Presently, there’s no cure for Alzheimer’s disease, in spite of the number of folks stricken with this disease. Various treatments have been useful in retarding and assuaging many of the symptoms, especially mental confusion and anxiousness, but nothing has been proven to stop the advancement of the illness itself. While treatment and care for Alzheimer’s disease has been advancing, scientists are nonetheless at a loss for where to look to discover an Alzheimer’s remedy.

Research Towards a Remedy

Much research has been done into nutritionary and complementary medicine as a potential step towards an Alzheimer’s cure. The antioxidant Vitamins C and E, as well as the omega-3 fatty acid existing in fish oils, have been proven to improve cognitive functions and to slow down the progress of the disease. Additionally, research is being done involving the utility of the herbaceous plant gingko biloba in caring for, preventing, or healing Alzheimer’s.

Research is likewise being carried on toward producing an Alzheimer’s vaccine. Opposed to other vaccines, which are conferred before the contraction of a disease, the Alzheimer’s disease vaccine would be given to folks who have already been diagnosed with Alzheimer’s disease. Its purpose would be to condition the body to assail the chemical compounds that contribute to brain troubles. New tests of this vaccine were halted, however, when a lot of the participants experienced serious side effects, including swelling of the brain.

Additional auspicious fields of research towards an Alzheimer’s remedy lies with the cholesterol reducing drugs known as Statins. They’ve been proven in many empirical analyses to have favorable results upon cognitive functioning, but this hasn’t thus far been verified by observational research. Likewise nonsteroidal anti-inflammatory drugs,, such as acetaminophen and aspirin, have been evidenced to have some effect only more research is necessitated.

One treatment that was believed to allow for relief has, regrettably, lately been controverted. The Women’s Health Initiative, among the greatest longitudinal wellness reports ever executed, indicated that Hormone Replacement Therapy doesn’t deliver an advantageous effect on repressing the relative incidence or severity of Alzheimer’s disease.

Prevention is the Soundest Choice

Right now, while there’s still no Alzheimer’s disease remedy, there are more and more optimistic research reports being executed on Alzheimer’s disease prevention and risk decrease. Especially for those with a household history or additional risk elements for the disease, it’s essential to remain physically active, mentally aware, and socially engaged. Additionally, research is demonstrating that the life-style factors normally referenced as precluding heart disease, such as decrease in fat consumption and total cholesterol, could likewise assist in preventing Alzheimer’s disease. Until an Alzheimer’s remedy is discovered, prevention and overall health upkeep remain the soundest steps to take for most people.

A good deal of the frustration and ire an individual with Alzheimer’s disease experiences stems from trouble with communicating. Many times they can no longer convey what they’d like, such as needs or opinions and can’t obtain or understand information as they formerly could. When communicating with your loved one, grant them a substantial amount of time to process the information and then time to react to the info. We might believe the individual is experiencing difficulty hearing, when in fact, they’re working on the information more slowly and might require sufficient time to reply.

One very productive form of communicating with an individual with Alzheimer’s disease is by validation. All people need their opinions corroborated, the individual with AD is no different. In reality, they necessitate more due to their retention loss and feelings of insecurity. Feelings are very genuine to them and if they’re eschewed and not corroborated, it may contribute to frustration, anger and potential outbursts. Validation lets an individual acknowledge they’re being heard, hopefully cutting back episodes of frustration and angriness.

Validating someone’s feelings doesn’t inevitably imply you concur with them, it signifies you’ve heard and recognised what they’re feeling.

For example, your beloved is inquiring for their parents who have been departed for several years. You need to attempt to see beyond the inquiry and ascertain what they’re experiencing; dejected, gloomy, deserted or are they mourning because they miss them?

An effective all-purpose answer would be, “I’ve always treasured your parents, what is your favorite memory of them? Or “Remember the good pot roast your mom made?”

This validates they’re thinking of their parents and provides them the chance to reminisce. Reminiscing is very pacifying to them and assists with feeling assured about “who” they are. It likewise assists in the conversion from the consuming impressions to feeling more relaxed. A different illustration: “I am so dumb, I just can not think like I used to.” Respond: “Honey, I know you’re feeling mad and disappointed. I become disappointed as well when I forget things. We are going to have to assist each other.” You’ve validated the opinion and simultaneously have quieted them by recognising the feeling, then provided support. Corroborating their opinions is essential to their dignity!

The idea of substantiation of feelings deals with the beliefs) at that instant. With short term memory loss, we have to center on the moment at hand. The old philosophy was “reality orientation” or forever taking them back to the present. This conception can still apply depending upon the respective individual and their degree of orientation and memory.

For example, if your loved one was inquiring about their parents and you answered “gosh honey, you know they’ve been deceased now for over twenty years, they are buried in St. Andrews graveyard just outside of your hometown.” This single assertion could bring up numerous questions such as “My parents are deceased?” “How did they pass away?” “Why can’t I remember they passed away?” “Aren’t we still living in my hometown?” Successively that can contribute to notions such as desertion, anger, defeat, desolation, sorrow, etc..

As you can see, this answer can induce anxiousness and perhaps even terror. Allowing for them to stay in the present moment and not pointing them to reality, isn’t just satisfactory but nearly essential for their emotional wellbeing. A lot of times seeking to orient them to reality will induce opposition, making them defensive and wanting to “lash out.” As they say, “Just go with the flow.”

