LBD is a condition that leads to the development of dementia and which predominantly affects people over the age of 50 (Taylor et al., 2020). In the United States, over 1 million patients, with higher prevalence among men when compared to women (Sanford, 2018). The etiology of LBD is the abnormal alpha-synuclein deposits in one’s brain. Alpha-synuclein is a protein that obstructs the brain’s normal functioning because the Lewy body deposits impact the brain’s chemistry. The exact cause of these proteins’ deposits is currently unknown, but scientists have found a link between the brain’s loss of chemicals that produce neurotransmitters and the accumulation of alpha-synuclein. The two types of chemicals associated with the loss of cognition capabilities and mood are dopamine and acetylcholine. As a result of LBT, one’s cognition, behavior, movement, and mood can change. Moreover, LBD is the most common cause of dementia.
The diagnostic criteria for LBT are the impairment of cognition and movement abilities (Taylor et al., 2020). Some signs that may point to LBT are visual hallucinations, changes in cognition, such as thinking problems, alertness, issues with attention and concentration, and loss of thinking abilities that affect a person’s day-to-day life. However, the diagnosing process of LBW is challenging during the initial stages of the disease because it is often confused with other brain conditions or psychiatric disorders. Moreover, LWB can be a standalone condition or can accompany another brain-related illness. The risk factors for LBT include RAM sleep disorder and Parkinson’s disease (Sanford, 2018).
The recommended course of action includes treatment of symptoms, as some of them respond to medication, although this effect lasts for a limited time; physical therapy and counseling. The prognosis for treatment is currently based on care and support for the patients with LBD because as the condition progresses, they become more dependent on the help of others in performing everyday activities. Currently, there is no cure for LBD, although the research into the condition and potential ways of stopping its progression are ongoing (Taylor et al., 2020). The life expectancy for people with LBD is between 2 to 20 years from the time of diagnosis and till death. However, this is a progressive disease, which means that the symptoms of LBD worsen over time.
Effect of Condition and Related Limitations on Functioning
LBD affects all aspects of the person’s functioning, including their physical, cognitive, and behavioral patterns of behaviors. The effects of LBD on one’s physical functioning are the following: stiffness or rigidity of muscles. For example, one of the early warning signs that a person is developing LBD is the change of one’s handwriting or difficulty in writing something by hand. However, one should note that some people do not experience physical symptoms until the late stages of this disease, and therefore, their impairments may be noticeable to others for a long time. Other physical effects include tremor at rest, loss of coordination, balance issues, which can manifest as repeated falls. Slow movement is another symptom, as well as a weak voice, a changed facial expression, and difficulty swallowing (Elder et al., 2019). All in all, LBW affects all of the patient’s physical capabilities, which is why once the disease progresses, they begin to rely severely on the help of others.
Cognitive functioning is affected because the patient is more forgetful and can struggle to recall basic things. The social functioning of a person with LBW is impacted due to the stress that the patient experiences as a result of their symptoms; for example, they can forget their friends or relatives. The emotional functioning is impaired due to the patient’s mood changes. In general, it is typical for a patient with LDB to experience character changes or mood changes, especially as the condition progresses and the cognitive abilities continue to decline. The patient may have depression or show apathy and lack of interest towards others and other things (Taylor et al., 2020). Additionally, they might have agitation, paranoia, or anxiety, all resulting from the changes in the brain chemistry.
A client’s independence in performing everyday activities and going to work or school is severely impacted by LBW. Most importantly, as this disease progresses, the symptoms worsen, and a person becomes reliant on their caregivers as they develop issues with movements and thinking. This is why some researchers recommend LBD patients to join support groups and why community members should be involved in caring for people with LBD. The effect of LBT is lifelong and will continue to affect the client till their death, with the symptoms progressing and worsening over time.
Sample Client
Josy is a 53 years old woman diagnosed with LBT two years ago. Since the diagnosis, Josy’s disease has progressed, and she experiences issues moving around, visual hallucinations, and issues with memory. Josy is currently enrolled in a long-term care facility that specializes in the treatment of Parkinson’s and Alzheimer’s diseases. She has become forgetful and is sometimes lost along with the premises of the facility. Over the last two months, Josy has fallen twice and has injured her ankle as a result.
Client Needs and RT Service Providers
As a recreational therapist, the most pressing need for a client with LBD is to stimulate the physical, cognitive, speech, and occupational functions, as these ones are vital and most affected by the disease. Some research suggests that recreational therapy activities can slow down the progression of LBT (Taylor et al., 2020). Additionally, it is vital to engage family members in the process as LBT patients become reliant on their caregivers as their functioning capabilities decrease.
Physical activity is one of the essential elements of recreational therapy for LBT patients. The disease affects the patient’s ability to move and their coordination, which often leads to multiple falls. This issue can cause injuries, which is why one of the goals for recreational therapy is building strong muscle and improving balance. Activities that help maintain cognition are also essential and can include speech therapy, art activities, music therapy, and socialization. The range of options includes offering patients to play musical instruments or listen to music, painting, reading, participating in group sessions, among others.
Additionally, this range of activities means that patients with LBT can choose the things they enjoy doing. Another issue with LBD is that as the cognitive functioning of the patient declines, they may become forgetful, struggle with getting dressed or have trouble eating, or become lost even in familiar places. To address these issues, a team intervention is needed; for example, the caregivers can label the drawers to help the patient be less confused or use technology to allow the individual to walk around safely.
Goals
- Improve coordination and balance.
- Work on cognitive skills.
Intervention (To meet goals): occupational therapy.
Objectives
- The client will attend physical training sessions three times a week.
- The client will attend cognitive skills training with an RT specialist twice a week.
References
Elder, G., Colloby, S., Firbank, M., McKeith, I., & Taylor, J. (2019). Consecutive sessions of transcranial direct current stimulation do not remediate visual hallucinations in Lewy body dementia: A randomised controlled trial. Alzheimer’s Research & Therapy, 11(1). Web.
Sanford, A. (2018). Lewy Body Dementia. Clinics In Geriatric Medicine, 34(4), 603-615. Web.
Taylor, J., McKeith, I., Burn, D., Boeve, B., Weintraub, D., & Bamford, C. (2020). New evidence on the management of Lewy body dementia. The Lancet Neurology, 19(2), 157-169. Web.