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A Holistic Approach To Alzheimer’s Disease Care Ginny Fuller February 28, 2008 Dr. Hadley.

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Presentation on theme: "A Holistic Approach To Alzheimer’s Disease Care Ginny Fuller February 28, 2008 Dr. Hadley."— Presentation transcript:

1 A Holistic Approach To Alzheimer’s Disease Care Ginny Fuller February 28, 2008 Dr. Hadley

2 Objectives Provide an overview of Alzheimer’s disease Discuss standard treatment options Discuss complementary treatment options Address religion and spirituality in the patient, caregiver, and from a provider’s prospective

3 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 >80 have diagnosable AD

4 Diagnosis of AD Diagnosis must include memory impairment plus at least one of the following: – Apraxia – Agnosia – Aphasia – Impaired executive functioning

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

6 Standard Treatment Acetylcholinesterase Inhibitors NMDA Receptor Antagonists Behavioral Treatments

7 Complementary and Alternative Treatments Ginkgo biloba Phosphatidylserine Huperzine A Curcumin Music therapy Touch therapy and massage

8 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

9 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

10 Spirituality from a Provider’s 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

11 Spirituality from a Provider’s 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

12 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 Provider’s 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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14 Khouzman H and Smith C. Bible therapy; a treatment of agitation in elderly patients with Alzheimer’s disease. Clinical Gerontologist. 1994; 15(2): Koenig H. A commentary: the role of religion and spirituality at the end of life. The Gerontologist. 2002; 42(3): Lenshyn J. Reaching the living echo: a new paradigm for the provision of spiritual care for persons living with Alzheimer’s disease. Alzheimer’s Care Quarterly. Oct-Dec 2004; 5(4): Mayo Clinic. Alzheimer’s disease Available at: Accessed on 7 November 2007.http://www.mayoclinic.com/health/alzheimers-disease/DS00161 Mazza A, Capuano A, Bria P, Mazza S. Gingko biloba and donepezil; a comparison in the treatment of Alzheimer’s dementia in a randomized placebo-controlled double- blind study. European Journal of Neurology. 2006; 13(9): Mooney S. A ministry of memory: spiritual care for the older adult with dementia. Care Management Journals: Journal of Case Management. Fall 2004; 5(3): Morano CL, King D. Religiosity as a mediator of caregiver well-being: does ethnicity make a difference? Journal of Gerontological Social Work. 2005; 45: Namenda® Prescribing Information Available at Accessed on 18 February National Institute on Aging. Alzheimer’s disease fact sheet Available at : Accessed on 7 November 2007.http://www.nia.nih.gov/Alzheimers/Publications/adfact.htm Paun O. Female Alzheimer’s patient caregivers share their strength. Holistic Nursing Practice. Jan-Feb 2004; 18(1): Powdrill S. Interview with Ginny Fuller. University of Kentucky. 25 January Post S. Alzheimer’s and grace. First Things. April 2004; Roff L, Parker M. Spirituality and Alzheimer’s disease care. Alzheimer’s Care Quarterly. October 2003; 4(4): Schardt D. Spice rack or medicine chest? Nutrition Action Healthletter. October 2007; Sierpina V, Sierpina M, Loera J, Grumbles L. Complementary and integrative approaches to dementia. Southern Medical Journal. June 2005; 98(6): Stuckey J, Post S, Ollerton S, Fallcreek S, Whitehouse P. Alzheimer’s disease, religion, and the ethics of respect for spirituality: a community dialogue. Alzheimer’s Care Quarterly. Summer 2002; 3(3): 199. Stuckey J. Blessed assurance: the role of religion and spirituality in Alzheimer’s disease caregiving and other significant life events. Journal of Aging Studies. March 2001; 15(1): 69. Taylor R. Alzheimer’s disease experienced: from the inside out. Alzheimer’s Care Quarterly. Oct-Dec 2005; 6(4): US Bureau of the Census. Statistical abstract of the United States: the national data book. Washington DC: US Government Printing Office; Table 759. Winblad B, Palmer K, Kivipelto M, Jelic V, Fratiglioni L. Introduction: mild cognitive impairment: beyond controversies towards a consensus. Journal of Internal Medicine. 2004; 256:


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