Question

Identify a common perceptual, neurological, or cognitive issue and discuss contributing factors. Outline steps for prevention or health promotion for the patient and family.

Answer 1

The division of mental health disorders that primarily affect cognitive abilities including learning, memory, perception, and problem solving, are called neurocognitive disorders (NCD). The NCD are mainly Dementia and Delirium.

Alzheimer's disease is the most commonly seen dementia disorder, and it occurs due to the wasting of brain cells, causing permanent brain damage. The Alzheimer's disease is a progressive disorder, causing steady drop in the thinking (cognition), behavioral and social dexterity, leading to inability in sovereign functioning.

The immediate memory or the recent incidents memory are lost , but the person may remember old events, in the beginning periods of the disease. Then it progresses irreversibly to severe memory loss and daily tasks couldn't be fulfilled by them.

Contributing factors of Alzheimer's disease:

The exact cause or reason for the disease is yet to figure out. The researchers have come up with many factors that can risk the patient for this disease. It is thought to be a blend of genetic, environmental and life style factors. the proteins in the brain cells get destroyed and the normal neurological function get impaired, the neurons get loss connection with each other causing lethal damage to neurons. The neuronal damage starts years before the person presents with the primary symptoms.The main risk factors are

• Age: the chance of getting the disorder increases with age.
• Gender: Females have increased chances of getting the disease, as they live longer than men.
• Family history: If a person's first degree relative(parents or siblings) has Alzheimer's, the risk for the person to get the disease is more
• Down's syndrome: Down 's syndrome people have more chances of getting Alzheimer's disease and that also earlier than others.
• Poor sleep pattern: Scientists say, people who have difficulty in falling sleep and continuing sleep status have more risk of getting the disease.
• Past trauma to brain: Any previous trauma or injury to brain increase the risk of Alzheimer's
• Life style changes: Habits like smoking and sometimes passive smoking, people with high blood pressure, high cholesterol, obesity and lack of exercise etc have high risk of developing the disease.

   Health promotion of the patient with Alzheimer's and family :

The care giver of the patient with Alzheimer's has to be cared too. All the responsibility of the health promotion of the patient lies on the care giver, as the patient can never regain independence and the patient's psychologically disturbed to the core, with no individuality remaining. So the care giver has to be educated and trained to take care of the patient.

Avoid Annoyance of the patient to the minimum:

• chart the routine wisely: The patient may be difficult on some days and may be very familiar on some days. Plan medical appointments, activities like bathing etc on times when the patient is flexible.
• Provide sufficient time: The patient care needs time, and in between activities, the care giver also can rest.
• Involve the patient: The patient can be allowed to do small tasks by herself, with supervision.
• Provide simple instructions: Do not complicate the conversation or instruction, it should be simple and clear.
• Provide choices: two options for drinks, dress to wear etc can be allowed. Do not give too many options , that may confuse and irritate the patient.
• Restrict short naps: Get the patient involved with activities to avoid multiple naps during the day. This helps them to have a steady idea of what's happening around them.

Flexible care giver:

the care giver must be soft and understanding, at some points the patient is completely dependent on the care giver.

If the care giver is not adamant, the patient annoyance will be less, and this may ease the process to some extent.

Also the presentation of symptoms and progress of illness vary with individuals, and the care giver is the best person to know about these.

Protect from injuries:

The patient has to be protected from injuries like a small child. For this the environment has to be designed well and the patient has to be supervised steadily.

• Thermal injury: Avoid thermal injury by not keeping hot liquids near by, lowering thermostat on the hot water heater etc
• Chemical and sharp injury: Keep cupboards locked, if they contain any hazardous chemicals, or drugs, alcohol, toxic items or even sharp items
• Fire injury: Never allow the patient to be alone in kitchen. Keep match box and lighters out of reach.
• Fall injury: Avoid clutter like wires, or toys or slippery rugs on the floor. Install bars or hand rails in walking areas, toilets etc.