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Example research essay topic: Alzheimer Disease Primary Caregiver - 1,583 words

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Alzheimer's Disease does not kill instantly; it destroys the individual bit by bit, tearing away at their person-hood and self-identity. Most victims suffer for 9 to 15 years after onset of the illness. It is the most common type of dementia in the United States and Canada and after age 40, the risk of developing it doubles with aging every 5. 1 years during adults' life. A form of dementia, the DSM-IV-R's (Diagnostic and Statistical Manual) criteria for diagnosing dementia include: impairment in short- and long-term memory, at least one of the following: impairment in abstract thinking, impaired judgement, other disturbances of higher cortical functioning, personality change, significant interference with work, social activities, or relationships, in addition, symptoms do not occur exclusively during the course of delirium; and specific etiologic organic factor is evidenced or can be presumed. For an individual with this terrible disease, living with memory loss and its associated disabilities are very frightening.

Alzheimer's includes behavioral characteristics that extend beyond its cognitive explanations. These behaviors require study because of the influence on both the patient and caregiver. Treatment often looks to drugs for relief of symptoms and to slow the course of progressive decline, rather than on assisting the individual with coping mechanisms. It has been termed a "family disease", not only because of possible genetic relation between victims, but because family members provide 80 percent or more of the care giving. Chronic and progressive mental and physical deterioration decrease the victim's capacity for independence and increase the need for support from family members caring for the victim at home.

The victim attempts to make sense of a seemingly new and hostile world, and this leads to dubious and uncharacteristic changes in behavior, personality, decision-making, function, and mood. Certain symptoms that are often associated with depression may be observed in patients who are cognitively impaired but not depressed. Professionals must be aware of all the symptoms the patient is experiencing, and reports from family members must also be taken into account. The patient usually reports fewer negative feelings or mood problems than are identified by caregivers. Patients often attempt to cover up their disease by modifying the behaviors of others, rather than identifying their own inevitable retrogression.

Fears of the unknown, fears of abandonment, lowered frustration tolerance, and loss of impulse control may result in problematic behavior. Also, appropriate behavior may simply be forgotten, and faces of family members and friends unfamiliar. However, the victim of Alzheimer's often denies these symptoms. More obvious, even to themselves are the expression of emotions such as panic and deprivation. Experiences such as early retirement and anticipated changes in the responsibilities of daily life are never realized. The inability to drive a car is especially painful and frustrating for some.

Self-esteem and sense of worth plummet. Individuals with Alzheimer's lose their capability to plan, postpone, wait, or predict the outcomes of their actions. Family members very often fail to attribute losses similar to those previously mentioned to a disease. They tend to deny the existence of the disease.

Family members may go through a period of denial in which they make excuses for the patient, attributing the problems they encounter to normal aging, stress, etc. Alzheimer's disease creates new demands on the family, who have to adopt numerous roles. The parent, once the primary caregiver to their children, is now like a child receiving care. Each family member defines the situation differently, but display common management behaviors that will be discussed further. Within these similar stages of management, reflection of individual attitudes is obvious due to unique interpretations of the stages.

The spouse is usually the primary caregiver of the patient, but when unable to provide the care necessary, an adult child is the most likely candidate. These adult children fear that the disease terrorizing their family and destroying a loved one will be hereditary. Negative behavior changes that are undergone by the victim have major effects on the caregiver. Mental health and life satisfaction of the caregiver seem to decrease rapidly, but according to Lisa Gather (1994), the key to minimizing these effects is to strategically change responses by the human and physical environment. Changing the responses of the outside world, rather than attempting to change the responses of the individual with the disease helps to organize difficult changes. Experienced spouses and wise families learn to distract the patient rather than confront them on their shortcomings.

