October 13, 2008 | Web Exclusive
Patients | Treating Elderly
Senior moments
Treating patients with Alzheimer’s disease.
by Anastasia Turchetta, RDH
It’s safe to say that we’ve all forgotten a name, misplaced an item or missed our destination exit while driving. We probably even joke about it as we quickly rebound from our “senior moment.” These momentary memory lapses we experience are considered normal, provided they occur occasionally. A warning sign for true concern about one’s memory or cognitive abilities involves the frequency of those occurrences.
Dementia is a general term referring to a decline in both memory loss and interference in performing daily activities. Depending upon the diagnosis, dementia may be reversible or irreversible. The most common form of irreversible dementia is Alzheimer’s disease; it accounts for 50% to 70% of all dementias. As many as 5.2 million Americans are living with Alzheimer’s disease, 5 million of whom are over the age of 65.
As healthcare professionals, our complete understanding of this disease is critical in accomplishing optimal oral health for those patients as the systems we have been taught for delivering treatment and educating most patients must be adapted to accommodate the various symptoms associated with this disease. This article will provide a basic review of Alzheimer’s disease and introduce realistic action plans to obtain and maintain oral health when communicating with patients, caregivers and fellow team members.
What you’re facing
Alzheimer’s disease is a progressive brain disorder that eventually destroys the capability to learn new information, retain information, concentrate, make sound decisions, and perform daily tasks such as bathing, paying bills, walking and writing. Personality changes may be swift, ranging from disorientation, aggression, and anxiety, to repetition and suspicion. Although no known cure exists, some medications are thought to delay the onset.
Risk factors for Alzheimer’s disease include age—mainly 65 and over—family history, heart disease, high blood pressure, stroke, diabetes, tobacco, excess use of alcohol, weight management, lack of social interaction or lack of physical and mental exercise.
It is more than likely that you will notice early signs of Alzheimer’s disease before your patient is diagnosed. Document the subtle occurrences you observe during the preventive appointment as this will guide you in determining which oral hygiene product may lead to the best patient compliance for oral health. For example, mild to moderate signs include the inability to retain new information, provide current information regarding their health history, personality or appearance changes.
Your challenge is to arrive at the best possible outcome—best meaning simplest. When discussing a product for dry mouth, sensitivity, caries risk or remineralization, you must consider the time plus delivery method required for the product(s) to be effective and whether your patient will be able to follow through with the directions on a daily basis. If the patient is not able to complete this task, ask yourself: Will the caregiver have time to be accountable for further oral care beyond brushing?
consider the caregiver
In 2007, 9.8 million family members provided unpaid care for their loved ones diagnosed with Alzheimer’s. The average caregiver is between the ages of 48 and 50. At about 16.6 hours a week, caregiver stress is real, as many are juggling their own family and employment in addition to the responsibility of providing transportation, attending medical/dental appointments, delivering medication, home care, groceries and taking care of finances for their loved one. External symptoms of caregiver stress are depression, denial, anxiety anger, insomnia and exhaustion.
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