Language Intervention and Alzheimer’s Disease

1. Language Intervention and Alzheimer’s Disease Lindsay K. Tice May 6, 2006

2. Statistics of Alzheimer’s disease… • By 2050 the number of individuals with Alzheimer’s could range from 11.3 million to 16 million. • One in 10 individuals over 65 and nearly half of those over 85 are affected. • The average lifetime cost of care for an individual with Alzheimer’s is $174,000. • Half of all nursing home residents have Alzheimer’s disease or a related disorder. (www.alz.org)

3. Alzheimer’s disease… • Found by Dr. Alois Alzheimer in 1907 • Characterized by plaques and neurofibrillary tangles • The amyloidal plaques are of a protein make-up • Affects over 12 million people worldwide (Jarvik & Winograd, 1988, Khachaturian & Radebaugh, 1996, Citron, 2002 )

4. Alzheimer’s disease… • Usually defined in two categories • Pre-senile dementia or Early Onset Alzheimer’s disease, which affects people under the age of 65 and is usually attributed to genes • Senile dementia or Alzheimer’s disease which affects those over 65, no known cause so far…

5. Alzheimer’s disease… • Tests such as MMSE are helpful in gauging progression of the disease. • MMSE is limited to those who have no auditory or visual impairments • The brain is affected in the frontal, temporal, and the parietal cortex and atrophy of the hippocampus and amygdala, where the main sites for memory are found

6. Stages of Alzheimer’s disease • Stage 1:No impairment • Stage 2:Very mild cognitive decline • Stage 3:Mild cognitive decline • Stage 4:Moderate cognitive decline • Stage 5:Moderately severe cognitive decline • Stage 6:Severe cognitive decline • Stage 7:Very severe cognitive decline (www.alz.org)

7. Kitwood’s Theory of caregiving for a person with Alzheimer’s disease • recognition • negotiation • collaboration • play • Timalation • celebration • relaxation • validation • holding • facilitation (Seman & Stansell, 1999)

8. Intervention in Facility Caregiving… • Base training program for nursing and activity staff on Kitwood’s theory. • Preserve human dignity and self-worth of individual • Stress importance of caring attitude • Gain trust of the resident

9. Intervention in Facility Caregiving… • Train staff to respond to resident in a positive matter even if speech is disturbed • Stress importance of gestures to complete ADL’s • Use language style preferred by resident (e.g., name for bathroom) • Encourage easy-going attitudes that can relax and help the resident form clear thoughts. • Speak in a clear, audible voice for those with hearing impairments

10. When visiting with someone with Alzheimer’s disease… • Implement manipulatives into the session (folding clothes, puzzles, etc. to engage conversation) • Take walks • Speak clearly • Hold hands, give hugs, touch person’s arm • Use helpful reminiscing • Implement music for relaxation

11. On a Personal Note… • After spending countless hours working with people with varying levels of Alzheimer's disease, I have found that Kitwood’s theory of caregiving is ideal for CNA's to gain the trust of a resident for hands-on care. • I am also a believer in using gestures and language that the resident understands to communicate properly with him or her. I try to have a deep feeling of empathy for what they must feel when they cannot understand language and sometimes can’t form their own sentences to communicate.

12. References • Citron, M. (1998). Alzheimer’s Disease: Treatments in discovery and development. Nature Neuroscience, 5, 1055-1057. • Jarvik, L. F. & Winograd, C. H. (1988). Treatments or the Alzheimer’s Patient. New York, NY: Springer Publishing Company, Inc. • Khachaturian, Z. S., & Radebaugh, T. S. (1996). Alzheimer’s Disease, Causes, Diagnosis, Treatment, and Care. New York, NY: CRC Press. • Seman, D. & Stansell, J. (1999). Rethinking Alzheimer’s Care. Baltimore, MD: Health Professions Press, Inc. • Alzheimer’s Association. www.alz.org

13. with years, “We turn not older but newer everyday.” -Emily Dickinson