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... lings related to dementia from both groups include: anger, anxiety, stress, acceptance, and frustration. The number of individuals who report negative feelings greatly outweigh those of acceptance. At initial meetings, bonding is established through the sharing of early memory experiences.
Gradually, comfort comes from knowing that the victims are not alone; there are others with the same limitations. The realization that the victims are ordinary people with a chronic illness, rather than an uncontrollable mental illness, is comforting. Overall, the most effective coping occurs when the individual recognizes their own mental change, realizes the diagnosis, and deals with the unexpected attitudes of others. Benefits of group support in this early stage of Alzheimer's are considerable. Individuals sharing similar situations gain insight and encouragement through verbal exchange; when real world suggestions were needed, and non- verbally; when words were simply not accessible.
However, as word comprehension and creation becomes increasingly difficult, the individual enters a new stage of disease development. Short-term memory, orientation, and concentration are now severely impaired. Throughout this stage, remote memory, intellectual functioning, comprehension, and judgement decline steadily. Ability to care for one's self also declines, and sleep patterns are altered; this is a severe blow to the patient's independence and self-esteem. The patient then becomes suspicious and paranoid, even of those closest to them. Likelihood of involvement in accidents at home and abuse of medication increase.
Behaviors may include night wandering, night shouting, and nocturnal micturition (night- time urination). Obviously, traditional family behaviors and interactive patterns realize drastic alteration. Family members begin to feel guilty for their impatience and intolerance of the patient, even though many of the demands of the patient are unrealistic and illogical. A major problem for those closest to the patient is readjusting expectations of the patient and themselves. Changes and problematic behavior become a source of stress during this phase, but overall limitation and conflict is reported to decrease, which may simply be the result of institutionalization of the victim.
Use of drugs is found to be twice as high in care-givers as in community subjects, and care-givers often let their own health deteriorate. Particularly for the spouse's caregivers, social isolation becomes an issue of psychological well being. Lack of time, energy, and interest in social activities becomes prominent as the deterioration of the patient increases. In one study, spouses of patients exhibited higher levels of stress, in comparison to adult children caregivers; but husbands, in comparison to wives, report fewer burdens, and are more willing to admit the difficulty of the tasks at hand and seek out professional help. Adult male children are as likely as women are to assist their parents, but the men appeared to have the ability to distance themselves from the aging parent. This physical and emotional separation seemed to lower the amount of guilt felt by the men.
Possibly because of these differing abilities to deal with the disease, there is often conflict between family members as to how to care for the victim. Two broad coping techniques of family members of Alzheimer victims are: (1) Distancing techniques and (2) Enmeshing techniques. Distancing techniques (as discussed earlier) involve establishing distance between the patient and caregiver both emotionally and physically. Enmeshing techniques involve the intensification of the relationship, and often the exclusion of others. This option is usually observed in cases where the spouse is the primary caregiver. Apparently, it is very difficult for spouses who use the Enmeshing technique to become involved in social support groups.
Social support is a proven mediator and alleviator of family stress and patient dejection. Adult day care programs provide respite for family members, and allow the patient to interact with individuals with similar conditions. Generally, the patients see the support group as being most helpful in the areas of information sharing and peer support. This information and assistance may help determine the strength of the individual in last stages of the disease. This phase is the final stage of Alzheimer's disease.
Mental deterioration is complete; many patients are completely unaware of, or unable to respond to their surroundings. The patients are totally dependent on others for all aspects of daily living. The patient will, most likely, not identify family and friends, and may not communicate at all. Paranoia, agitation, and combativeness increase significantly, if the patient is able to display these emotions at all. He / she eventually becomes extremely weak, incontinent, non-ambulatory and bedridden. It has been hypothesized that at least some of the pre morbid changes in strength and weakness may be predicted from changes observed in the earlier stages.
Descriptions by caregivers of pre morbid personality traits of the victim are similar to symptoms of depression, hallucinations, and delusions. It is during this stage that most victims are admitted to an institution for professional care. Several behavioral problems such as aggression and wandering appear to increase as individuals are moved from the community to nursing homes. Acceptance of this disturbing disease comes very slowly to the family members. The disease's sly onset and the original appearance by the victim of retention of regular physical vigor make acceptance increasingly difficult. As the disease progresses further and further, the changes that occur for the victim become increasingly obvious and family members tend to define the situation more similarly than in previous, seemingly inconspicuous stages.
The grieving process is lengthy, because the death of the person is long before the death of the physical body. Although the loved one is long gone, their shell lives on. At some point during this stage, the spouse must undergo the final challenge of marital evaluation. Because the patient does not recognize anyone, the spouse is totally alone, but not single. Obtaining a divorce often creates many difficult legal issues. Many caregivers need assistance coping with the guilt of "abandoning" their spouse when placing them in a nursing home.
Thus, financial problems come into the picture. Paying for nursing home services is difficult, as all effort in previous years has been put into caring for the patient. Relatives of deceased victims can be compared to those whose family member is still living. Wives and husbands display similar feelings of burden, but the husbands report more social limitations. On the contrary, sons and daughters are different in their descriptions of burden.
Sons report less social limitations than daughters do, and less affective limitation when the demented parents had died. The sons of the deceased elderly also report less conflict with others than the daughters do. The need for individual support for the caregiver and family of the deceased is important, especially at this stage of sorrow. There may also be a sense of relief and release, as the extensive suffering of a loved one has finally ended. The empty body, which once contained a loved one, can finally be put to rest. Help and support from the staff at institutions with dealing with the grief of the final loss of a loved one is valuable and most definitely appreciated.
Alzheimer's Disease is a ceaseless debilitating disease without known cause or cure. Deterioration of mental and physical processes is inevitable, but varies between individuals- the cause for this variance has only been looked at hypothetically. It is a terrifying disease for the victim, who is constantly aware of the losses that are occurring, but can do nothing to prevent the disease from proceeding on its deadly course. Family members respond to the disease within certain guidelines, but the attitude towards the different stages differs for all involved. Social support systems have proven extremely effective for both the victim and caregiver in the Forgetful phase of the illness. From that point on, influence on patients decreases significantly, but personal gain for caregivers continues.
There is an evident need for publicly funded support for Alzheimer's disease victims and their families. The obvious lack of information concerning the symptoms and results of the disease show the necessity for incorporation of education and support into intervention strategies for caregivers. Evaluation of a patient with possible dementia requires a complete medical history, neurologic evaluation, and physical examination. At the present time, no diagnostic tests for Alzheimer's are available in laboratories. It is simply a diagnosis based on elimination of other diseases. There is great need for a biological marker that would confirm the diagnosis of Alzheimer's in a living patient.
Rapid progress has been made in identifying a potential genetic marker that could be used to diagnose the disease without autopsy, biopsy, or extended evaluations. Potential disadvantages of this approach would be the reluctance of both patients and physicians to have lumbar punctures done, and the potential overlap of normal patients and Alzheimer sufferers. These potential markers are a glimpse of light at the end of a dark tunnel. Metaphorically, Alzheimer's can be seen as a house that is constantly being eaten by termites, from the inside out. Although the house may look the same on the outside, the very foundation of the house, the part that makes it a home, deteriorates.
Attempts to stop the decay are futile and, at best, temporary. Eventually, one will not feel comfortable at home, and will most likely leave the home- possibly for someone else to deal with. This relief is also temporary. The eating away of the house continues, until it eventually topples into an unrecognizable heap of what used to be a home. This feeling was best described by one individual in the middle stages of the disease: " (J) ust a wild lost world. I'm here but I don't know where I am." Bibliography:
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Research essay sample on Alzheimer Disease Family Members
