Introduction

In the elderly population, Alzheimer's disease is among the most prevalent forms of dementia (Mirzaei and Adeli, 2022). Carers, loved ones, and patients all feel the effects of Alzheimer's disease, which progressively worsens mental abilities, memory, and everyday functioning.

An increasing number of people are predicting that the prevalence of Alzheimer's disease will increase as the world's population ages (Nichols et al., 2022). The project will focus on care requirements for older people with Alzheimer's. It will highlight the ways in which the disease develops, the difficulties that patients face on a physical and mental level, and the best ways to provide care and support. 

The project will consider the case of "Amelia Doe," a 75-year-old female who received a diagnosis of early-stage Alzheimer's Disease two years ago. A senior care facility that specialises in dementia is where Amelia resides. She initially lived with her daughter, but her condition worsened and she needed more specialised care.

Her Alzheimer's began with memory lapses like losing items and forgetting appointments. Her symptoms worsened, causing language difficulties, disorientation in familiar places, and personality changes. A thorough medical history, neurological, and cognitive evaluation confirmed the diagnosis. Amelia has been treated by a geriatrician, neurologist, nurses, and health care assistant since her diagnosis to manage her symptoms and quality of life.

Ageing Process

The World Health Organisation defines healthy ageing beyond disease-free (World Health Organization, 2020). It encompasses developing and maintaining functional abilities for later life wellbeing. This concept is crucial as the population of older adults grows rapidly due to improved healthcare and lifestyle changes. The goal is to help older people stay healthy, independent, and active while doing what they value.

As people age, cells, organs, and the musculoskeletal system undergo physical changes (Stefanacci, 2022). Cellular function decreases. Cells age from apoptosis, limited cell division, and external damage. Cell numbers decrease in the liver, kidneys, and reproductive organs, affecting function. Stroke and Alzheimer's disease can damage the brain, which is somewhat cell-resistant. Ageing reduces bone density, increasing osteoporosis risk. 

Wear and tear on joints, cartilage, ligaments, and tendons reduces mobility and strength. Regular exercise can reduce muscle mass and strength loss. By 75, body fat doubles and changes shape (Stefanacci, 2022). Vision, hearing, taste, and smell decline with age, lowering quality of life. Skin becomes thinner, less elastic, and drier, indicating ageing. While the brain compensates for nerve cell loss, mental functions may slow.

Negative stereotypes about ageing include frailty, dependency, and cognitive decline (Doncel-García et al., 2022). Stereotypes can cause ageism, harming older adults' mental and physical health. Ageing should be seen as a time of opportunity and challenge, not just decline.

Ageing has major financial, retirement, and cultural effects on older adults (Hayes, 2021). Retirement often reduces income, causing financial problems for many older adults. The combination of lower earnings and rising healthcare costs can strain finances. Thus, adequate financial planning and support are essential for later life stability and access to essential services.

Retirement also alters society. Moving away from work changes routines and social networks, which can lead to isolation and purposelessness. However, it can also provide opportunities for personal growth, leisure, and pursuing interests previously sidelined by work. Retirement often requires social adaptation and reevaluation of personal identity and community roles.

Ageing attitudes vary widely across cultures. Some cultures revere older adults as wise and experienced. Such societies value ageing as natural and normal. In contrast, some cultures marginalise the elderly, ignoring their contributions and minimising their role in society. These cultural perspectives shape ageing, from policymaking to interactions with older people. A respectful and inclusive society requires acknowledging the elderly's contributions and needs.

Healthy ageing includes physical, mental, and social well-being (Kim, 2021). Individuals, communities, healthcare professionals, and policymakers must work together to help the elderly live fulfilling, independent, and active lives. 

Specific Illness: Alzheimer’s Disease 

Alzheimer's disease is a progressive neurological disorder that impairs memory, thinking, and daily tasks. While examining the brain tissue of a deceased patient with unusual mental symptoms, Dr. Alois Alzheimer discovered it in 1906 (National Institute on Aging, 2021).

Although widely recognised and studied, Alzheimer's remains a difficult and complex condition with no cure.
Alzheimer's causes brain changes like amyloid plaques, tau tangles, and neuronal loss (Ashrafian et al., 2021). They disrupt the brain's normal functioning, especially memory regions, then language, reasoning, and social behaviour. Genetic, environmental, and lifestyle factors may cause Alzheimer's.

