Most Common Dementia: Alzheimer's Disease

Alzheimer’s Disease

Alzheimer’s disease is the most common cause of dementia in older people. Alzheimer’s disease is an irreversible and progressive brain disease that slowly destroys memory and other important mental functions, which is due to degeneration between the brain cells and the brain cell receptors (Alzheimer’s Stages & Behaviors, 2014). Alzheimer’s disease results in the loss of intellectual and social skills (Alzheimer’s Stages & Behaviors, 2014). According to the Alzheimer’s Association there are 7 stages to this disease (Alzheimer’s Stages & Behaviors, 2014). The first signs of Alzheimer’s disease are typically forgetfulness or mild confusion (Alzheimer’s Stages & Behaviors, 2014). Stages 1 through 3 show mild cognitive decline, Stage 4 is moderate cognitive decline, Stage 5 is moderately severe, Stage 6 is severe cognitive decline and Stage 7 is very severe cognitive decline (Alzheimer’s Stages & Behaviors, 2014). Accurate staging of an Alzheimer’s patient is difficult, because some stages overlap with one another (Alzheimer’s Stages & Behaviors, 2014). This week’s case discusses Mr. Jones, an 83-year-old man, diagnosed with mild dementia. Mr. Jones is admitted to the Emergency room with respiratory distress and complications due to Diabetes. While in the Emergency Room the attending physician notices Mr. Jones has gangrene on his right foot up to his ankle. The nurse believes his dementia is due to his respiratory distress and the disorienting atmosphere of the Emergency Room. Mr. Jone’s daughter is his caregiver, but has not been designated as an advanced directive surrogate nor does Mr. Jones have an advanced directive in place. Mr. Jones insists that he has lived long enough and does not want to h...

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...es in the decision-making process. Disregarding questionable capacity is unethical and could lead to civil liability (Pozgar, 2014). Mr. Jones did not designate an advanced directive surrogate and with a history of Alzheimer’s a capacity assessment is required. The health issues that brought Mr. Jones into the Emergency Room are slow progressing, which gives clinicians time to assess before moving forward with or without surgery. This extra time could also give Mr. Jones time to think about the amputation. Despite the need for an amputation his clinicians are ethically bound to accept his health care decisions as long as he is found capable. If Mr. Jones is found incapable of making decisions a surrogate will be assigned to him. Since his daughter is his caregiver and is involved in his care she will be appointed as long as there is no evidence of elder abuse.