● Family caregivers often have a sense of grief, loss, and guilt pertaining to their loved one, so providing support for the caregiver can be a tremendous asset to the entire care team. ● Providers and healthcare professionals are often unaware of the available resources in the community, so engage and educate them so that they can refer people. ● Create a support network for family caregivers—often they provide insight and recommendations that can be helpful. ● Draw boundaries, as appropriate, between social services and family caregivers—while it is the goal to address each Conclusion Alzheimer’s disease is complex, difficult to comprehend, and full of conflicts for the patient and caregivers. Understanding the stages and disease progression allows for planning, lifestyle changes, and integration of safety measures that can improve well-being. As more people are diagnosed, there will be a continued need for research, testing, and communication among the AD community to identify innovative ways to improve. • Alzheimer’s Association. (2022). Bathing . https://www.alz.org/help-support/caregiving/daily- care/bathing • Alzheimer’s Association. (2022). Stages of Alzheimer’s . https://www.alz.org/alzheimers- dementia/stages • Borda, M. G., Jaramillo-Jimenez, A., Tovar-Rios, D. A., Ferreira, D., Garcia-Cifuentes, E., Vik-Mo, A. O., Aarsland, V., Aarsland, D., & Oppedal, K. (2020). Hippocampal subfields and decline in activities of daily living in Alzheimer’s disease and dementia with Lewy bodies. Neurodegenerative Disease Management , 10 (6), 357-367. https://doi.org/10.2217/nmt- 2020-0039 • Flo, B. , Matziorinis, A. , Skouras, S., Sudmann, T. Gold, C., & Koelsch, S. (2022). Study protocol for the Alzheimer and music therapy study: An RCT to compare the efficacy of music therapy and physical activity on brain plasticity, depressive symptoms, and cognitive decline, in a population with and at risk for Alzheimer’s disease. PLOS ONE , 17 (6). https:// doi.org/10.1371/journal.pone.0270682 • Johns Hopkins Medicine (2022). https://www.hopkinsmedicine.org/health/conditions-and- diseases/dementia/dementia-with-lewy-bodies • Johns Hopkins Psychiatry (2022). https://www.hopkinsmedicine.org/inhealth/precision- medicine-centers/alzheimers/index.html • Mayo Clinic. (2022, February 19). Alzheimer’s disease: Symptoms and causes . https:// www.mayoclinic.org/diseases-conditions/alzheimers-disease/symptoms-causes/syc- 20350447#:~:text=Scientists%20believe%20that%20for%20most%20people%2C%20 Alzheimer%27s%20disease,virtually%20guarantee%20a%20person%20will%20develop%20 the%20disease • Michael J. Fox Foundation, (2022). https://www.michaeljfox.org/parkinsons-360 • References • Alzheimer’s Association (2022). Quick facts. Müller, M., Jürgens, J., Redaèlli, M., Klingberg, K., Hautz, W. E., & Stock, S. (2018). Impact of the communication and patient hand-off tool SBAR on patient safety: a systematic review. BMJ Open , 8 (8), e022202. https://doi.org/10.1136/bmjopen-2018-022202
individual situation as it arises, there must be a general focus on service delivery that is for the good of the community served. Understand that caregivers are often exhausted and confronting stress they are unprepared for, combined with grief and loneliness. The synergy between a caregiver, the professional support, and the person with ADRD can be lifesaving and improve the overall well-being of everyone in a difficult time. As healthcare providers it is incumbent on us to align with the appropriate professionals who can fill in gaps of care, communication, and shared information to empower and serve our patients with honesty and integrity. This disease requires a comprehensive community approach to ensure that people have access to healthcare and services that can be of value to both caregivers and patients. • National Institute on Aging. (2021). What is Dementia? Symptoms, types, and diagnosis . https://www.nia.nih.gov/health/what-is-dementia • National Institute on Aging. (2022). Parkinson’s disease: Causes, symptoms, and treatments . https://www.nia.nih.gov/health/parkinsons-disease • Ophey, A., Wolfsgruber, S., Roeske, S, Polcher, A., Spottke, A., Frolich, L., Hull, M., Jessen, F., Kornhuber, J., Maier, W., Peters, O., Ramirez, A., Wiltfang, Jens., Liepelt-Scarfone, I., Becker, S., Berg, D., Schulz, Jorg., Reetz, K., Wojtala, J., Kassubek, J., Storch, A., Balzer- Geldsetzer, M., Hilker-Roggendorf, R., Witt, K., Mollenhauer, B., Trendkwalder, Wittchen, H., Riedel, O., Dodel, R., Wagner, M., Kalbe, E. (2021). Cognitive profiles of patients with mild cognitive impairment due to Alzheimer’s versus Parkinson’s disease defined using a base rate approach: Implications for neuropsychological assessments. Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association, 13, e12223. https://doi.org/10.1002/ dad2.12223 • Palmdorf, S., Stark, A., Nadolny, S., Eliaß, G., Karlheim, C., Kreisel, S., Gruschka, T., Trompetter, E. & Dockweiler, C. (2021). Technology-assisted home care for people with dementia and their relatives: Scoping review. JMIR Aging , 4(1). https://doi. org/10.2196/25307 • Shin, J. Y., & Habermann, B. (2022). Caregivers of adults living with Alzheimer’s disease or dementia in 2020: A secondary analysis. Journal of Gerontological Nursing , 48 (9), 15-25. https://doi.org/10.3928/00989134-20220805-02 • https://doi.org/10.1002/dad2.12223World Health Organization (2022). Dementia. https:// www.who.int/health-topics/dementia#tab=tab_2 • Zhao, Y. L., Qu, Y., Ou, Y. N., Zhang, Y. R., Tan, L., & Yu, J. T. (2021). Environmental factors and risks of cognitive impairment and dementia: A systematic review and meta-analysis. Ageing Research Reviews , 72, 101504. https://doi.org/10.1016/j.arr.2021.101504
ALZHEIMER’S DISEASE AND OTHER DEMENTIAS: SYMPTOMS, STAGES, AND COMMUNICATION STRATEGIES (MANDATORY) Self-Assessment Answers and Rationales
1. The correct answer is B . Rationale: Dementia is a combination of behaviors and impairment that are a result of brain change. If a person is manifesting dementia symptoms, it is important that they undergo a physical exam to identify the root problems causing the issues. 2. The correct answer is A. Rationale: Amyloid plaques and tau tangles form on the brain and over time impair normal cognitive function. The plaques and tangles take about 15–20 years to cause noticeable AD symptoms. Early detection and lifestyle adjustments may help slow symptoms. 3. The correct response is C. Rationale: As AD progresses it is imperative that the patient is kept safe while still having a sense of autonomy. This stage is pivotal in the life of the afflicted. Maintaining a dignified life is important, while at the same time ensuring physical safety to avoid accidents and wandering.
4. The correct answer is B. Rationale: Aphasia may begin in earlier stages of ADRD but can worsen over time as the brain is further impaired. The person may be aware of this loss of language and can become frustrated. Caregivers need to identify other means of communicating with the person. 5. The correct answer is A. Rationale: Clothing that is easy on/easy off will enable the patient to remain independent for a longer period of time. This will also reduce stress for the caregiver and can potentially reduce conflict and disruption.
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