Alzheimer's develops gradually, with early symptoms including difficulty recalling recent conversations and events, difficulty finding appropriate words, visual perception challenges and challenges with decision-making and planning (Budson and Solomon, 2021).

Alzheimer's symptoms worsen, including difficulty identifying people and places, increased anxiety, aggression, or depression and lower interest in hobbies and socialising. 

Five stages characterise Alzheimer's disease (Mayo Clinic, 2023):
Stage 1: Preclinical Alzheimer's—Brain changes without symptoms.
Stage 2: MCI—Minimal memory and thinking changes.
Stage 3: Mild dementia—clear memory loss and cognitive difficulties. 
Stage 4: Moderate Dementia—Massive memory loss and confusion; assistance needed.
Stage 5: Severe Dementia—Inability to communicate and carer dependence.

According to Julia (2023), Alzheimer's deaths tripled from 44,536 in 1999 to 134,242 in 2020. Alzheimer's is the 5th leading cause of death for people 65 and older and the 7th in the US. Alzheimer's disease complications killed 1.87 million people from 1999 to 2020, 82,965 per year. The highest annual increase was 110,561 deaths in 2015, up 18.2% from 2014.

The 2020 median Alzheimer's death age was 79. Over two-thirds of Alzheimer's deaths in 2020 were women (69.3%). Men made up 30.7% of cases. Age 85 and older accounted for 63.8% of Alzheimer's deaths in 2020. Alzheimer's deaths were 88.7% White, 8.2% Black, 2.7% Asian or Pacific Islanders, and 0.4% American Indians or Alaska Natives.

Alzheimer's treatments concentrate on symptom relief. Cholinesterase inhibitors and Memantine treat memory loss, confusion, and thinking problems (Mayo Clinic, 2023). However, these treatments do not stop disease progression. Research is underway to develop therapies that could slow or stop its progression.

Alzheimer's treatment research is varied and ongoing.  Monoclonal antibodies are being tested to prevent or clear amyloid plaques, but they cause brain swelling. Repurposed drugs like saracatinib and new amyloid plaque and tau protein drugs are being studied.

Beta-amyloid production blockers had limited success and serious side effects. Clinical trials use tau aggregation inhibitors and vaccines to prevent tau tangles (Mayo Clinic, 2023). Anti-inflammatory treatments for Alzheimer's aim to reduce brain cell inflammation. Insulin Resistance Research involves insulin nasal spray trials to study brain function. The Heart-Head Connection is studying how cardiovascular and brain health affect Alzheimer's development. Early studies showed hormone replacement therapy reduced Alzheimer's risk, but later research has mixed results.

Alzheimer's disease is a growing concern as the population ages. Clinical research, public health, and social support are used to study and treat the disease. Future directions include improving early detection and monitoring, focusing on diet, exercise, and mental stimulation as preventative measures, strengthening support networks for patients and carers, and creating public policies to meet the growing number of Alzheimer's patients.

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Physical Needs of Client

A comprehensive and empathetic approach to Alzheimer's Disease care must address the many physical and emotional needs that arise at different stages. This responsibility includes managing symptoms and preserving dignity and quality of life.

Safety is paramount as Alzheimer's progresses and the person loses danger recognition. Risk mitigation requires living environment adaptation. This includes installing grab bars in bathrooms, securing or removing rugs to prevent falls, and eliminating household hazards that could cause injuries. Prevention of wandering and risky behaviour requires constant monitoring or companionship (Alzheimer’s Association, 2023). Emergency response systems like alarms and carer alerts ensure prompt help. To avoid medication errors and misuse, proper storage, labelling, and dispensing are essential.

Due to appetite, preference, and eating ability changes, Alzheimer's patients' nutritional needs can be complicated. Simplifying meal choices, maintaining regular meal schedules, and creating a calm, distraction-free environment can encourage eating and proper nutrition (Alzheimer’s Association, 2023). Providing utensils or finger foods can help with eating as coordination declines.

Dehydration prevention requires regular fluid intake. Preventing choking requires modifying food textures and supervising meals in advanced stages.

Personal hygiene is essential for Alzheimer's patients' comfort, health, and dignity. As the disease progresses, bathing, dental care, grooming, and dressing become more important. Personal hygiene preferences and privacy must be respected (Huang et al., 2020). To avoid further health issues, check for sores or rashes regularly, especially if the patient is immobile.

