Many older people of different occupations receive the ‘dementia’ diagnosis nowadays. As a rule, dementia develops after the age of 65 and has three stages – early, moderate, and advanced (Khachaturian & Radebaugh, 2019). The development of the disease may be hard to prognosticate, while the average life expectancy after diagnosis is about seven years, during which the main task of caregivers is to alleviate the patient’s condition. This paper aims to critically evaluate the situation of Mr. M. and formulate a conclusion based on this evaluation.
Mr. M. is having trouble recalling the names of his family members, remembering his room number, and even repeating what he has just read. He is becoming agitated and aggressive quickly and appears to be afraid and fearful when he gets aggressive. Mr. M. has been found wandering at night and could frequently become lost, needing help to get back to his room. He has also become dependent on many activities of daily living, whereas a few months ago, he was fully able to dress, bathe, and feed himself.
To confirm the primary diagnosis of’ moderate stage of Alzheimer’s disease, it will be necessary to conduct magnetic resonance imaging (MRI). MRI will help to detect the accumulation of amyloid plaques and neurofibrillary tangles in brain tissue (Khachaturian & Radebaugh, 2019).
The patient’s behavior and his cognitive functions are usually analyzed to make the secondary diagnosis; in this case, it has been already done. However, some abnormalities in the patient’s behavior may be expected to develop, considering positive for a moderate amount of leukocytes and cloudy Urinalysis results, which are apparent indicators of urinary tract infections (UTI). In older people with dementia, a UTI may cause delirium. That is why it is strongly recommended to prescribe antibiotics for urgent UTI treatment.
For now, Mr. M.’s ability to independently carry out daily activities has decreased significantly; he also has problems with short-term memory. Such symptoms can damage the psychological and emotional state of the patient, while the relatives may suffer as well. The loss of independence due to cognitive impairment and self-doubt because of problems with short-term memory are among the most common psychological consequences (Khachaturian & Radebaugh, 2019).
In this regard, a psychosocial intervention may be recommended, which involves behavioral, emotional, cognitive, and stimulatory-oriented approaches. Behavioral interventions are aimed to identify and reduce the prerequisites and consequences of problem behaviors. Emotional interventions include reminiscence therapy, validation therapy, supportive psychotherapy, sensory integration, and simulated presence therapy (Martins et al., 2019). Reality orientation and cognitive retraining are used to reduce cognitive deficits. Stimulating therapies include exercises, art therapy, music therapy, therapies in which patients interact with animals.
In addition to the present symptoms, Mr. M. may develop speech disorders and loss of reading and writing skills in the future. Lack of coordination when performing complex sequences of movements can also be developed over time (Martins et al., 2019). At this stage, memory problems may intensify (the patient does not recognize close relatives). Then, long-term memory may become disrupted; urinary incontinence may develop, as well as false identification syndrome, and other symptoms of delirium.
Thus, Mr. M was diagnosed with a ‘moderate stage of Alzheimer’s disease.’ For the secondary diagnosis, Mr. M. was recommended to undergo an MRI. It was also found out that Mr. M. has a UTI, which is especially dangerous for people with dementia. Thus, psychosocial intervention, along with pharmacological intervention and caregiving, was strongly recommended. Potential problems that arise at the latest stage of dementia have also been pointed out.
References
Khachaturian, Z., & Radebaugh, T. (Eds.). (2019). Alzheimer’s disease: Cause(s), diagnosis, treatment, and care. Boca Raton, FL: CRC Press.
Martins, R., Brennan, C., Fernando, B., Brennan, M., & Fuller, S. (Eds.). (2019). Neurodegeneration and Alzheimer’s disease: The role of diabetes, genetics, hormones, and lifestyle. New York, NY: John Wiley & Sons.