Cognitive Issues

On November 30, 2011, the American Academy of Neurology reported in its online journal Neurology an advancement in scientific knowledge that will help elderly adults universally. Prior to this study, doctors used an FDG marker to detect any changes in the brain’s metabolism that could signify either Alzheimer’s or a type of dementia called frontotemporal lobar degeneration. Although both are types of dementia with very similar symptoms, the treatments for each vary vastly and it is therefore important to distinguish the two in order to determine the best and most effective treatment.

Instead of using an FDG marker, this new method employs a PIB marker that detects a type of brain plaque called amyloid that is associated with Alzheimer’s, but not frontotemporal lobar degeneration. The study found that PIB markers had higher sensitivity rates, and better accuracy and precision in measuring qualitative factors that differentiate Alzheimer’s from frontotemporal lobar degeneration. For purposes of comparison, the PIB marker had a sensitivity rate of 89.5 percent, while the FDG marker had a sensitivity rate of only 77.5 percent.

This scientific advancement has many implications. Beyond the most apparent fact that it will improve the quality of life for many elderly adults worldwide, it also proposes the question of whether or not your loved one is receiving the most advanced and effective treatments, especially if he or she resides in a nursing home. Often, since nursing homes are underfunded and understaffed, they do not have the financial backing to provide your loved one with the best treatments. Nursing homes that are privately owned are often more concerned with personal profit than the well-being of your loved one. This is a direct violation of your loved one’s rights, as nursing home residents are entitled to receive the best possible care in response to any and all of their circumstances.

The quality of care provided by a nursing home is directly linked to its staff. Not only must there be an adequate staff, but this staff must also be well-trained and knowledgeable. Furthermore, caregivers must be continually educated and trained and re-trained as science advances and new discoveries are made. It is crucial that caregivers are kept updated with new treatments because nursing home residents may be suffering from preventable conditions that may even lead to death.

There are so many other unfortunate conditions that are prevalent in nursing homes, such as dehydration and malnutrition, pressure sores, incontinence, infections, and more.

Studies show that one in five adults residing in nursing homes experience agitation, which can manifest itself as irritability, apathy, or depression. While agitation occurs in adults who are relatively healthy, it becomes problematic when adults who have dementia become agitated because these cases of agitation are more likely to progress into more serious phases. In a study titled “Dementia-Related Agitation,” available in the November 2011 Journal of American Medical Directors Association, John B. Morley studies the relationship between dementia and agitation in nursing home residents and proposes some solutions to this issue.

One cause of agitation is pain. Therefore, it is very important for nursing homes to have high-quality pain management programs such as music therapy, dance therapy, and pet therapy. Psychosocial interactions and exercise therapy have proven to be the most effective treatments for pain management. However, for any of these treatments to reach their full potential in terms of effectiveness, caretakers must be thoroughly educated in these areas and must be provided the tools and resources necessary to implement such programs by the nursing home’s owners and operators. For this and for many other reasons stressed in the series of articles published in this nursing home and elder abuse blog, It is critical for you to ensure that your loved one’s care facility is adequately staffed and that your loved one is being properly cared for by a knowledgeable and well trained staff. If you watch your loved ones like a hawk, you will instinctively know when a facility is not only understaffed, but also undertrained and not properly supplied with the resources it needs.

Malnutrition also factors in to the causes of agitation. A lack in nutrients can cause visual and oratory problems that may hinder the ability to see or hear and consequently increase the risk of agitation. Additionally, studies have proven that there is little evidence to support that the use of feeding tubes helps to improve nutrition in elderly adults.

A final common cause of agitation is delirium. It is often a consequence of polypharmacy, which is the excessive use of multiple prescribed drugs simultaneously. Since the use of drugs is a direct cause of delirium, and thus agitation as well, it is only logical to conclude that agitation should not be treated by using additional drugs. Specialists confirm that the best treatment for agitation is behavioral, not chemical.

However, some nursing homes may not have your loved one’s best interest at heart. Such facilities may be using drugs such as antipsychotics to chemically restrain elderly adults who suffer from agitation in order to subdue them and make them easier to handle. Furthermore, evidence has shown that use of antipsychotics may increase the risk of falls, mortality, and hip fractures. Not only is this is a direct violation of your loved one’s Patients’ Rights, but it can also be detrimental to his or her physical and mental well-being.

Articles Posted in Cognitive Issues

Scientific Discovery: A New Way to Distinguish Alzheimers from Dementia

Recent Study Shows that Use of Antipsychotics to Chemically Restrain Nursing Home Residents Directly Aggravates Dementia-Related Agitation