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Although a large number of elderly who have problems with activities of daily living (ADL's) are still able to live independently, there are groups of elderly individuals who are frail and suffer from serious chronic diseases such as Alzheimer's, Strokes, and Parkinson's, and more manageable diseases such as Diabetes Type II, arthritis, osteoporosis etc. According to the Administration on Aging Profile of Older Americans: 2000 (www.aoa.gov/aoa/stats/profile):
Limitations on activities because of chronic conditions increase with age. In 1997, among those 65-74 years old, 30.0 percent reported a limitation caused by a chronic condition. In contrast, over half (50.2%) of those 75 years and over reported they were limited by chronic conditions. Shifting the focus to disability, in 1994-95 more than half of the older population (52.5%) reported having at least one disability. One-third had at least one severe disability. Over 4.4 million (14%) had difficulty in carrying out activities of daily living (ADLs) and 6.5 million (21%) reported difficulties with instrumental activities of daily living (IADLs).
The percentages with disabilities increase sharply with age. Disability takes a much heavier toll on the very old. Almost three-fourths (71.5%) of those age 80+ report at least one disability. Better than half (53.5%) had one or more severe disabilities. The percentage of those age 80+ having difficulty with ADLs (27.5%) and with IADLs (40.4%) is about double that of the 65+ population in total. (ADLs include bathing, dressing, eating, and getting around the house. IADLs include preparing meals, shopping, managing money, using the telephone, doing housework, and taking medication.)
Typically professional caregivers are called into the home, when adult children experience their elderly parents becoming more frail and dependent. Most elderly prefer to stay at home as long until placement becomes the choice of last resort due to emotional and physical exhaustion. Many caregivers are unfamiliar with how to deal with someone who is diagnosed with dementia. It is important for the caregiver--whether they are a paid professional or family member-- to understand the causes of dementia and how to handle a person who is resistant or difficult to handle. To care effectively for those suffering from chronic diseases it is essential that caregivers be taught about the symptoms of various diseases, and how to handle individuals who suffer from these disabilities.
Dementia is actually a syndrome that can be caused by 60-70 medical disorders. Dementia is the result of an underlying medical condition. and therefore a thorough medical and neurological examination are necessary to point to the source or reason for dementia. Dementia can be of two types; reversible or irreversible. The two most common type of irreversible dementia is due to Alzheimer's' and Multi-Infarct Dementia (vascular strokes).
Alzheimer's is often "staged" to help caregivers deal and anticipate possible symptoms or behavioral manifestations of the disease. Some researchers indicate that the stages to Alzheimer's, include mild, moderate, severe and terminal. Other researchers have divided the manifestations of Alzheimer's into seven stages. It is important to remember that not everyone will manifest the behaviors in all of the stages. Each stage, however, gives the caregiver an idea of what to expect. Within the context of this course, the stages in Alzheimer's include: Mild Dementia, Moderate Dementia, Severe Dementia, and the Terminal Stage.
Another irreversible dementia recently diagnosed is Lewy Body and Frontotemporal Dementia. Lewy Body dementia consists in one of the following: 1) visual or auditory hallucinations 2) mild extrapyramidal symptoms (muscle rigidity and slow movements) or 3) repeated or unexplained falls. Frontotemporal Dementia is characterized by personality changes due changes or bodies in the front of the cells..
Very often, individuals ask what are the first symptoms of dementia? Perhaps the first clues that something is seriously wrong occurs when someone is no longer able to calculate or balance check books. A significant sign that something is wrong occurs when individuals no longer remember where or why they are going to a particular destination. Significant memory loss requires that individuals receive a medical and neurological test to rule out causes of dementia.
pp. 1-46. Mahoney, Ellen. Volicer, Ladislav, Hurley, Anne. (2000) Management of Challenging Behaviors in Dementia. Baltimore, Md: Health Professions Press.
To learn more about dementia complete review the attached PowerPoint presentation by pointing and clicking on Dementia.
The following websites provide information regarding Alzheimer's latest research, treatment and findings.
Complete on-line Quiz #1. Dementia Quiz.
