A Holistic Approach To Alzheimer

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A Holistic Approach To Alzheimers Disease Care
Ginny Fuller February 28, 2008 Dr. Hadley
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Objectives

• Provide an overview of Alzheimers disease
• Discuss standard treatment options
• Discuss complementary treatment options
• Address religion and spirituality in the patient,
  caregiver, and from a providers prospective

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Epidemiology

• AD is the most common form of dementia worldwide
• AD affects over 4.5 million Americans
• Prevalence increases dramatically as age
  increases after 60
• Nearly 50 of individuals gt80 have diagnosable AD

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Diagnosis of AD

• Diagnosis must include memory impairment plus at
  least one of the following
• Apraxia
• Agnosia
• Aphasia
• Impaired executive functioning

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Pathophysiology

• Decreased acetylcholine
• Increased glutamate
• Diffuse brain atrophy
• Inflammation
• B-amyloid plaques
• Tau protein tangles

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Standard Treatment

• Acetylcholinesterase Inhibitors
• NMDA Receptor Antagonists
• Behavioral Treatments

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Complementary and Alternative Treatments

• Ginkgo biloba
• Phosphatidylserine
• Huperzine A
• Curcumin
• Music therapy
• Touch therapy and massage

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Spirituality and the AD Patient

• AD patients religion and spirituality must be
  taken into consider during treatment
• Involvement with religious activities and
  practices may improve health and longevity and
  may slow cognitive impairment
• Sermons, singing, scripture study, prayer, and
  socializing improve and stimulate cognitive
  functioning
• Even highly progressive AD patients can be
  reached on a spiritual level
• Patients may use religiosity to accept, make
  sense of, and be at peace with their diagnosis
• It is estimated that nearly 90 of AD patients
  pray

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Spirituality and the AD Caregiver

• Spirituality plays a major role in the day to day
  lives of many AD caregivers
• Caregivers find support through a local church or
  religious organization
• Caregivers use their spirituality and faith as a
  type of coping mechanism to deal with grief,
  loss, and depression
• They may use AD as an opportunity for spiritual
  growth
• Religiosity may lead to lower levels of
  depression, a higher perception of stress, and
  higher levels of self acceptance

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Spirituality from a Providers Standpoint

• 82 of Americans over 65 state that they are
  actively a part of a faith community, but there
  is very little training given to health
  professionals dealing with spirituality and
  religion
• Providers must listen to family and patient
  concerns and wishes and must acknowledge various
  faith traditions and practices
• Especially with end of life care, spiritual needs
  may be just as important as physical, social, and
  psychological needs

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Spirituality from a Providers Standpoint

• Forms like the Sacred Center Assessment are
  available to health care providers to help
  address patients spiritual wants and wishes
• Professionals must provide support and develop
  individualized plans for each AD patient
• Providers must cooperate with clergy and other
  individuals in faith communities
• Encourage caregivers and AD patients to join care
  and support groups
• We are not obliged to reorient them into our
  reality, but we are obliged to be an attentive
  presence in theirs. S. Post

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Conclusions

• The number of individuals affected with AD is
  expected to continue to grow in the future
  decades, tripling by 2050
• Research regarding spirituality and the patient,
  caregiver, and practical tips for providers must
  be continued and increased
• More in depth studies regarding complementary and
  alternative therapies in AD patients need to be
  performed
• A holistic approach needs to be adopted by
  physicians and other healthcare providers caring
  for patients with dementia
• Providers must treat every patient as an
  individual, with specific customs, beliefs, and
  practices, which are unique
• Patients, providers, caregivers, and other
  members of society need to work together to
  provide the most thorough and encompassing care
  possible

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