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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.
This ethical scenario presents an 86 year old female with numerous health issues and chronic illnesses. Mrs. Boswell’s advancing Alzheimer’s disease makes it extremely difficult to initiate dialysis, leading her physician to conclude a poor quality of life. The ethical dilemma portrayed in this case is between nonmaleficence and autonomy. Health care workers should focus on promoting the patient’s overall wellbeing and weigh the benefits and risks of the course of action, while also considering what the family declares they want done. Since the patient is deemed unable to make decisions, the goal is to collaborate with family, assess patient quality of life, address prognosis, and establish realistic care goals.
An effective advance care planning process follows a series of steps that incorporates the patient’s preferences, their values, and a dialog to help identify proxies. The educated person must first consider a proxy and determine the goals of their care. Ideally, the chosen proxy will then partake in the advance care planning process. It is important that the person completing the advance directive make the proxy aware of their authority, the goals of treatment, important personal factors, and the scope of discretion for that individual. It is also imperative that the advance care directive be available to both the proxy and healthcare providers.
Dementia is the loss of a person’s mental skills from their daily routines. The symptoms of dementia could easily be over looked, they include forgetting things, daily routines are hard to complete, misplacing things, depression, aggravation and aggression, emotion are high, even feeling like someone is a threat to their life (Web MD,2012). Caring for someone with dementia can be difficult if with resources like healthcare, living facilities, nursing homes and medicine is involved, but sometimes healthcare and facilities do not provide the proper care. This disease is very common in the elderly community past the age of sixty-five. Finding out that a loved
performance that involves, but is not limited to, a loss in at least 2 of the
Dementia is the progressive deterioration and impairment of memory, reasoning, and other cognitive functions occurring as the result of a disease or condition. Dementia can affect the person’s ability to carry out daily activities. For example, the person may forget where they live or they might think they have already done their activities but never did. Dementia can also cause the elderly to become incontinent and can’t control their urinary system. Many people get confused that dementia is a disease. Dementia is not a disease. However, it can lead to a disease or condition. Dementia is more common in the elderly population. It’s normal for people to forget things, but to a certain extent it becomes a critical issue. Depression also plays a role in the affects of dementia. Studies have been made to believe that the biological mechanisms for depression relating to dementia is, “interactions with vascular diseases, changes in glucocorticoid steroid levels that can result in hippocampal atrophy, accumulation of amyloid-[beta] plaques, inflammatory processes, and lack of nerve growth factors” (Heser et al., 2013). Dementia is caused because of plaques and neurofibrillary tangles. This can also be known as Alzheimer’s Disease. Dementia is the leading cause for Alzheimer’s Disease in the elderly. For all dementia cases, 60 to 80 percent of people with dementia will have Alzheimer’s Disease. The disease has 3 different stages, the early stage, the middle stage, and the late stage. Each of those stages has a variety of symptoms that affects the memory impairment of the person (Wieregna, Bondi, 2011). Also relating to dementia is Parkinson’s Disease and Huntington Disease. These diseases can result in impairment, which can cause challeng...
Paramedics deemed the patient competent and therefore Ms. Walker had the right to refuse treatment, which held paramedics legally and ethically bound to her decisions. Although negligent actions were identified which may have resulted in a substandard patient treatment, paramedics acted with intent to better the patient despite unforeseen future factors. There is no set structure paramedics can follow in an ethical and legal standpoint thus paramedics must tailor them to every given
Any act done or decision made on behalf of an individual deemed to lack the capacity (following a capacity assessment), must be done in their best interests, this can cover financial, health and social care decisions.
