The Patient With Alzheimer’s Disease
DH-24 Mrs. Kunz
Summary
Alzheimer’s disease is most common among people over the age of 65. By age 85, 47% of the population suffers from some level of Alzheimer’s symptoms. Twice as many women suffer from Alzheimer’s disease as men.
Early symptoms of Alzheimer’s disease are loss of memory, errors in judgment, a significant reduction in personal hygiene and appearance and disorientation in time. These develop so that patients have difficulty eating walking, talking or understanding speech. They may also fail to recognize familiar objects.
Finally, they often suffer from seizures, delusions, and hallucinations leading to anxiety and aggressive behavior. Other symptoms include oral problems and a weakened immune system that can lead to death from infection.
It appears that these symptoms are caused by the loss of neurons in the brain. However, there are no tests to determine whether a patient has Alzheimer’s disease. The only definitive diagnosis is a post-mortem examination of the brain. A series of questionnaires can be given to test a patient’s mental abilities but these cannot confirm that the cause of any reduction in mental abilities is due Alzheimer’s disease.
In addition, there are no cures for Alzheimer’s disease. However, there are medicines that can reduce the symptoms in some patients.
Alzheimer’s patients appear to be more likely to accumulate plaque, form calculus and suffer from gingival bleeding that other patient’s of the same age and sex. The reduction in cognitive abilities is also associated with patient’s having older and less clean prostheses. Reduced salivary flow increases the risk of caries and periodontal diseases. Other oral symptoms include: gingival hyperplasia, oral ulceration, attrition, migration and abrasion of the teeth.
Treatments for patients with Alzheimer’s disease must be designed around the patient’s physical and mental abilities and their needs and desires.
Early treatment is required as patients’ may become unable to care for their teeth in the second phase of Alzheimer’s’ disease. As the disease progresses, they may become agitated by being in an unusual location, the dental office. This can prevent the doctor from being able to complete a treatment program. In the final stages of Alzheimer’s disease, the patient’s compromised immune system significantly increases the risk of infection from invasive treatments.
Coordination with the patient’s primary care physician, caregiver and other health care professionals is required to manage the timing of the treatment and patient care
It is important that the patient is involved in all conversations related to their care. Even in the later stages, when they may not understand the conversation, this can help reduce their anxiety. When a patient is incapable of giving their informed consent due to the progression of the disease, this must be obtained from the patient's legal guardians or from the courts.
Preventive strategies are important for patients with Alzheimer’s disease must be designed to fit the patient’s abilities. For mild cases, the patient may be able to take care of their own oral hygiene. Otherwise, the patient’s caregiver must be trained in the appropriate procedures.
Dental hygienists must understand the disease, its treatment, and its impact on the patients’ physical health and their ability to maintain their oral health. Proper communication is very important in treating Alzheimer’s disease patients: show caring and understanding; use a soft and calm voice; speak slowly and clearly; repeat and explain; and be patient. Keeping appointments short, scheduling them early in the day, and a stress free environment help patients be more relaxed and comfortable.
PERSONAL REFLECTION
One of our long-term patients, in the office that I had worked at for over 10 years, had Alzheimer’s disease since the age of 62. The last time he came to our office he had little left of his memory. He kept asking the same question over & over. His wife had to be in the room with him for the whole treatment. He was able to cooperate calmly and was well behaved during the entire procedure. He was a tall, big, and kindly gentleman with the outgoing, social character of a businessman. Now he was like a child. It shocked me hard. I realized how powerful was the effect of the disease that can change a person’s life entirely. Life is so fragile! It gives me a strong idea of taking good care my health such as eating quality nutritious food, sleeping enough, exercising regularly, drinking more water, and reducing stress. I hope, I will have less suffering from disease and a healthy body in my old age.
Citation:
Gitto, C., Moroni, M., Terezhalmy, G., & Sandu, S. (2001)
The patient with Alzheimer's disease.
Quintessence International, Mar2001, Vol. 32 Issue 3: 221-231.
ADDITIONAL INFORMATION
http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp
Call our 24/7 Helpline: 800.272.3900
Locate a chapter in your community
Use our Virtual Library
http://www.nytimes.com/interactive/2010/06/02/health/te_alzheimers.html
DH-24 Mrs. Kunz
Summary
Alzheimer’s disease is most common among people over the age of 65. By age 85, 47% of the population suffers from some level of Alzheimer’s symptoms. Twice as many women suffer from Alzheimer’s disease as men.
