Alzheimer’s Disease Research Paper
Therapeutic
Approaches to Challenging Behaviors of Patients with Alzheimer’s Disease:
Introduction
Alzheimer’s disease is a very serious health problem that affects many people and results in the dramatic change of their lifestyle and the life of their environment. It is necessary to underline that such health problems as Alzheimer’s disease need a profound attention not only from the part of health care professionals but also from the part of members of the family of an individual suffering from this disease because his/her behavior can become very dangerous for him/herself and for his/her environment. It should be said that the risk of challenging behaviors progress in the course of the development of the disease and its growing impact on the physical and psychological state of a patient. It is not a secret that even the early stage of the development of the disease can provoke some challenging behavior such as increased aggressiveness, for instance.
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At the same time, the prevention of challenging behaviors of patients with Alzheimer’s disease is of a paramount importance since it can minimize the negative impact of the disease on the life of the patient and his/her environment. On the other hand, without the assistance of his/her family and health care professionals an individual suffering from Alzheimer’s disease cannot cope with challenging behaviors. In fact, the most effective treatment of Alzheimer’s disease and challenging behaviors related to this heath problem should combine the mutual efforts of the family of a patient and work of health care professionals, including effective medication.
Basic challenging behaviors of patients with Alzheimer’s disease
In actuality, specialists underline that the progress of Alzheimer’s disease may be accompanied with various challenging behaviors which are, to a significant extent, determined by the environment of the patient and his lifestyle (Walker and Rosen, 2006, p.332). At the beginning of Alzheimer’s disease challenging behaviors may be not so obvious, though it even at the first stage of the disease it is possible to notice the decline of logical thinking, independent judgments, and problem solving abilities. In such a situation, the behavior of a patient make become really unpredictable and sometimes is accompanied by the growing aggressiveness, which, though, is not so obvious as on the later stages of the disease. The middle stage of the progress of Alzheimer’s disease is characterized by the growing risk of the development of challenging behavior since a patient’s health problems may result in confusions and disorientation. As a result, cannot behave adequately in various social situations or even get lost in his/her own house. At the final stage, a patient practically cannot lead an independent life. Eventually, he/she cannot even eat and drink without the assistance of another person, a caregiver. In such a way, the middle stage of the disease is characterized by the growing challenging behaviors and, at this stage, patients are probably the most dangerous for their environment as well as for themselves since on the first and the last stages they can either relatively control their behavior or, in contrast, they are disabled.
Speaking about the most widely spread challenging behaviors, it should be pointed out that the most common challenging behaviors are wandering, rummaging through things or hidden things, unmotivated anger, belligerence, aggressiveness, hallucination, illusions, paranoia, eating problems such as refusal to eat.
In fact, challenging behaviors of patients with Alzheimer’s disease are provoked by psychological problems such as growing anxiety, hallucinations, etc. At the same time, the physiological changes also produce a profound impact on the inner state of patients. This is why it is necessary to take these factors into consideration, while working out effective strategies of the prevention of negative effects of challenging behaviors of patients with Alzheimer’s disease.
Positive and negative aspects of family carrying
Obviously, family carrying plays an extremely important role in the prevention and treatment of challenging behaviors of patients with Alzheimer’s disease. In this respect, it should be said that members of the family of a patient are very significant people to the patient and, therefore, the state of patient is highly dependent on the attitude and assistance of his family. It is worthy of noting that, as a rule, members of the family of a patient are the main caregivers who naturally assist to the work of health care professionals. On the other hand, it is necessary to underline that the impact of the family on the state of the patient and his challenging behaviors may be dubious. To put it more precisely, the family of a patient may produce not only positive but also negative impact on the patient and his psychological state.