According to the NICE (2015) health and social care professionals should always seek valid consent from people with dementia. This should entail informing the person of options, and checking that he or she understands, that there is no coercion and that he or she continues to consent over time. If the person lacks the capacity to make a decision, the provisions of the Mental Capacity Act 2005 must be followed. The nurse assessed the patient capacity and ensured that the decision made was in the best interest of the patient. The doctor uses specialist knowledge and experience and clinical judgement, and the patient’s views and understanding of their condition, to identify which investigations or treatments are likely to result in overall benefit for the patient (GMC, 2008). They took into consideration how the decision made will benefit Jean. After carrying out a full assessment, it was clear that Jean lack capacity and was therefore place under the mental capacity act
In this day and age, it seems as though almost everyone has experience a loved one taken away form a very serious disease known as Alzheimer’s disease. Alzheimer’s disease is unbelievably devastating for everyone affected by it. This disease is causing major economical problems such as less occupancy in the nursing homes, and hospitals due to the rising population of elderly men and women being diagnosed with it everyday. Because there is not yet a cure for this disease and the percent of the population being diagnosed keeps rapidly rising, more time and money needs to go towards Alzheimer’s research.
Alzheimer's Disease Introduction to Alzheimer's Alzheimer's disease is a progressive, degenerative disease of the brain. It was first described by the German neuropathologist Alois Alzheimer (1864-1915). in 1905. This disease worsens with advancing age, although there is no evidence. that it is caused by the aging process.
Advance directives might have many guidelines for patient’s preferences with regard to any number of life-affecting, or end of life situations, such as chronic disease or accident resulting in traumatic injury. It can include directions for other health situations, such as short-term unconsciousness, impairment by Alzheimer disease or dementia. These guidelines may consider do-not- resuscitate (DNR) orders if the heart or breathing stops, tube-feeding, or organ and tissue donation. The directive might name a specific person, or proxy, to direct care or may be very general with only basic instructions given for treatment in time of the incapacitation of a patient. Some states say that if you do not have a written directive, a spoken directive is acceptable.
As I sit here writing this research paper on the fourth anniversary of my grandfather’s death to Alzheimer’s, I cannot help but to feel especially connected not only to the physical destructiveness of the disease, but also to the emotional tolls associated with having it affect a family member. When I was in my freshman year of high school, my grandpa (mother’s father) began his steady decline from his diagnosis of this ailment. A man who I knew my whole life to be strong and independent started to become physically fragile and even more mentally so; after some time, he began to show signs of drastic memory loss, constant confusion and a hazardous inability to perform tasks once done with minimal effort. The onset of these debilitations had an immeasurable impact on my family. My grandmother (his wife) possessed the largest burden of the constant care for my grandfather as he slid into a state of powerlessness and incapability for basic self-maintenance. However, since my grandma never learned how to drive, taking full care of my grandpa become a near impossible task. After nearly a year and a half of my family witnessing my grandfather losing himself to Alzheimer’s, my family decided to place him in a hospice care facility that could provide him with the proper care before his inevitable passing to the disease a few months later.
Alzheimer’s disease slowly steals a person’s dignity and erases precious memories. The “Alzheimer’s Disease Guide”, found on WebMD explains that tasks become more difficult to do often leading to confusion and behavior changes. The article further explains the progression of the disease also brings hardship to family and friends (1). To best cope with Alzheimer’s we must better understand the disease.
Alzheimer’s disease (AD) is a progressive, terminal, degenerative brain disease. It is the fourth leading cause of death in adults and currently affects over four million people in the United States. This number is expected to increase over the next several years as the baby boomers age, until it reaches fourteen million by the year 2025.
Alzheimer’s Disease is formed in the brain but yet, has no known cure or treatment. Alzheimer’s Disease has many symptoms. Memory is the biggest symptom along with mood swings and having a hard time with keeping a conversation. A patient with Alzheimer’s goes through 7 stages; The first stage, which is misplacing things or forgetting what something is used for, second stage, they start losing more of their memory and they begin to forget where they are or what they are doing, the third, fourth and fifth begin to mentally decline and need someone to take care of them and worsen over time.The sixth stage they begin to have an even more difficult time going to the bathroom and cleaning themselves or using electronic devices such as phones or televisions. The final stage, at which the long goodbye comes to an end, they now are mentally and physically gone. Some doctors prescribe medication to the patients to help deal with some of the symptoms.