients to regularly visit the doctor in order to manage other medical conditions. Since the individuals and their family members may experience a wide range of emotions during the course of the disease, social workers may provide help in managing such emotions. Therefore, they provide education about the disease process and advise them on what to expect in future. Social workers can also encourage the family to keep daily routines and engage in common activities that are not strange to the individual. Limiting new situations may also help in making individual’s adjustment more manageable.
The caregivers are usually faced with several demands as they live with an individual with Alzheimer’s disease. Some of the demands include physical, financial and emotional constraints. The social workers come in handy during this difficult moment. In order to assist families to meet their financial needs, the social workers may encourage them to obtain community services or apply for benefits.
Social workers usually assess an individual in order to know the services that are required by the person. They may then plan, coordinate and advise on the services that need to be accessed. These professionals may be based on a number of places such as hospitals and social services departments. In this case, they may be referred to as care managers. Social workers may also work as home care workers. Such workers provide more personalized care such as taking the individual from bed, helping them wash up and get dressed. They may also help in providing supervision, feeding and taking of medication when needed. When it comes to feeding, the individual should be provided with a nutritious meal. Therefore, the social worker may be of great help in ensuring that the meals are balanced. Such social workers may also provide the individuals with company and participate in social activities with them.
Studies have shown that individuals with Alzheimer’s disease should be placed in familiar surroundings since they are most comfortable there. Therefore, social workers ensure that the individuals are placed in a setting that would meet these conditions. The social worker also ensures that the patient has the opportunity to interact with other people. Since the disease affects cognitive abilities, social workers may provide mind-stimulating activities in order to counteract this condition.
Conclusion
Alzheimer’s disease has no cure but can be managed effectively by trained social workers. Social workers play an important role in providing relevant information, advice, care and treatment to individuals with the disease. They may help in educating the family on how to handle the individual appropriately. With proper training, the individuals suffering from the disease may regain some of the abilities and attain some level of independence.
References
Alzheimer’s Association. (2013). Alzheimer’s Association 2013 Alzheimer’s Disease Facts and Figures: Alzheimer’s & Dementia. Journal of the Alzheimer’s Association, 9(2), 208-245.
Brookmeyer, R., Johnson, E., Ziegler-Graham, K., & Arrighi, M. (2008). Forecasting the global burden of Alzheimer’s disease. Alzheimer’s and Dementia. 3(3), 186-191.
Caplan, J.P., & Rabinowitz, T. (2010). An approach to the patient with cognitive impairment: Delirium and dementia. The Medical clinics of North America, 94(6), 1103-1116.
Doraiswamy, P.M., Gwyther, L., & Adler, T. (2008). The Alzheimer’s action plan: What you need to know—and what you can do—about memory problems, from prevention to early intervention and care. New York: St. Martin’s Griffin.
Gould, E. (2013). Alzheimer’s Disease & Related Dementias: Social Work’s Role in Helping Individuals and Families. Web.
MNT. (2014). What is Alzheimer’s disease? Causes, symptoms and treatment. Web.
Pearce, N. (2010). Helping families affected by Alzheimer’s. Social Work Today, 10(10). Web.
Waldemar, G. (2007). Recommendations for the Diagnosis and Management of Alzheimer’s Disease and Other Disorders Associated with Dementia: EFNS Guideline. European Journal of Neurology, 14(1), 1-26.