Running head: CHRONIC ILLNESS 1

CHRONIC ILLNESS 8

Treatment of Dementias, Including Alzheimer’s Disease

Estrella Gonzalez

South University

SU-NSG4055-WK1-A3

Treatment of Dementias, Including Alzheimer’s disease

About Dementia and Alzheimer’s disease

Dementia is characterized by the declining of cognitive functioning. The thinking, memory, and reasoning capabilities of a person with dementia is influenced to a point that interferes with their ability to do their daily activities (Alzheimer’s Association, 2016). The dementia itself is not an illness it is the most prevailing symptom of Alzheimer’s. Alzheimer’s disease is the cause of between 60% and 80% of all dementia cases (Alzheimer’s Association, 2016). There are various other factors that can lead to a demented state such as severe mental illness such as depression, delirium, dehydration, chronic alcoholism, some brain tumors and illnesses, or even Vitamin B12 deficiency (Ridley, Draper & Withall, 2013; Rossor et al., 2010). The reason for selecting dementias and Alzheimer’s disease is because these are associated with much other comorbidity which can easily affect a patient when not properly taken care of. Individuals with dementia are three times more prone to be hospitalized for preventable reasons. The loss of cognitive functioning makes the patients of dementia and Alzheimer’s to be dependent on others to do even the simplest of daily tasks. This makes coping with these conditions hard not only for the patients but also for their caregivers, family, support groups, and peers. Therefore, it is important to develop a good care plan for such patients to cater for their psychosocial needs as well as their biomedical needs.

Morbidity and Comorbidity of Dementia and Alzheimer’s disease

Other form of dementia and Alzheimer’s are leading cause of disability in America. In 2014 Alzheimer was one of the principles causes of mortality in the United States. Based on the death certificate data, Alzheimer’s is the 6th leading cause of mortality for adults aged 18 and older (HealthyPeople2020, nd). This illness is mainly common among the elderly population aged 65 and older. As of 2016, the prevalence of this disease in this population group was 11%, which are approximately 5.2 million people. Around 4% of all deaths in 2014 were Alzheimer’s related (HealthyPeople2020, nd). The percentage of Alzheimer’s disease-related deaths has increased significantly, partly because of the increased elderly population. The death rate due to Alzheimer’s has increased by 55% since 1999 (HealthyPeople2020, nd).

Alzheimer’s and other forms of dementia are commonly associated with other physical and psychiatric comorbidities. Some of the common psychiatric comorbidities associated with dementia and Alzheimer’s include depression, bipolar disorder, and schizophrenia (Garcez et al., 2015). They have also been associated with other non-psychiatric illnesses such as sleep apnea, thyroid disorder, glaucoma, and osteoporosis (Duthie, Chew, & Soiza, 2011). Beatriz Poblador-Plou et al. (2014), also found that dementia commonly co-occurs with other illnesses like diabetes, hypertension, congestive heart failure, cerebrovascular diseases, Parkinson’s disease, cardiac arrhythmia, and neurosis.

The Impact of Dementia, including Alzheimer’s disease on the Overall Health of the Nation

Alzheimer is expected to increase double in the future costs of America’s public health system. Currently more than 5 million individuals live with dementia in our country, Alzheimer’s disease being the most common and only 4% of the diagnoses being of people below the age of 65 (Dharmarajan & Gunturu, 2009). Dementia is one of the most costly chronic illnesses in our country. The government uses costs above $100 million in efforts to take care of this syndrome. The average annual cost of taking care of Alzheimer’s per patient is around $42,000 for hospitalized patients and $12,000 for those living within the communities (Dharmarajan & Gunturu, 2009). Therefore, one of the main impacts of this illness on the nation is the increased healthcare costs, which are catered for by the government and the families, friends, and support systems of the patients.

