Summary
Diseases associated with neurocognitive or psychiatric disorders have always been one of humanity’s main problems in healthcare. There may be no full-fledged treatment for such diseases, but only the slowing down of the process of the procedure. It means that there is a possibility that a person does not know about the course of the disease, which negatively affects one’s healthcare in the future. It is essential to detect any illness in time, contact a specialized doctor, and prescribe the proper treatment to avoid further problems. This paper describes such a disease as Alzheimer’s, specifying its origin, stages, possible treatment, and patient care.
Description of the Condition
For the first time, the disease was described in 1907 by a German psychiatrist and neurologist, Alois Alzheimer, hence the name Alzheimer’s disease. Alzheimer’s disease is the most common type of dementia, a condition in which the brain stops appropriately performing its functions. According to Weller and Budson (2018), dementia is a clinical syndrome characterized by a progressive decline in two or more cognitive domains, including memory, language, executive and visuospatial function, personality, and behavior. It causes a loss of ability to perform instrumental or basic activities of daily living, and Alzheimer’s disease is the most common cause of dementia and accounts for up to 80% of all dementia diagnoses. Other problems caused by the disease include:
- Problems with performing tasks that previously did not cause difficulties.
- Difficulties with solving simple challenges.
- Changes in mood, character, and distance from family and friends.
- Changes in visual perception, for example, challenge image interpretation.
Thus, these are the most common consequences of the disease.
However, it is necessary to distinguish neurocognitive and psychiatric disorders by defining them. Cognitive impairments can be represented by impaired memory, attention, orientation, visuospatial functions, speech, gnosis, praxis, and thinking. Structurally, they can be associated with the dysfunction of each of the brain’s three main structural and functional blocks. The defeat of the formations that structure the first block, the middle and intermediate brain structures, primarily affects the activation processes that ensure the inclusion of individual brain structures. As a result, mainly neurodynamic disorders develop, including attention disorders, secondary memory disorders, and psychomotor retardation.
The second brain’s block is responsible for receiving, processing, and storing information, including the structures of the parietal, temporal, and occipital lobes of the cortex. Its damage worsens model-specific processes associated with visual or auditory information processing and complex integrative cognitive processes that lie based on symbolic, speech, and intellectual activity (Weller & Budson, 2018). Functional disorders include speech, praxis, gnosis, and primary memory disorders that occur when this block is affected. Finally, the third block is mainly associated with the prefrontal sections of the frontal lobes, which form the front striate system. In case of its violation, the formation of plans and goals of mental activity, the regulation, and control of individual actions and behavior is disrupted. These cognitive impairments are called regulatory. Nevertheless, psychiatry disorder is a symbiosis of emotional-personal and psychotic disorders. The first is expressed in disorders such as depression, apathy, manic state, obsessive thoughts, and personality changes. Emotional-personal disorders usually occur against the background of cognitive deficits but can be disproportionately more pronounced and even occur independently of it. They develop due to dysfunction of the front striate circles, mainly the lateral orbitofrontal and medial frontal. They, therefore, may resemble the behavioral changes that occur with damage to the frontal lobes. In addition, psychotic disorders in hallucinatory or paranoid syndromes, sensations of presence or passage, illusions, syndromes of impaired identification, episodes of confusion, and delirium are especially characteristic of dementia with Lewy bodies and Huntington’s disease. Still, they are also possible in other extrapyramidal disorders. Summing up all the above facts, it is possible to state that Alzheimer’s disease refers to neurocognitive diseases.
Case Analysis
The patient with the name R has reached the age of 71. He developed Alzheimer’s disease due to diseases inherent in older people. These diseases are overweight, diabetes mellitus, and uncontrolled hypertension. The characteristic features of Alzheimer’s disease are visible in his behavior. The patient cannot eat independently, monitor hygiene, and change clothes. He has memory problems; he cannot even remember people close to him and his relatives.