As a caregiver, your goal is to communicate in a method that won’t disturb or induce your beloved to get uneasy or disturbed. You need them to feel as secure and safe with this situation as conceivable. Effective communication won’t only aid your loved one, but might make your function as caregiver less nerve-wracking and more gratifying.

WHY: Approximately 15 – 60 % of elderly patients experience a delirium prior to or during a hospitalization but the diagnosis is missed in up to 70% of cases. Delirium is associated with poor outcomes such as prolonged hospitalization, functional decline, and increased use of chemical and physical restraints. Delirium increases the risk of nursing home admission. Individuals at high risk for delirium should be assessed daily using a standardized tool to facilitate prompt identification and management. Risk factors for delirium include older age, prior cognitive impairment, presence of infection, severe illness or multiple co-morbidities, dehydration, psychotropic medication use, alcoholism, vision impairment and fractures.

BEST TOOL: The Confusion Assessment Method (CAM) includes two parts. Part one is an assessment instrument that screens for overall cognitive impairment. Part two includes only those four features that were found to have the greatest ability to distinguish delirium or reversible confusion from other types of cognitive impairment.

VALIDITY/RELIABILITY: Concurrent validation with psychiatric diagnosis revealed sensitivity of 94-100% and specificity of 90-95%. The CAM significantly correlated with the Mini-Mental Status Examination, the Visual Analog Scale for Confusion and the digit span test.

STRENGTHS AND LIMITATIONS: The tool can be administered in less than 5 minutes.

It closely correlates with DSM-IV criteria for delirium. There is a false positive rate of 10% and the instrument has not been widely tested as a bedside tool for nurse raters. The tool identifies the presence or absence of delirium but does not assess the severity of the condition, making it less useful to detect clinical improvement or deterioration.

FOLLOW-UP: The presence of delirium as indicated by the algorithm, warrants prompt intervention to identify and treat underlying causes and provide supportive care. Vigilant efforts need to continue across the healthcare continuum to preserve and restore baseline mental status.

Permission is hereby granted to reproduce this material for not-for-profit educational purposes only, provided The Hartford Institute for Geriatric Nursing, Division of Nursing, New York University is cited as the source. Available on the internet at www.hartfordign.org. E-mail notification of usage to: hartford.ign@nyu.edu.

By Christine M. Waszynski RN, C, MS, APRN

67.7% of assisted living residents have dementia and 26.3% have an active non-cognitive psychiatric disorder. Screening has been found to be helpful in assisted living facilities and nursing homes.
Research shows that in nursing homes with treatment:
• 51% of participants with dementia and depression did improve their quality of life.
• 58% of those with depression alone, receiving counseling and medication recovered six months later and had a better quality of life.
• Only 25% of those receiving medication alone improved, but did not have a significantly better quality of life.
• Patients need to be seen 1-4 times per month in order to monitor-the constant fluctuation of behavioral and psychiatric symptoms and medical problems.
• Post stoke depression usually resolves in 6 months but can last two years.
In conclusion, patients who received psychotherapy (counseling) did 100% better than those that received medication alone. They also had a significant decrease in behavioral problems sooner and a better quality of life for longer.
Without psychotherapy, individuals with depression or dementia or both:
20% continued to-exhibit behavioral symptoms.
• 40% exhibited physically and/or verbally aggressive behavior
Because of these residents at nursing homes and assisted living facilities:
• Need to be routinely screened for depression
• All patients with behavioral problems need to be evaluated by a team of psychiatrist and mental health professionals.
• Most patients with many medical illnesses are not depressed.
• Staff needs to realize that many demented people will not spontaneously engage in activities because of depression or Alzheimer’s.
• Residents with dementia are taking several medications for problems such as insomnia or anxiety, the resident’s physician needs to review and possibly reduce the number of medications.
In conclusion, early evaluation and accurate comprehensive diagnosis is necessary. Medications alone are not enough. A comprehensive plan of 6-24 months with counseling is necessary to maximize results, prevent relapse and improve lie quality of life.

Because 50-90% of patients are undiagnosed with dementia and other brain or psychiatric problems that lead to behavior problems they are under treated or over treated. This often results in difficulties with Medicare surveyors with the consequences of F501, F329, F330 and F429 tags. Senior PsychCare, in cooperation with nursing staff, has developed a progress to conduct initial screening s on all patients. We utilize objective tests to evaluate the neurocognitive status of patients and cover a range of . mental processes, such as motor performance, attention, and memory if there is suspicion of a problem. We ten have professionals so neuro behavioral evaluations and if indicated a more comprehensive computer assessment called BCNI (Borrell Cognitive Neuropsychiatric Inventory) is conducted. This assessment allows to:

• Establish and document current status and use in later treatment decisions

• This distinguishes early mild or subtle behavioral problems in patients through comparison to other individuals his/her age

• This leads to decision making on the course of action to take. Counseling, medications, and social eatments to maintairr quality of life are provided:

• It helps families understand the problem that effect emotion and behavior. Also it allows making a prediction of the future functions, emotional, and social needs to improve the quality of life.

Senior PsychCare will make best efforts to use the evaluation to direct treatment in collaboration with the family, facility, staff and primary care physician. More information about the screening process is available by contacting Tammy Simon, FIR Director at SPC, at 713 850 0049. Based on the fact that we are committed to providing the best and available care, we are providing there services under the professional staff of your long-term health care center. Thus we comply and are compliant with all HIPAA regulations.

Thank you for your time.

Sincerely,

Leo J Borrell

Medical Director