Dementia is the loss of intellectual and social abilities severe enough to interfere with daily functioning. For centuries, people called it “senility” and considered it an inevitable part of aging. It is now known that dementia is not a normal part of the aging process and that it is caused by an underlying condition. People with this condition need special assistance to carry on with their normal lives. This paper will explain some of the social services that are helping to combat this disease and an analysis of the services effectiveness.
More than four million older Americans have Alzheimer’s, the most common form of dementia. And that number is expected to triple in the next 20 years as more people live into their 80s and 90s.
Still, there’s reason for hope. There are as yet no cures, but researchers studying Alzheimer’s have made progress, especially in the last 5 years. New drugs that can temporarily improve mental abilities in some people with mild Alzheimer’s are now available, and more drugs are being studied. Researchers also have discovered several genes associated with Alzheimer’s. Furthermore, scientists are defining subgroups of dementias and their distinguishing characteristics in the hopes of refining treatments.
Although Alzheimer’s disease is the most common of the dementias, there are many types, even hundreds, of dementias — some reversible, and others, like Alzheimer’s disease — irreversible.
What is Dementia? Dementia is the loss of intellectual and social abilities severe enough to interfere with daily functioning. For centuries, people called it “senility” and considered it an inevitable part of aging. It is now known that dementia is not a normal part of the aging process and that it is caused by some underlying condition.
Symptoms of dementia vary in severity, order of appearance and with the type of dementia. But all dementias involve some impairment of memory, thinking, reasoning and language. Personality changes and abnormal behavior may also occur as dementia progresses.
Of the diseases that produce dementia, Alzheimer’s is the most common. The disease was named after Alois Alzheimer, a German physician. In 1906, Dr. Alzheimer noticed changes in the brain tissue of a woman who had died of an unusual mental illness. He found abnormal clumps (plaques) and tangled bundles of fibers (tangles). Other changes in the brains of people with Alzheimer’s disease include a loss of nerve cells in the areas of the brain vital to memory and other mental functions, and lowered levels of chemicals in the brain that carry complex messages back and forth between billions of nerve cells important to thinking and memory.
The first sign of Alzheimer’s disease may be mild forgetfulness. The disease progresses to affect language, reasoning, understanding, reading or writing. Eventually, people with Alzheimer’s disease may become anxious or aggressive, and may even wander from home.
The problem of Alzheimer’s disease is considered a growing problem in the United States. As our population gets older our need for elderly services increases dramatically. This means that healthcare costs are on the rise and we need more care facilities for our aging elderly. As we all know in this election year prescription drug prices are a hot topic. Prescriptions for the elderly are getting so expensive that they cannot afford them anymore, therefore relying on some other source to help buy the prescriptions. The toll is not only financial, but proves to cause emotional turmoil for the families dealing with an aging relative.
Some of the goals and values of society that are affected by this problem are: the rising costs of healthcare, prescription drug prices, and the toll on the individual and their family. This presents a problem for those who cannot afford it and therefore rely on society for help. It is also hard for a family to put a loved one in an institution.
Alzheimer’s disease is non-discriminatory. It can affect any race or nationality. It does not matter if you are rich or poor, male or female. It can happen to anyone, there are some younger cases of the disease but it remains most common in the elderly population. Alzheimer’s disease affects brain tissue directly, causing progressive brain deterioration in middle or late life. So far, only age and heredity are proven risk factors. But like cancer and cardiovascular disease, Alzheimer’s probably results from a combination of factors. Researchers are studying:
Age: Alzheimer’s usually affects people older than age 65, but can, rarely, affect those younger than age 40. The average age at diagnosis is about 80.
Only one to two people in 100 have Alzheimer’s at age 65, but that risk increases to about one in five by age 80. By age 90, half of all people this age have some symptoms.
The incidence of Alzheimer’s is about the same for all races, but women are more likely than men to develop the disease, in part because they live longer.
Heredity: Family history plays a role in about 40 percent of people with early onset Alzheimer’s. If your parents or a sibling developed Alzheimer’s, you’re more likely to as well. But, even in families with several people who’ve had Alzheimer’s, most members don’t get it. It’s clear that most Alzheimer’s involves some disease process in addition to a genetic vulnerability.
Environment: Researchers are studying environmental factors to discover both possible causes and preventions of Alzheimer’s. For example, some people with Alzheimer’s have small deposits of aluminum in their brains. But scientists who’ve studied environmental aluminum sources from antacids and antiperspirants to cooking pots and drinking water haven’t found a link between aluminum and Alzheimer’s.
On the other hand, some studies hint at a possible protective effect from estrogen, nonsteroidal anti-inflammatory drugs (NSAIDs), vitamin E and other factors, some studies even show that a lower calorie diet help reduce the chances of getting the disease. But more research is needed to confirm any benefit.