Early symptoms of Alzheimer’s disease are loss of memory, errors in judgment, a significant reduction in personal hygiene and appearance and disorientation in time. These develop so that patients have difficulty eating walking, talking or understanding speech. They may also fail to recognize familiar objects.
Finally, they often suffer from seizures, delusions, and hallucinations leading to anxiety and aggressive behavior. Other symptoms include oral problems and a weakened immune system that can lead to death from infection.
It appears that these symptoms are caused by the loss of neurons in the brain. However, there are no tests to determine whether a patient has Alzheimer’s disease. The only definitive diagnosis is a post-mortem examination of the brain. A series of questionnaires can be given to test a patient’s mental abilities but these cannot confirm that the cause of any reduction in mental abilities is due Alzheimer’s disease.
In addition, there are no cures for Alzheimer’s disease. However, there are medicines that can reduce the symptoms in some patients.
Alzheimer’s patients appear to be more likely to accumulate plaque, form calculus and suffer from gingival bleeding that other patient’s of the same age and sex. The reduction in cognitive abilities is also associated with patient’s having older and less clean prostheses. Reduced salivary flow increases the risk of caries and periodontal diseases. Other oral symptoms include: gingival hyperplasia, oral ulceration, attrition, migration and abrasion of the teeth.
Treatments for patients with Alzheimer’s disease must be designed around the patient’s physical and mental abilities and their needs and desires.
Early treatment is required as patients’ may become unable to care for their teeth in the second phase of Alzheimer’s’ disease. As the disease progresses, they may become agitated by being in an unusual location, the dental office. This can prevent the doctor from being able to complete a treatment program. In the final stages of Alzheimer’s disease, the patient’s compromised immune system significantly increases the risk of infection from invasive treatments.
Coordination with the patient’s primary care physician, caregiver and other health care professionals is required to manage the timing of the treatment and patient care
It is important that the patient is involved in all conversations related to their care. Even in the later stages, when they may not understand the conversation, this can help reduce their anxiety. When a patient is incapable of giving their informed consent due to the progression of the disease, this must be obtained from the patient's legal guardians or from the courts.
Preventive strategies are important for patients with Alzheimer’s disease must be designed to fit the patient’s abilities. For mild cases, the patient may be able to take care of their own oral hygiene. Otherwise, the patient’s caregiver must be trained in the appropriate procedures.
Dental hygienists must understand the disease, its treatment, and its impact on the patients’ physical health and their ability to maintain their oral health. Proper communication is very important in treating Alzheimer’s disease patients: show caring and understanding; use a soft and calm voice; speak slowly and clearly; repeat and explain; and be patient. Keeping appointments short, scheduling them early in the day, and a stress free environment help patients be more relaxed and comfortable.
PERSONAL REFLECTION
One of our long-term patients, in the office that I had worked at for over 10 years, had Alzheimer’s disease since the age of 62. The last time he came to our office he had little left of his memory. He kept asking the same question over & over. His wife had to be in the room with him for the whole treatment. He was able to cooperate calmly and was well behaved during the entire procedure. He was a tall, big, and kindly gentleman with the outgoing, social character of a businessman. Now he was like a child. It shocked me hard. I realized how powerful was the effect of the disease that can change a person’s life entirely. Life is so fragile! It gives me a strong idea of taking good care my health such as eating quality nutritious food, sleeping enough, exercising regularly, drinking more water, and reducing stress. I hope, I will have less suffering from disease and a healthy body in my old age.
Citation:
Gitto, C., Moroni, M., Terezhalmy, G., & Sandu, S. (2001)
The patient with Alzheimer's disease.
Quintessence International, Mar2001, Vol. 32 Issue 3: 221-231.
ADDITIONAL INFORMATION
http://www.alz.org/alzheimers_disease_what_is_alzheimers.asp
Call our 24/7 Helpline: 800.272.3900
Locate a chapter in your community
Use our Virtual Library
http://www.nytimes.com/interactive/2010/06/02/health/te_alzheimers.html