Functional Abilities
The patient is able to move with the help of special equipment or other people. Also, he hardly manages to solve the simplest tasks and remember what happened to him recently. R can write and read, but also not without difficulties. The patient can sleep, eat, change his clothes, and do the daily duties of a person in general under the supervision of doctors or caregivers.
Limitations
Alzheimer’s disease has a long course. It develops gradually and for a long time, practically does not manifest itself. As the pathological changes increase, the symptoms become more noticeable. Doctors distinguish four stages of the development of the disease, each of which has its symptoms and determines particular limitations:
- Pre-dementia is the initial stage of Alzheimer’s disease, characterized by erased symptoms. Most of them can be identified only in the process of special testing. Common difficulties include:
- Coming up with the right word or name.
- Remembering names when introduced to new people.
- Having difficulty performing tasks in social or work settings.
- Forgetting material that was just read.
- Losing or misplacing a valuable object.
- Experiencing increased trouble with planning or organizing (“Stages of Alzheimer’s”, 2022).
- Early dementia is associated with short-term memory becoming visible. At the same time, a person perfectly remembers events from his youth, any learned facts, and applies old skills. Many patients also develop apraxia, agnosia, and speech disorder.
- Moderate dementia manifests itself in the loss of the ability to independently living. As a result, a person ceases to perform daily tasks: eating, hygiene procedures, and changing clothes. Memory disorders continue to progress; the patient does not remember and does not recognize even close people. At this stage, the patient becomes psycho-related.
- Severe dementia is the last stage of the disease and turns a person into a helpless invalid. It is characterized by incoherent speech, extreme apathy, and loss of control over physical and physiological processes.
Client’s Work History
Rehabilitation potential is a complex of biological, personal, and socio-environmental factors that form the basis of the patient’s resocialization. The development of an Alzheimer’s rehabilitation program is always individual. Patients with the initial stages of the disease development can be treated outpatient, visiting the clinic to perform prescribed procedures. At the same time, they require systematic monitoring by their relatives. Patients with late Alzheimer’s are recommended to be treated in specialized clinics under the round-the-clock supervision of qualified specialists. Such patients lose control over their actions, so their stay at home is unsafe for both the patient himself and his family members.
There is no cure for Alzheimer’s disease; scientists are still working on developing it. Treatment of Alzheimer’s disease may include caring for the patient and taking medications to alleviate the symptoms of dementia. Many studies on senile dementia have clarified how Alzheimer’s disease affects brain cells. Scientists are looking for more effective treatments and measures to prevent this disease and improve brain health. This also includes drug therapy, disease prevention, and diet, which reduce the risk of this disease. These facts mean that there is no effective tactic for the absolute cure of the disease, but preventive actions are practical and help a person fight it.
Vocational Profile
The patient’s age is 71 years old, and he has completed higher education in economics. R was a senior accountant at an international law firm. Since his duties included calculating all the services and costs of the company, his workload was spent a lot of time sitting at the computer in one position per day. Due to the severity of the patient’s condition, it is impossible to transfer his abilities, and, unfortunately, he will not be able to find a suitable job.
Recommendations as a Rehabilitation Counselor
Based on the patient’s condition, it is necessary to prescribe substitution (compensatory) therapy, protective therapy, psycho pharmacotherapy, physical therapy, and household exercises. Additionally, it is essential to ask R if he is aware that he is ill. Moreover, questions about his attitude toward his personal mental and physical abilities are required. My rehabilitation goals are to restore and preserve the patient’s memory and cognitive functions of the brain and improve the psychological state. Also, my goals include:
- Restoring and involving him in his everyday social life.
- Restoring neural connections.
- Training thinking and memory.
References
Stages of Alzheimer’s. (2022). Alzheimer’s Disease and Dementia, Web.
Weller, J., & Budson, A. (2018). Current understanding of Alzheimer’s disease diagnosis and treatment. F1000Research, 7, 1161. Web.