Support and assistance increase with mobility loss. Providing walkers, canes, or wheelchairs can help maintain independence. Exercise helps maintain muscle strength and balance. Rearranging furniture and removing obstacles can also make movement easier and safer. Alzheimer's patients, especially those in advanced stages, need continence care (Aldridge and Harrison Dening, 2021). A toilet break routine reduces accidents. Use easy-to-remove clothing to simplify toileting. Advanced stages may require absorbent pads or adult diapers.

Alzheimer's care often disrupts sleep (Irwin and Vitiello, 2019). Maintaining a bedtime routine can help regulate sleep. Providing a comfortable, quiet, and dark sleeping environment is essential.

Patients who become active or wander at night must be protected. Alzheimer's end-of-life care requires compassion and comfort. Pain relief, emotional support, and respecting end-of-life care preferences and advance directives are essential. Care includes treating the body with dignity and according to family or cultural traditions post-mortem.

Cognitive Needs of Client

Effective communication, memory support, behavioural management, cognitive rehabilitation, and engaging recreational activities are needed to care for Alzheimer's patients. As the disease progresses, these aspects become more important for quality of life and independence.

Effective communication is key in Alzheimer's care (Alzheimer’s Association, 2023). Patients struggle to communicate and understand others as the disease progresses. Include them in conversations, speak directly, and give them time to respond. Their dignity and involvement are maintained by encouraging thought and feeling expression.

Individual conversations in quiet, distraction-free settings are beneficial. Slow, clear speech and simple sentences aid comprehension. Visuals and written notes can also help communicate. Touch, facial expressions, and tone of voice also matter, especially in the disease's later stages when verbal communication may be limited. Providing Alzheimer's patients with security requires patience and comfort.

A structured and familiar environment helps Alzheimer's patients remember (Heersmink, 2022). Calendars, reminders, and lists aid daily tasks and orientation. A regular routine and familiar surroundings reduce confusion and anxiety. Helping the person enjoy and succeed at familiar tasks, storytelling, and activities like listening to music or looking at family photos can boost cognitive function and self-esteem.

Understanding Alzheimer's behavioural changes' causes—environmental or medication side effects—is crucial (Alzheimer’s Association, 2023). Treatment should begin with non-pharmacological methods. Redirecting attention, calming the environment, and avoiding conflict work. Regular pain, safety, and discomfort monitoring is essential. For a harmonious care environment, carers must be trained in behaviour management and recognising distress and unmet needs.

Cognitive rehabilitation aims to preserve cognition. Maintenance of memory, problem-solving, and other cognitive abilities is involved. Medication can manage symptoms and slow disease progression, but cognition-focused interventions like cognitive exercises and activities tailored to the individual's abilities can improve independence and reduce disability. These interventions can include memory exercises, puzzles, and arts and crafts.

Recreational activities improve Alzheimer's patients' quality of life (Liang et al., 2022). Memory, mood, and accomplishment can be boosted by music and art therapy. Simple puzzles and games maintain cognitive function and give a sense of accomplishment, while gardening stimulates the senses and gives purpose. Sharing old photos and stories can comfort and connect you to the past.

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Role of HCA

Health Care Assistants (HCAs) need to be sensitive to the unique needs of people with Alzheimer's (Rawles, 2019). They must have specialised training to meet those needs.

Every patient's unique requirements, preferences, and medical background must be carefully considered. Adaptable care is necessary because the symptoms experienced by people with Alzheimer's disease range in both type and severity (Porsteinsson et al., 2021). Healthcare assistants assist patients with the fundamental needs like eating, dressing, and getting around in a dignified and respectful manner, which can become more challenging as the disease advances.

Beyond just satisfying basic necessities, healthcare providers aim to make patients feel valued and respected regardless of their cognitive state. Patients' sense of autonomy and self-worth are enhanced by the opportunities they are given to make decisions regarding their care and daily lives. The dignity of the patient is always prioritised, even when dealing with challenging care tasks such as managing incontinence or behavioural changes.

Health care advocates play a crucial role. People with Alzheimer's disease frequently struggle with verbal expression (Martínez-Nicolás et al., 2021). Health care assistants speak up for them and relay their concerns to the medical staff. As an advocate, you'll work with the patient's family and other carers to create a comprehensive and coordinated care plan that prioritises the patient's needs.

