Dementia Essay – NURS 6521 – Week 5 Discussion

Dementia

Dementia is a general term for a decline in mental ability severe enough to interfere with daily life (Alzheimer’s Association, 2018). Memory loss is an example (Alzheimer’s Association, 2018). Alzheimer’s is the most common type of dementia (Alzheimer’s Association, 2018). Though most symptoms of dementia vary they include memory loss, communication and language impairment, ability to focus and pay attention, reasoning and judgment impairment, and visual perception (National Institute on Aging, 2018). The multiple psychological changes range from anxiety, depression, personality changes, inappropriate behavior, agitation, hallucinations, and paranoia (Mayo Clinic, 2017).

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Dementia is caused by damage to the brain cells through excess alcohol use, medication side effects, depression, thyroid problems, trauma to head, stroke, and vitamin deficiencies (Alzheimer’s Association, 2018). There is no one test used to diagnose dementia, so the use of an extensive medical history including familial history, physical examination; changes in how the patients’ think, function, and behave are all used to help make this diagnosis. The progressive types of dementias are Alzheimer’s disease (AD), vascular, Lewy body, frontotemporal, and mixed (Mayo Clinic, 2017). Other disorders that are linked to dementia are Huntington’s, Parkinson’s, and Creutzfeldt-Jakob (Mayo Clinic, 2017). Dementia Essay – NURS 6521 – Week 5 Discussion.

Pharmacotherapy for Dementia

The main goal for the treatment of dementia is to improve the patient’s quality of life and prolong the disease process as long as possible. According to Arcangelo and Peterson (2017) there are several possible medications that patients could be on that could cause reversible effects of dementia that include anticholinergics, antipsychotics, benzodiazepines, and histamine blockers. To treat the disease itself, one would prescribe medications such as cholinesterase inhibitors and memantine (Arcangelo & Peterson, 2017). Some of the cholinesterase inhibitors include Aricept, Exelon, and Razadyne (Arcangelo & Peterson, 2017). When used in conjunction, the cholinesterase inhibitors and memantine help to prolong the disease as long as possible thereby giving the patient greater quality of life and functionality.

It is currently unknown how long this treatment will continue to be of benefit to these patients, however once the disease reaches it’s inevitable conclusion most prescribers will remove the medications due to lack of beneficial therapeutics and cost of maintenance (Arcangelo & Peterson, 2017). The cholinesterase inhibitors have been shown to slow the progression of AD (Arcangelo & Peterson, 2017). These medications have also had positive effects on the noncognitive or behavioral symptoms of AD (Arcangelo & Peterson, 2017). They have been shown to reduce apathy, psychosis, anxiety, depression, and agitation (Arcangelo & Peterson, 2017). Dementia Essay – NURS 6521 – Week 5 Discussion.

Dementia and Age

Senior citizens are most affected by this disease process, but it can afflict those that are younger as well. Being elderly down not predispose one to this disease process, however there are risk factors that cannot be changed such as family history, Down Syndrome, age, and mild cognitive impairments. Risk factors that can be changed to either lessen the chances of acquiring the disease or stop it completely include alcohol use, depression, diabetes, cardiovascular risk factors, smoking, and sleep apnea.

In order to reduce any side effects, the APRN can include the family in all of the teaching that is done, advise them to monitor all medication administration in order to maintain compliance, and to advise them that at some point further care will need to be addressed for patient functionality and activities of daily living. Also, the elderly can be very sensitive to medications so proper dosing will need to be taken into account in order to avoid hypersensitivity. To avoid this, the prescriber should begin treating at the lowest doses and working up from that point.

References

Alzheimer’s Association. (2018). What is dementia. Retrieved June 27, 2018 from https://www.alz.org/alzheimers-dementia/what-is-dementia

Mayo Clinic. (2017). Dementia. Retrieved June 27, 2018 from https://www.mayoclinic.org/diseases-conditions/dementia/symptoms-causes/syc-20352013

National Institute on aging. (2018). What is dementia. Retrieved June 27, 2018 from https://www.nia.nih.gov/health/what-dementia

I enjoyed reading your post this week and liked what you had to say on migraines and gender. The link between hormones and migraine has uncovered new details about how fluctuating estrogen levels – and the life stages when women tend to experience them – could increase their vulnerability to migraine attacks (American Migraine Foundation, 2018). Furthermore, of the more than 38 million Americans who experience migraine headaches, 28 million are women. Dementia Essay – NURS 6521 – Week 5 Discussion. Compared to men, women also experience more frequent and severe migraines and don’t respond as well to drug treatments (Science Daily, 2018). My mother-in-law suffers badly from migraines. As she has gotten older, the migraines have become fewer, which suggests there may very well be a link between hormones and migraines, however I find it an extra kick in the gut that women also don’t respond as well to medications that are made to help with this dilemma.

References

American Migraine Foundation. (2018). Understanding the migraine gender gap. Retrieved June 29, 2018 from https://americanmigrainefoundation.org/2017/09/21/understanding-migraine-gender-gap/

Science Daily. (2018). Potential source of gender differences in migraines. Retrieved June 29, 2018 from https://www.sciencedaily.com/releases/2018/04/180423085434.htm

I enjoyed your post this week on epilepsy and age. The Epilepsy Foundation (2018) state after age 55, the rate of new cases of epilepsy starts to increase, as people develop strokes, brain tumors, or Alzheimer’s disease, which all can cause epilepsy. Furthermore, the Centers for Disease Control and Prevention (CDC) (2018) reports: About 3 million US adults aged 18 years or older have active epilepsy. Nearly 1 million of those adults are aged 55 or older. With our elderly living longer, there will no doubt be more and more patients who fall victim to this disease process. What are your thoughts on this possibility? Dementia Essay – NURS 6521 – Week 5 Discussion.

References

Centers for Disease Control and Prevention. (2018). Epilepsy and seizures in older adults. Retrieved June 30, 2018 from https://www.cdc.gov/features/epilepsy-older-adults/index.html

Epilepsy Foundation. (2018). Who gets epilepsy. Retrieved June 30, 2018 from https://www.epilepsy.com/learn/about-epilepsy-basics/who-gets-epilepsy

Dementia Essay – NURS 6521 – Week 5 Discussion

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