In actuality, the family is highly responsible for patients suffering from Alzheimer’s disease. At the same time, it is the family that face challenging behaviors of patients with Alzheimer’s disease first. This is why it is extremely important that members of the family were very attentive to patients and notified all the changes that occur to patients and inform health care professionals about them. In such a way, the latter will be able to react adequately and in time on the changes in the progress of the disease. This means that the family fulfils the assistant role in the treatment of the patient and prevention of challenging behaviors.
Furthermore, members of the family should be very careful in their attitude to the patient with Alzheimer’s disease. What is meant here is the fact that it is the ambiance within the family, the surrounding of the patient, the attitude of the family to him/her that influence considerably his/her state. In practice, this means that the family should create a positive ambiance within the family, in order to prevent any kind of psychological disturbance which can provoke challenging behaviors such as aggressiveness, or even paranoia.
At the same time, the family should constantly take care of the patients, especially on the middle and naturally late stages of the disease in order to minimize the risk of patients getting involved in some problematic situations, such as getting lost that may provoke a profound nervous stress, while the latter may lead to challenging behaviors such as wandering or hallucinations, for instance.
On the other hand, there are also considerable risks of producing negative impact on the state of the patient from the part of the family. First of all, it should be pointed out that the family may not pay enough attention to the patient that may contributed to the rapid progress of the disease. Moreover, health problems of the patient may be simply ignored by members of the family. The latter is particularly important, if the patient lacks communication with other people. In actuality, the lack of communication is one of the causes of Alzheimer’s disease and its progress, deteriorated by the lack of communication, can naturally result in challenging behavior, such as hallucination, wandering, inability or refusal to eat, and others. In the situation, when the family ignores such problems of the patient his/her state deteriorates and challenging behaviors progress making him/her socially dangerous, though the patient can also cause harm to him/herself.
Also, the family may provoke challenging behaviors of the patient if his/her family cannot provide him/her with a positive ambiance. In practice, this means that the problem of challenging behaviors of the patient with Alzheimer’s disease can deteriorate considerably if there are some conflicts or scandals within the family, or if the patient is constantly humiliated or oppressed, for instance (Schmitz et al, 2004, p.1496). Naturally, such an attitude cannot improve the state of the patient and, what is even more important, it can deteriorate his/him state and minimize the positive impact of medication or treatment conducted by health care professionals.
At any rate, it is obvious that the family of the patient should be cooperative in order to increase the effectiveness of treatment. In this respect, it is also worthy of mention of the problem of objectivity in the assessment of the state of the patient. What is meant here is the fact that often members of the family of the patient cannot adequately and objectively assess the state of the health of the patient and believe that he/she does not really have any health problems, while, in actuality, Alzheimer disease may progress, at the moment (Walker and Rosen, 2006, p.333).
Management/therapeutic approaches to the treatment of challenging behaviors
Obviously, the prevention and treatment of challenging behaviors of patients with Alzheimer’s disease need the implementation of effective approaches of treatment, which should be based on the cooperation of the family and health care professionals as the main caregivers that help the patient to cope with his/her problems, including challenging behaviors.
First of all, it should be said that one of the major conditions of the effective prevention and treatment of challenging behaviors of patients with Alzheimer’s disease is the diagnosis of the disease at the early stage of its development. This is extremely important because it provides health care professionals with an opportunity to start the treatment of the disease at the beginning that will naturally slow down the progress of the disease and, therefore, this will minimize the risk of challenging behaviors. Basically, the medication treatment is considered to be quite effective to overcome the main challenges the patient with Alzheimer’s disease may face, especially at the early stage of its development. For instance, it is possible to use sedative medicaments to decrease the aggressiveness of patients, minimize the level of stress they can suffer from and, consequently, decrease the risk of such challenging behavior as wandering (Rickey, 2002, p.238).
At the same time, it is necessary to remember that health care professionals should also play an important role in the changing of the attitude and proper behavior of members of the family to the patient. In other words, health care professionals should amply consult members of the family of the patient suffering from Alzheimer’s disease what actions they should undertake in order to minimize the risk of challenging behaviors and prevent the deterioration of the state of the patient. In such a way, heath care professionals should be consultants of the family in this regard.
