Alzheimer’s disease affects 5.4 million Americans today, and it projected to affect 16 million Americans by 2050 (Alzheimer’s Association, 2012). Currently, 1 in 8 people over the age of 65 has Alzheimer’s disease, and nearly half of those over the age of 85 have the disease.
Alzheimer’s disease is the most prevalent form of dementia; although all forms of dementia involve destruction of nerve cells, neurons, in the brain. Alzheimer’s disease is characterized by cognitive decline including memory deficit, difficilty or inability to generage coherent speech, failure to understand language, inability to recognize or identify objects, difficulty or inability to execture motor activities, and comprehension, among other symptoms (Alzheimer’s Association, 2012). Individuals require exhaustive care, often for many years. This will clearly affect our health care system and work in health care.
A major impact of the disease is the cost to our health care system. It costs 200 billion dollars to date, including $140 bllion to Medicare and Medicaid (Alzheimer’s Association, 2012). These costs are expected to rise. The Alzheimer’s Association predicts a 500% rise in Medicare and Medicaid costs and total costs of 1.1 billion by the year 2050.
Health care workers will encounter Alzheimer’s patients in hospitals, adult day care, and full time residential facilities. Day and overnight facilities are increasing to provide relief for full-time care givers. Managing Alzhiemer’s patients requires special care because of the often severe cognitive deficits and aggressive behaviors of the patients. Below are innovative approaches that three facilities use.
One facility, Lakeview Ranch, developed an innovative person-centered approach to caring for Alzheimer’s patients with often aggressive and challenging behaviors. They have a highly trained team, do extensive evaluations of patients, and provide “daily dementia-specific activities and therapies (including animal, music, and spiritual therapy)” Their program has reduced the need for psychiatric visits and behavior-related medications. Here is an article about the facility: (http://www.innovations.ahrq.gov/content.aspx?id=3035
Another program, called Timeslips has developed weekly story-telling sessions of Alzheimer’s and dementia patients, where the patients “use their creativity and imagination to create a story with their peers” (Timeslips, 1998). Studies have shown that the program enhances quality of life, improves verbal skills, improves behavior reduces confusion, and increases sociability. Here is more on the timeslips program: http://www.innovations.ahrq.gov/content.aspx?id=2113
Beatitudes, a nursing facility highlighted in a A New York Times article, uses an unusual approach to manage dementia patients. Beatitudes essentially allows patients whatever they desire, including babydolls, unlimited chocolate, bedtime nips of alcohol, and other usually-considered-unhealthy foods, even at odd times of the night or whenever they want. They found that allowing the patients more freedom reduced aggressive and combative behaviors. Allowing the patients chocolate is not considered appropriate in most facilities, but Beatitudes found it to helps tremendously. The latest research indicates that creating a positive emotional experience “diminishes distress and behavior problems” (New York Times, 2010).
Statistics indicate that Alzhiemer’s disease will increase in coming years, and that new approaches to providing care will need to be explored. Most health care workers will undoubtedly have to handle some dementia patients at one time or another. Therefore, training or knowledge in the area of dementia and Alzheimer’s disease will help the patients, families, and health care facilities. Most of us entering the health field may want to think about this population of patients and take a look at the literature regarding new approaches to care.
August Deter, 1901, first patient diagnosed with Alzheimer’s disease by Alois Alzheimer.