Healthy People 2020 Goals and Objectives for Dementias and Alzheimer’s disease

The main goal of the Healthy People 2020 initiative is to decrease the deaths linked with this medical conditions previous mentioned and reduce the expenses relate with keeping up and upgrading the personal satisfaction for the general population with Alzheimer’s disease and other forms of chronic dementia. There are two main objectives that need to be achieved for this goal to be materialized. First, Healthy People 2020 has the goal to expand the quantity of elderly above 65 years who are diagnosed with Alzheimer or other forms of dementia and to have caregivers who are aware of their respective diagnoses. Between 2007 and 2009, only 34.8 patients of dementia and Alzheimer’s were diagnosed of their respective illnesses and received the expected treatment. Healthy People 2020 hope to achieve a 10% improvement on this rate. The second objective is to reduce the number of preventable hospitalization of elderly people above the age of 65 who have dementia, including Alzheimer’s disease. Between 2006 and 2009, 23.5% of elderly people diagnosed with dementia or Alzheimer’s disease were hospitalized because of a preventable issue. Healthy People 2020 aim to have a 10% improvement to reduce this rate to 22.8. The achievement of these goals and objectives will ensure that patients with these conditions will receive the appropriate treatment and care to reduce the negative outcomes associated with them.

The above medical condition are also responsible for the overall decline of the quality of public health in America. The illnesses are associated with various other physical and psychological illnesses, which in some cases lead to the death of the patients. This is among of main causes of mortality for the older population in the United States. Therefore, there is need to develop better care models for patients with these conditions to reduce the negative effect their illness has on America’s public health.

Questionnaire for Care Plan Preparation

Considering that Dementias and Alzheimer’s disease are characterized by cognitive decline, it is expected that some patients may not be able to answer this questionnaire. Therefore, this questionnaire of meant for patients who are at the first stages of their illness when their cognitive skills are still not completely impaired so that they can have long enough periods of being lucid. For the patients without the cognitive abilities to understand or answer these questions, their immediate family members or caregivers with an extended understanding of their illness can answer the questions. These questions aim at understanding the psychosocial life of the patient to develop a care plan that will not only target the illness but also its psychological and social effects on the patient.

· Have you been diagnosed any of the disease mentioned before? If yes, how long ago?

· What symptoms have you experienced as a result of the illness?

· Have you had any treatments targeting this illness specifically?

· Have you experienced other illnesses relating to this illness?

· How do you feel dementia or Alzheimer’s disease has impacted the quality of your life?

· Do you have any support system such as family, friends, or acquaintances that assist in taking care of you?

· What are your likes, dislikes, and interests?

· How was your day structured before you were diagnosed with dementia or Alzheimer’s disease?

· At what time of the day do you function the best?

· What is your daily routine like after diagnosis?

References

Alzheimer’s Association. (2016) Alzheimer’s Disease Facts and Figures. Alzheimer’s and Dementia 12(4):405–509.

Dharmarajan, T. S., & Gunturu, S. G. (2009). Alzheimer’s disease: a healthcare burden of epidemic proportion. American health & drug benefits2(1), 39.

Duthie, A., Chew, D., & Soiza, R. L. (2011). Non-psychiatric comorbidity associated with Alzheimer’s disease. QJM: An International Journal of Medicine104(11), 913-920.

Garcez, M. L., Falchetti, A. C. B., Mina, F., & Budni, J. (2015). Alzheimer s disease associated with psychiatric comorbidities. Anais da Academia Brasileira de Ciências87(2), 1461-1473.

HealthyPeople2020 (n.d). Dementia, Inclusing Alzheimer’s Disease. Retrieved from: https://www.healthypeople.gov/2020/topics-objectives/topic/dementias-including-alzheimers-disease

National Center for Health Statistics. (2015). Health, United States, With Special Feature on Racial and Ethnic Health Disparities. Hyattsville, (MD): National Center for Health Statistics; 2016. Report No. 2016-1232. Retrieved from: http://www.cdc.gov/nchs/data/nvsr/nvsr64/nvsr64_02.pdf.

Poblador-Plou, B., Calderón-Larrañaga, A., Marta-Moreno, J., Hancco-Saavedra, J., Sicras-Mainar, A., Soljak, M., & Prados-Torres, A. (2014). Comorbidity of dementia: a cross-sectional study of primary care older patients. BMC psychiatry14(1), 84.

Ridley, N. J., Draper, B., & Withall, A. (2013). Alcohol-related dementia: an update of the evidence. Alzheimer’s research & therapy5(1), 3.

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