The service that is identified in this paper is the long-term care facilities which care for alzheimer’s patients. The purpose of long-term care facilities is to help with the daily living of patients while assisting and caring for them. When caregivers are faced with alzheimer’s patients they need to keep in mind that the brain changes and can cause communication problems that can result in irrational behavior. The patient is not doing this to be annoying or to irritate, but is probably not aware of his or her actions.
There are many ways that a person can receive help for their illness. One way is through seeing a health practioner and to be referred to a facility for an evaluation. If the there are symptoms that are pointing to the illness contact a health care provider to get their opinion and recommendation. You cannot just go on your own instincts and place the person in a care facility.
Every year, thousands of families in the United States face the time when deciding that it is the time for a loved one with Alzheimer’s disease to leave their home and enter a long-term care facility.
Early in the disease many people will do well on their own or with a spouse. But when the disease worsens and there needs to be changes in their home, lifestyles, or schedules it is time to think about long-term care facilities or having the immediate family care for the individual. Eventually, however, even the most loving and accommodating family may be unable to meet the needs of a person as the disease progresses.
The personal safety, wishes and needs of the person with Alzheimer’s, the caregiver’s own limits, the ongoing costs of living in a private residence and of hiring homecare providers all enter into the decision of when to seek new living arrangements.
Another factor affecting the timing of such a decision is that most facilities have waiting lists. It may be better to begin exploring options before a crisis arises, such as an injury, that allows for a more thorough evaluation without additional pressure.
This decision may be further complicated by the caregiver’s feelings of love, loyalty and guilt, as well as by awareness that when a person leaves a home environment, he or she must give up more independence and privacy.
Because there is a spectrum of impairment associated with Alzheimer’s disease, the choice of a facility may be more complicated than just choosing a regular long-term care facility. Fortunately, in recent years the list of options between home and a nursing home has greatly expanded. Many facilities offer “home-like” environments and amenities, and opportunities for caregivers to stay involved as partners in their loved one’s life.
Here is a list of the general types of living arrangements available for people with advanced Alzheimer’s.
·Nursing homes — For years, nursing homes cared for most people with Alzheimer’s disease. However, as a result of declining reimbursement and increasing regulation over the past decade, it has become increasingly difficult to find nursing homes that will admit Alzheimer’s patients.
People with Alzheimer’s disease need custodial care, including meals, assistance with personal activities such as toileting, dressing and bathing, general supervision, and space in which to live and move safely. However, doctors point out that if the person with Alzheimer’s has other serious medical problems, a nursing home may be the only option.
·Special care units — Today, many nursing homes feature special care Alzheimer’s units that provide a quiet, safe environment with activities that encourage mental and physical stimulation.
However, be aware that special care units in some nursing homes are no different from the rest of the facility. When you visit, ask the staff what makes the unit “special.” This should include information about dementia training for all employees, specialized activities and a calm, home-like environment.
·Assisted- or supervised-living facilities — Assisted-living arrangements are best for people who have moderate functional impairment, don’t need full-time nursing care, but who can still engage in such tasks as feeding themselves and getting in and out of chairs. These facilities are typically large complexes with apartments or townhouse-like units that feature communal dining, assistance with personal care, housekeeping services, and social activities and programs. Residents also may be encouraged to participate in meal preparation, laundry and other tasks.
·Continuing-care retirement communities — These facilities, sometimes called life care centers, offer many services a la carte so that, as people age and their needs change, they may receive different levels of care in the same complex. Services are designed to provide a continuum of support for those who can live independently to those who need nursing home care. This kind of facility typically offers people with Alzheimer’s disease the chance to live in one place for the rest of their lives. Loved ones have the peace of mind that no matter what future care is needed, it’s available, if not in the same room, then at least within the same complex.
When evaluating facilities, be sure to visit. It’s helpful to take along another family member or friend who also can ask questions and with whom you can share observations.
Request to see the most recent facility inspection report. This document will highlight the kind of care provided.
The level and quality of physical care provided is extremely important, but it’s only one aspect of the total care environment. It’s also important that residents have their emotional, social and spiritual needs met.
To determine the philosophy of care at a facility, ask for a description of its philosophy and mission statement. Then tour the facility, perhaps at different times of day, to see how residents are treated and how they spend their time. Do staff members take pride in their work?
Activities should include both group and individual opportunities. Ask if the facility modifies its programs to meet individual needs. Activities should include everyday tasks such as bedmaking, brushing teeth, setting the table, etc. Activities should also include reminiscing with residents about the past since long-term memory is better than short-term memory in people with Alzheimer’s.
Deciding when a loved one with Alzheimer’s disease needs a more structured care setting is often difficult. But touring facilities, asking good questions and making careful observations can help make a better choice.