Question

Explain management and care strategies for Alzheimer’s

Answer 1

Alzheimer's disease:-a term used for both senile and presenile dementia which has characteristics pathological degenerative changes in the brain.

Management:- there are three line of treatment

1)Pharmaceutical/medicinal

2) psychological

3)care giving

Medicinal:-use of acetylcholinesterase inhibitors(donezepil,

rivastigmine). These are used t decrease the rate of breaking dow of acetylcholine thus increasing the concentration of

acetylcholine. Memanthine is N -Methyl-D -Aspartate receptor antagonist which acts on glutamate system by blocking NMDA receptors.

Glutamate excites the neurotransmitters of nervous system which can lead to cell death known as excitotoxcity(due to the over stimulation of glutamate receptors).

To reduce aggression and psychosis antipsychotics are moderately used.

psychological management

1) Behavioural therapy:-

is done by decreasing the consequences of

problematic behaviour, by reducing incontinence.

music therapy is effective in reducing Behavioural

and psychological symptoms.

Reminiscence therapy given by discussing

past experiences of a person with the help of

videos, photographs.

Simulated therapy by involving in playing of

recorded voices of near and dear ones.

Reduction of cognitive deficits we need to give orientation presentation about time , place , people so that the patient knows the surroundings.

Stimulation orientated treatment by indulging the patient

painting, pet and other activities lead to improvement in mood and behaviour.

Care giving :- is a very essential part of treatment

patient safety, implementation safety locks, labellng on house hold items,reminder pone Call for medicine, alarms on doors to make sure patient doesn't goes out alone.personal supervision to prevent injury , modifications in environment.

playing recorded voices videos to recall past experiences and memories about people trips.

Do remember behaviour patient may shout but patient doesn't want to hurt anyone intentionally so prevent emotional crisis be calm.

Make sure to enjoy good times try to make patient comfortable continue to socialise, travel and to participate in activities.

Avoid misinterpretation patient may not be able to understand you verbally which can lead to anxiety in both you and patient so do not use confusing communication be clear.

prevention of malnutrition, pressure ulcers, taking care of hygiene and othet oral, skin ,eye infection.

Serving pureed food whe patient has swallowing difficulty use of feeding tubes.