An important part of a health care assistant's job is to inform patients' loved ones about their condition and how they can help their sick loved one the most (Cho et al., 2020). This requires informing them about the progression of Alzheimer's disease, how it impacts speech, and how it alters behaviour. Helping hands aren't the only thing that HCAs do for Alzheimer's patients; they also aid patients' loved ones emotionally and offer advice.

Similarly, the HCA values health promotion highly. People with Alzheimer's disease benefit physically, mentally, and emotionally from HCA’s work. Among these may be the facilitation of physical activities, the encouragement of social interaction, and the improvement of cognitive function. Participating in these activities may help patients improve their physical health and put off the beginning of cognitive decline.

HCA provide an optimistic and caring view of ageing by highlighting the talents and achievements of older people, including those with Alzheimer's. This way of thinking promotes a more caring attitude towards caring for the old and helps in the battle against ageism. They are a source of solace for many patients, particularly when they are distressed or confused. 

Role of Specific Services 

The Department of Health and Human Services (HHS) and the Alzheimer's Association are key players in older adult care and support, particularly for those with Alzheimer's disease. Their roles and the variety of care settings show the multifaceted approach needed to support the ageing population.

HHS, a statutory agency, is vital to American health, including older adults. Medicare and Medicaid cover hospital stays, doctor visits, and long-term care for seniors and disabled people. HHS promotes healthy ageing through preventive care, nutrition, and exercise (Fulmer et al., 2021). Expert help for managing chronic conditions in older adults. HHS develops health policies and regulations that affect older adult care and services. Funding and researching ageing and public health initiatives to improve senior health.

A voluntary organisation, the Alzheimer's Association provides comprehensive support and resources for dementia patients (Alzheimer's Association, 2019). Information on Alzheimer's symptoms, care, and management. Facilitating Alzheimer's support groups for patients, carers, and families. Alzheimer's patients receive 24/7 support and advice.

Individualised planning and family support. Organising Alzheimer's patient and carer community programmes. Funding Alzheimer's research for better treatments, care, and a cure. Promoting Alzheimer's care and support policy changes.

Various care settings for older adults meet needs and preferences (Plöthner et al., 2019).  Independent Living Communities are for self-sufficient seniors who want social activities and amenities for older adults.

Assisted living facilities provide daily assistance while allowing for privacy and independence. For seniors who need 24-hour medical care, nursing homes provide it. Memory Care Units focus on safety, structure, and specialised programmes for Alzheimer's and other dementia patients.

Home Care Services allow seniors to receive medical or daily assistance at home (Eustis and Fischer, 2019).  Adult day care centres provide carer relief and socialisation for seniors. Hospice Care provides compassionate palliative care, emotional support, and symptom management for terminally ill seniors and their families. Respite Care provides temporary care for carers and seniors, meeting their needs.

Each of these care settings is crucial to meeting the diverse needs of the elderly. These options provide older adults with the care and support they need at every stage of their ageing journey, from independent living in an assisted living facility to comprehensive care in a nursing home or memory care unit.

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Conclusion

Looking back at the project to improve care for older Alzheimer's patients, it's clear that understanding and meeting their needs is complicated. The research illuminated these individuals' unique challenges and the importance of personalized care.

The findings show that Alzheimer's care requires medical, psychological, and social support. Combining medical treatment with emotional and social support and emphasising the individual's history, preferences, and needs worked best. Carers and family members provide this support, but they need resources and training to manage the disease's progression and challenges.

Based on these finding, Alzheimer's carer training is suggested covering communication, behaviour management, and emotional support.

Promote Alzheimer's-specific community-based social and cognitive stimulation programmes. These programmes can help carers take a break and maintain cognitive function. Provide resources, counselling, and disease management advice to Alzheimer's families through support networks.

For improving care quality, create patient-specific care plans based on medical history, preferences, and behaviour. Music, art, and pet therapy can improve mood and cognition in Alzheimer's patients.

Use wearable devices and smart home systems to monitor health and safety, giving patients more independence and ensuring their well-being. Promote Alzheimer's care research and collaboration between healthcare providers, researchers, and policymakers to improve care.

Thus, caring for older Alzheimer's patients requires a compassionate, holistic approach that adapts to the disease's changes, supported by research and community involvement.

 

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