As for the family, its role in the management of the treatment of challenging behaviors of the patient with Alzheimer’s disease can hardly be underestimated. In fact, it has been already said that the attitude of the family and the correct behavior of its members in relation to the patient are, to a significant extent, determinant factors influencing his/her psychological state. In this respect, the family should avoid conflicts within the family that the patient may witness since it will affect his internal state negatively. Furthermore, there should exist a strict order in the house, in order to make the patient feel comfortable. This means that it is necessary to arrange the interior of the house in the simplest way so that patient could feel at ease, which changes in the house are not recommended since it may puzzle the patient and provoke challenging behaviors.
Another important aspect of the effective management of challenging behaviours is the necessity to constantly take care about the patient, especially at the middle and late stages of the disease. In practice, this means that the patient should not be left alone, he/she needs to feel always support of his/her family or, at any rate he/she should feel that he/she is not alone. By the way, the communication with the patient is also of a paramount importance in the prevention of challenging behaviours since this may result in certain stabilization of the state of the patient as he/she will feel support of other people.
Recommendations
Obviously, the effective treatment of patients with Alzheimer’s disease is quite a relative concept since, as a rule, it is very difficult to prevent the progress of the disease, while the prevention of challenging behaviours it provokes may be even more difficult. In such a situation, it is extremely important to develop an effective mode of behaviour in relation to the patient and establish certain rules the entire should follow in order to minimize the negative effects of the disease and possibly prevent challenging behaviours of the patient.
Primarily, it is necessary to underline that in the treatment of such challenging behaviours as wandering it is important to prevent the patient from going into areas of the house that are off-limits, such as stairwells, decks, etc. (Schmitz et al, 2004, p.1498) since it represents a serious threat to the health of the patient. Also, it is necessary to avoid leaving the house with a window or door to go outside since it may provoke the patient wandering and result in the patient’s getting lost since he/she cannot adequately react on the surrounding world and is not responsible for his/her actions. For the same purpose, it is necessary to prevent the patient from leaving the yard or property where the family actually lives (Schmitz et al, 2004, p.1500).
At the same time, it is possible to recommend making the life of patients more comfortable in order to prevent them from wandering. For instance, it is possible to recommend the acquisition of comfortable chairs that are difficult for patients with Alzheimer’s disease to get out of. Such chairs are pleasant and restrict the movement out of the chair. As a result, the risk of wandering decreases (Rickey, 2002, p.245).
On the other hand, it is also necessary to react immediately and adequately at the changes in the behaviour of the patient that indicates to his/her intention to start wandering that means that it is necessary to redirect pacing and restless behaviour into some productive activity. Also, it is necessary to reassure the patient if he/she appears disoriented. In general, it is necessary to clearly schedule the day of the patients so that he/she was constantly involved into some productive activity that would prevent him/her from wandering. It is worthy of mention that wandering may occur at a particular time of a day. In such a situation, it is necessary to involve the patient into some productive activity in this particular time of the day (Schmitz et al, 2004, p.1501).
At the same time, it is necessary to remember that such problems as wandering and disorientation may be the result of side-effect of medication. This is why it is necessary to inform the health care professional immediately about the side-effects of the medication and the latter should implement essential changes in order to prevent the negative consequences of medication.
Conclusion
Thus, taking into account all above mentioned, it is possible to conclude that challenging behaviours of patients with Alzheimer’s disease, such as wandering, are widely spread and are the result of the deterioration of psychological and physiological state of the patient. In such a situation, the assistance of the family of the patient and its cooperation with health care professionals is of a paramount importance. Basically, the treatment and prevention of challenging behaviours should target at the minimization of risks of the patient’s getting involved into some difficult psychological situations, such as conflicts within a family, and the thorough control over his/her behaviours that can be also quite effective.
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