Nowadays the humanity suffers a wide range of different diseases. Very often from news we hear about the epidemic of that or another illness which slowly kill the mankind. One of the diseases, a modern black death for aged people, is Alzheimer disease.
Alzheimer disease may be characterized by affecting human’s brain, the section responsible for memory, thinking and language, and this way it influences the performance of the simplest daily activity of a person. It is well known that mostly aged people suffer from this illness. Those, who are over 60 years old are in risk of being attacked by Alzheimer disease. But of course, there are cases of diagnosing this illness in younger people, but it is rare.
The symptoms and the signs to raise an alarm are temporal loss of memory, inability to perform usual activity, loss of communication skills. If such symptoms are observed it is necessary to go to a doctor in order to be medically checked. Such symptoms do not necessarily presuppose Alzheimer disease, but with the help of various testing it is possible to find this out and be sure.
In the process of diagnosing a doctor may perform the following procedures:
firstly, a patient or relatives tell about the symptoms and cases which seemed weird in the behavior of a patient;
then a doctor may test a patient with simple language tests or logical exercises;
the next step is to make several medical tests such as blood test and urine test in order to find out whether there are toxic elements within the body, which may indicate the presence of the Alzheimer;
finally, to be perfectly sure various brain scans are made. Among those are computed tomography (CT), magnetic resonance imaging (MRI), or positron emission tomography (PET), which help to identify the reasons of the symptoms present (NIH, 2016).
It is of high importance to call for a doctor the very moment when the symptoms appear, as on the early stages it is much easier to treat the disease and lessen the harmful influence upon the life of a patient. There is no guarantee that the disease begins with the symptoms only. It may happen the way, when the clinical symptoms do not appear for a long time, though the illness is inside the brain, influencing and slowly ruining it.
Situations with Alzheimer diseases require special patient treatment and ethical side is of high importance. Firstly, a doctor must be tolerant and responsible during diagnosing without making any preliminary conclusions which may not turn into real truth, but just provoke the intense worrying of a patient or family. If it happens the way that Alzheimer disease is proved to be within a patient, in this case it is necessary to be ethical to all the sides – family, doctor, nurses, people who take care of a patient. It should be mentioned that treating Alzheimer patient is very responsible and difficult, that’s why those, who can’t perform these tasks should leave it for people who can.
After making a research and analyzing the data I have found out the statistics of the spreading Alzheimer disease between people of different age in different countries. The unpleasant fact is that the widest spreading of Alzheimer disease in within the USA, on the second place – Brazil, in Europe and Chine the results are the lowest. Statistics also show that the lowest risk for Alzheimer disease is at the age of 65. The risk rises with aging and reaches the peak at the age of 90 and more (Qiu et al., 2009). The results show that women are more inclined to Alzheimer than men are. For example, at the age of 80-85 the frequency of Alzheimer among women is 14,2 %, while among men – 8.8 % (Schmidt et al., 2008).
Among the factors which influence the development of Alzheimer disease are the following ones:
genetics – these factors have strong epidemiologic evidences and show that people, who had relatives suffering this disease are in risk of suffering it as well;
heart diseases, diabetes, bad habits may cause and be the reason of Alzheimer disease in older age;
psychological factors – people who do not have a variety of mental and physical activities are under the risk of Alzheimer;
nutritional factors – their influence is not prominent, but the researches show their influence upon human’s health and the development of Alzheimer because of those as well.
Catherine’s case, due to its symptoms, may be regarded as the Alzheimer disease but we can’t make an exact statement. At first, I would have to contact with her family and try to explain the situation. The symptoms, though they coincide with Alzheimer, may belong to another disease. Such symptoms are the characteristic of brain tumor or just blocked veins and arteries which does not let to transport blood to the brain and this influences the mental activity. To be sure the tests will be necessary.
Working with elder people is not an easy thing. It may be difficult in the regard to physical factors and mental ones. Firstly, in case of hard influence of the disease some people may be invalid to move and this way the nurses must be physically stable to be able to take care of such patients. Secondly, as for psychological factors, many patients may be difficult to work with as because of their memory loss they may be aggressive about certain things. People who take care of elderly people must be sympathetic but at the same time they have to be strong to stand all the aspects and issues which are the result of the disease. Ethical education and code of ethics are very important in the treatment and care of Alzheimer patients, that’s why the working stuff and nurses must be selected carefully. As for the legal issues of treatment and care, they are the set of standards and rules a nurse have to follow in the process of the activity. Each nurse must be qualified according to the level defined and have all the knowledge and practice in order to perform the duties.
As for ethical and legal implications in Catherine’s case, there must be said the following: this situation requires great attention as the patient confided in her doctor, revealing her secrets and information she hadn’t told her family. But on the other hand, the doctor has to inform the relatives as it concerns the principles of veracity, beneficence and justice. But in order to be loyal to the principle of respect, the doctor should tell about his intentions the patient herself. Legal implications in the given case are based on the qualification of the doctor and his ability to diagnose the patient properly in order to put the right diagnose. The doctor has no right for a mistake as it would cause the row of legal federal issues or even criminal responsibility. In the state Tennessee several legal implications, such as various programs, take place. Among them are SCAN – this program includes the group of volunteers who visits Alzheimer patients six days per week and check their state. This program is aimed at decreasing of the fear of family members and caregivers. The state also provides legal implication in the form of financial aid which in 2008-2009 reached the number of almost 1 billion dollars (Hann, 2009).
Concerns, which may appear within this situation, are connected with the process of preparing the patient for informing about the possibility of Alzheimer disease and the way this information may be perceived. The patient has a loving daughter who takes her of her mother and this would be helpful in the given case.
The biggest challenge will be connected with the defining of the diagnose and informing the patient about it. Catherine became quite attached to the doctor and she confided in him only, this makes this situation more sensitive and intense.
At the given time Catherine needs support and help of her family. She is still in clear mind and momentary moments of oblivion may make her frightened or bring harm. It is also necessary to start the process of diagnosing and finding out the reason of the memory loss of the patient. As a counselor, my legal obligation is to inform the family and perhaps give a couple of advices to what clinic they should go in order to be checked.
I suppose that at that point counseling should not be stopped. It is a huge stress for a person to find out about the possibility of having Alzheimer disease, that’s why the necessity of therapy and psychological support is necessary. With the help of mental activities and exercises the process of disease development may be slowed and give the patient some more time. Understanding and help are the things needed most of all in such situations and a counselor is a person who can help. That’s why I would go on with the counseling this patient in order to do my best and help Catherine.
Hann, M. (2009). Tennessee Alzheimer’s Disease Task Force Final Report. TN: Tennessee Commission on Aging and Disability. Retrieved from http://www.alz.org/national/documents/Tennessee_State_Plan.pdf
NIH (National Institute of Aging). (2016). About Alzheimer Disease: Diagnosis. U.S. Department of Health and Human Services. Retrieved from https://www.nia.nih.gov/alzheimers/topics/diagnosis
Qiu, C. et al. (2009). Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention. U.S. National Library of Medicine. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181909/Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention
Epidemiology of Alzheimer's disease: occurrence, determinants, and strategies toward intervention
Schmidt, R. et al. (2008). Sex Differences in Alzheimer Disease. U.S. National Library of Medicine. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/18381051