They should learn to enrich the victims' pleasure in each moment, spurring preserved memories and skills to maintain the victims' positive feelings of competence, belonging, productivity, and self-esteem. Consistent reassurance and unconditional love are vital to peace and harmony within the family. The patient experiences degeneration of short-term memory, which often results in misplacement of objects and forgetting the names of familiar people. They have irrational or imaginary fears that make them suspicious of those closest to them, and they may accuse others of theft and / or infidelity. This is a source of increased frustration, confusion, distress, and irritability on the part of both the patient and the family. As a result, those involved may rely on alcohol and drugs to alleviate the stresses of coming to terms with the disease.

Many families of victims either fail to seek, or do not receive a correct medical diagnosis. They tend to become over-involved and angry, stages necessary in the process of adjustment. The family members attempt to counterweigh the losses experienced by the patient, because the deterioration is beginning to become obvious. Their anger, not necessarily with the patient, stems from the burden, embarrassment, and frustrations caused by the patient's behavior. Burden is reported to be highest in this phase of mild dementia. When the spouse is the primary caregiver (in comparison with adult children or others), care is more complete, and less stress, conflict, and ambivalence are observed.

Spouses tend to look for activities, or ways of interpreting the patients behavior, that allow for a continuing adult relationship, rather than a parent- child one, which may belittle the patient. Psychological stress results from conflict between resentment, anger, ambivalence, and guilt, self-blame, and the pain of watching a loved one deteriorate. Caregivers also report physical fatigue from providing care to their regressing loved one. Of all of these, the most difficult is performing the basic daily activities for the patient, and coping with upsetting behavior. Proactive approaches towards treatment of the disease involve the conscious decision that success is possible, both for the patient and family- unfortunately this is something that most afflicted individuals realize too late. In addition, the victims of Alzheimer's may or may not respond to certain types of intervention.

A patient may react to one type of treatment one minute and not the next. Immediate, observable changes in patient and family behavior, function, and mood were noted when caregivers learned to separate the resolution of the problem from the intention of the patient. For example, rather than confronting a patient or assigning blame when an object is lost, the caregiver replaces the item the patient claimed "stolen." In this way, unnecessary stress and tension are eliminated for both patient and caregiver. Each family member experiences a similar process of coming to terms with the changes. This process includes three stages: describing how the victim is the same, and / or different, prior to disease onset, rewriting the individuality of the victim, and redefining the relationship with the victim. During the first stage, family members look for behaviors that still represent the victims' "true" self, and those that the person with Alzheimer's no longer has.

In the second stage, the disease and individual with the disease must be seen as two in one. Part of the struggle in this stage is to maintain the adult identity of the victim while managing their child-like needs. Still, in the third stage of the adapting process, major problems continue to present themselves. These may include: family and social disruptions, increased marital conflicts, and employment-related difficulties. Family members are usually not aware of one-another's viewpoints; they do not understand that they are not all seeing the victim the same way. Due to the fact that they are not all having the same type of relationship with the victim, paths towards the common goal of attaining highest level of function for the victim may be divided.

As a result, the more effort individual family members put into achieving this goal, the more conflict is created. However, it individuals voice their different perspectives and encourage discussion, this may allow the family to function as a complete whole. Understanding between family members can be coupled with social support groups' ideas about the disease. A social network may be effective in protecting individuals with terminal diseases from some of the negative effects. An active organization, The Alzheimer's Disease and Related Disorders Association (ADRDA) established a network of individuals and families affected with dementia.

The speed at which this network is growing is clear evidence of the need for more groups like it. Information sharing, encouragement, and provision of social support are among the top objectives of such groups. A committee at the St. Louis Chapter of the Alzheimer's Association developed Project Esteem to provide emotional intervention for people with Alzheimer's in the Forgetful phase.

Its purpose is to provide opportunities to share thoughts and feelings with peers and professionals, and to have some fun. It came about as two separate groups, one being individuals with Alzheimer's and the other, caregivers. Reported fee...


Free research essays on topics related to: alzheimer disease, primary caregiver, family members, term memory, adult children

Research essay sample on Alzheimer Disease Primary Caregiver

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