Community Teaching Plan for Alzheimer’s Disease

 In the community teaching, Alzheimer’s Disease was the topic chosen from Healthy People 2020. The Alzheimer’s teaching was a very good experience because it was interesting to see how many people are living with Alzheimer’s or have family and friends that have been afflicted with this terrible disease, but yet know very little about it. The medical community still doesn’t have a cure for this disease so prevention becomes paramount in the fight against it.  The teaching touched on various prevention measures that people can implement to increase their odds against this disease.

Alzheimer’s Disease is the most common type of dementia. It’s a progressive disease beginning with mild memory loss possibly leading to loss of the ability to carry on a conversation and respond to the environment. It involves parts of the brain that control thought, memory, and language. Alzheimer’s Disease can seriously affect a person’s ability to carry out daily activities. Every 65 seconds someone in the United States develops the disease. Census data suggests that the prevalence of dementia among adults aged 65 years and older in the U.S. in 2016 is 11%, or 5.2 million people. Alzheimer’s Disease is the 6th leading cause of death in the United States. The symptoms of the disease can first appear after age 60 and the risk increases with age. Increasing age is the greatest known risk factor for Alzheimer’s. Younger people may get Alzheimer’s disease, but it is less common. The number of people living with the disease doubles every 5 years beyond age 65. This number is projected to nearly triple to 14 million people by 2060. Worldwide, around 50 million people have dementia, and there are nearly 10 million new cases every year. (“Dementia”, n.d) Many countries do not possess the diagnostic tools, and do not have the doctors and researchers with the expertise to diagnose this disease, therefore the number of undiagnosed patients may be substantially higher.

 Between two thousand and two thousand fifteen, the deaths from Heart Disease have decreased eleven percent while deaths from Alzheimer’s have increased one hundred twenty three percent. One in three seniors dies with Alzheimer’s or other types of dementia. This disease kills more than breast cancer and prostate cancer put together. The earlier this disease is diagnosed the more lives that could be saved. It is estimated that seven point nine trillion dollars in medical and care cost and be saved. In twenty eighteen Alzheimer’s and other types of dementias will cost the American people two hundred seventy seven billion by twenty fifty. It is possible for this cost to rise as high as one point one trillion dollars. (Facts and Figures, n.d)

Alzheimer Disease was named after Dr. Alois Alzheimer. Which in 1906, he noticed changes in the brain tissue of a woman who had died of an unusual mental illness. The women exhibited symptoms included memory loss, language problems, and unpredictable behavior. After she pasted away, Dr. Alzheimer examined her brain and found some abnormal clumps and tangled bundles of fibers. These clumps are now called amyloid plaques. Amyloid plaques and tangles in the brain are still considered some of the main features of Alzheimer’s disease. As Scientists continue to unravel this complex brain change involved with the onset and progression of Alzheimer’s disease, what has been learnt is that it appears that the damage to the brain starts decades or more before memory and other cognitive problems appear. As more neurons are destroyed, other parts of the brain start becoming affected, which causes them to begin to shrink. The final stage of Alzheimer’s damage is widespread, and brain tissue has shrunk significantly. (Alzheimer’s Disease Fact Sheet, n.d)

“Memory problems are typically one of the first signs of cognitive impairment related to Alzheimer’s disease. The first symptoms of Alzheimer’s vary from person to person. For many, decline in non-memory aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment, may signal the very early stages of Alzheimer’s disease”. (“Alzheimer’s Disease Fact Sheet”, n.d)

Alzheimer’s has three distinct stages mild, moderate and severe and also referred to early, middle and late stages. During the mild stage of Alzheimer’s, disease progresses and people experience greater memory loss and other cognitive difficulties. Some of the problems that manifest are wandering and getting lost, repeating questions, and taking longer to complete normal daily tasks. During the mild stage of Alzheimer is usually when people are diagnosed. During the moderate stage, damage starts occurring in different parts of the brain that control language, reasoning, sensory processing, and conscious thought. Memory loss and confusion can become worse, and people can even begin to have problems recognizing family and friends. Ultimately, things continue to get worse in the severe stage as plaques and tangles spread throughout various parts of the brain, and the brain tissue shrinks significantly. Once a person develops severe Alzheimer’s they cannot communicate and are completely dependent on others for individual care. (Alzheimer’s Disease Fact Sheet, n.d)

