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Persons with Down Syndrome and the Alzheimers Connection. Memory. Just a line to say I’m living, that I’m not among the dead; though I’m getting more forgetful and mixed up in my head.
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Memory Just a line to say I’m living, that I’m not among the dead; though I’m getting more forgetful and mixed up in my head. For sometimes I can’t remember when I stand at the foot of the stairs if I must go up for something or I’ve just come down from there. And before the refrigerator, so often my poor mind is filled with doubt, have I just put food away or have I come to take some out? I’ve got used to my arthritis, to my dentures I’m resigned, I can manage by bifocals, but, Oh God, I miss my mind!
Definition • Progressive, degenerative disease of the neurological system • Irreversible deterioration of the intellect and emotions • It affects over 4 million American adults • It is the fourth leading cause of death in adults after heart disease, cancer, and stroke • Pre-senile and senile dementia are used to describe any diminished capacity to think and to understand
Symptoms • Cells of the brain are affected, causing severe intellectual impairment and changes in mental and neurological functioning • Changes occur in the cerebral cortex – the outer layer of the brain • An accumulation of protein called “tangles” occur in the area of the brain that control recent short-term memory. This area of the brain is the “hippocampus”. This protein is located in the skin and intestines as well as the brain.
Healthy Neuron Synapse Axon Nucleus Cell Body Bendrites
Plaques Granulovacuolar Degeneration
Stages There are stages for the generic population There are Stages for persons with Down Syndrome Each stage can last up to years
Stage One • Anxiety or depression over memory loss • Decreased efficiency in performance • Defensiveness
Stage Two • Marked disorientation • Reduced capacity for speech • Decreased motor dexterity
Stage Three • Loss of self-help skills • Incontinence • Seizures develop • Delusional, persectory and hallucinatory behavior is exhibited
Causes • The cause is unknown • Suspected causes are: A gene in the 21st gene Slow virus or other infectious agent Accumulation of aluminum or other toxins Changes in immune system relating to aging
Diagnosis • There is no single clinical test to identify Alzheimers Other conditions must be ruled out: Depression Head injuries or brain tumor Adverse drug reaction Nutrition deficiencies Menopause
Diagnosis • A diagnosis of Alzheimers can be confirmed only after death by performing an autopsy
Alzheimers Losses Language skills Short Term Memory New learning ability Judgment, planning and foresight Inhibition/impulse control Reasoning and abstracting Sense of intimacy
Behavioral Changes Pacing Fearfulness Rummaging Sexual comments Hand wringing Hallucinations/Delusions Agitation Withdrawal Insistence Public Masturbation Repeating questions
Physical Factors • Urinary tract infections • Bowel impaction • Dehydration • Seizures • Pain/discomfort • Mood swings
Strategies • Provide quiet time • Alleviate boredom • Avoid many changes • Keep choices simple • keep consistent schedule • Reduce stimuli • Provide decaf beverages • Limit length of conversation
Communication Techniques • Make direct eye contact • Identify yourself • Use calm, clear voice • Eliminate background noise • Use short, simple sentences • Use one-step commands • Ask yes/no questions • Use word cues
Written Communication Label the environment Keep a schedule of the day Use notes as reminders Non-Verbal Communications Use an open, gentle approach Hold out items Wave goodbye Use expression of concern Nod your head
Use the R’s • Remain calm • Respond to feelings • Reassure the person • Remove yourself • Return later
And Also: • Be aware of client needs, information and resources available • Identify aspects of disease and screen their problems • Provide treatment through program development • Advocate and refer for further treatment
Programming • Reality Orientation:Brings information regarding time, place, person, and things • Sensory Stimulation: Activities are presented to accentuate a particular sense • Re-socialization: Uses group techniques to stress interpersonal relationships