Alzheimer’s disease is very complex, so it is unlikely that any one drug or intervention can successfully provide treatment. Currently, approaches tend to focus on helping people maintain mental function, manage behavioral symptoms, and slow down certain problems, such as memory loss. There are several medications for maintaining mental function approved by the U.S. Food and Drug Administration (FDA) to treat symptoms of Alzheimer’s. Donepezil (Aricept), rivastigmine (Exelon), and galantamine (Razadyne) are used to treat mild to moderate Alzheimer’s, (donepezil can be used for severe Alzheimer’s as well). Memantine (Namenda) is used to treat moderate to severe Alzheimer’s. These drugs work by regulating neurotransmitters, the chemicals that transmit messages between neurons. They may help reduce symptoms and help with certain behavioral problems. However, these drugs don’t change the underlying disease process. (Alzheimer’s Disease Fact Sheet, n.d)

Some additional options include keeping a safe environment by removing unnecessary furniture, clutter and throw rug in the home. Make sure all handrails on stairways and in bathroom are sturdy. Verify that shoes and slippers are comfortable and provide good traction. “The caregivers can provide high calorie, healthy shakes and smoothies to satisfy nutrition requirements. Exercise can also promote restful sleep and prevent constipation since activities help improve mood and maintain health of joints and muscles”. (Alzheimer’s Disease Fact Sheet, n.d)

My teaching is to educate Elderly- Adults (50 years of age and older) with higher risk of Alzheimer’s disease the information available to them in accordance to the Healthy People 2020 objectives. Based on the data available at Healthy People 2020, at baseline, 34.8 percent of adults aged 65 or over with a dementia diagnosis, or their caregiver, were aware of the dementia diagnosis in 2007–09. The target is 38.3 percent, based on a target-setting method of 10 percent improvement. To achieve progress towards this, actions include ensuring that both the public and health care providers are aware of the early warning signs of Alzheimer’s dementia; educating health care providers on early detection and diagnosis, including patient/family communications and documentation in medical records; and assessing cognition during the Medicare Annual Wellness Visit (AWV). (Dementias, Including Alzheimer’s, n.d)

The community response to the teaching was positive but it is important to remember Dementia is a rapidly growing problem in all parts of the developing world. Many of these societies are characterized by low levels of awareness regarding this disease as a chronic degenerative brain syndrome. They often have a lack of supportive health and welfare services. People with this affliction will have a reliance on their families as the cornerstone of support and care. However, surprisingly little is known of the care that is arranged for the people with dementia and the strain experienced by the family and caregivers.  In a study of seventy caregivers of people with Alzheimer’s disease identified through an innovative case-finding program in five different community in Indo-Nepal Border, information obtained from the range of care arrangements, attitudes towards care giving roles and sources of the strain that care givers are experiencing. It was found that the majority of caregivers were young women, often the daughters-in-law of women with dementia.

I have many areas of strengths and defiantly have some areas that I can improvement for my next presentation. I often find my speech delivery is one of my weaknesses as I speak to the crowd. Although I am usually able to maintain a lively voice and keep people engaged but I struggle to stand still. I also find myself not making enough eye contact with my audience. No matter how much I try to stop myself, I always find myself fidgeting. Some of my strengths are arranging and delivery. I present the material in a well-organized fashion. I structure my speeches so that I can thoroughly explain my thoughts with my introduction, body, and conclusion. I always like to ensure that my audience has a full understanding of the point that I am making. I also make sure my audience know the reasoning behind every individual point. I also like to explaining and reiterating my thoughts to ensure that the audience can fully understand what I am saying. My delivery often has several positive aspects. Although, I would not consider myself a monotone speaker, I always make sure to have some inflection and excitement when I am delivering my speech. This makes the topic seem more interesting to the listeners and keeps them engaged.

 In conclusion, I find this entire experience of creating a pamphlet and the community teaching to be very satisfying. I became a nurse to help people that are suffering from various ailments find some kind of relief. Teaching the elderly about different aspects of a disease which in turn will allow them to make better healthy choices is as good as it gets. After my presentation, many of the attendees personally addressed me with praises for taking the time out to educate them on this topic.

References

• 10 Early Signs and Symptoms of Alzheimer’s. (n.d.). Retrieved from https://www.alz.org/alzheimers-dementia/10_signs
• Alzheimer’s Disease and Healthy Aging. (2018, October 02). Retrieved from https://www.cdc.gov/aging/index.html
• Alzheimer’s Disease Fact Sheet. (n.d.). Retrieved from https://www.nia.nih.gov/health/alzheimers-disease-fact-sheet
• Dementia. (n.d.). Retrieved from http://www.who.int/en/news-room/fact-sheets/detail/dementia
• Dementias, Including Alzheimer’s Disease. (n.d.). Retrieved from https://www.healthypeople.gov/2020/topics-objectives/topic/dementias-including-alzheimers-disease
• Facts and Figures. (n.d.). Retrieved from https://www.alz.org/alzheimers-dementia/facts-figures