Based on the observations presented by Marisol regarding her mother Julia, I believe Julia is showing signs of Alzheimer’s dementia. As stated in the the text, “patients experience impairment of memory and at least one other area of cortical function, such as language, calculation, spatial orientation, decision making, judgment, or abstract reasoning” (Hammer & McPhee, 2019). While Marisol states her mother has always been a bit forgetful, it has worsened recently. Patients may display symptoms of dementia including irritability, agitation, anxiety, depression and impulsivity before any memory deficits become apparent (Mao, Fisher, Yang & Dong, 2020).

I would start by ordering labs and possibly a CT scan to rule out underlying causes of this increase of forgetfulness such as hypothyroidism, infection, tumor and cerebrovascular disease. Alzheimer’s disease presents with extracellular neuritic plaques in the cerebral cortex as well as intraneuronal neurofibrillary tangles (Hammer & McPhee, 2019).  Once any underlying disease or cause is ruled out, it would be important to assess the home situation further. Are there changes that can be made in the home to ensure the safety of Julia, such as removing tripping hazards including cords or throw rugs? Door alarms may be something Marisol could look into to alert her if her mother becomes confused and tries to wander. I would suggest that Julia wear an med alert bracelet with Marisol’s contact information should Julia ever become lost and unable to find her way back home. Because Marisol is the sole caretaker, it is important to establish a support system, whether it be other family members or a visiting nurse service. As her disease worsens, it may become too much for Marisol to keep her mother at home. If Julia’s symptoms were to progress to a level in which her safety was in question, a long term care facility specializing in Alzheimer’s care would be a likely solution.

Hammer, G., & McPhee, S. (2019). Pathophysiology of disease: An introduction to clinical medicine (8th ed). McGraw-Hill

Mao, Y., Fisher, D. W., Yang, S., Keszycki, R. M., & Dong, H. (2020). Protein-protein interactions underlying the behavioral and psychological symptoms of dementia (BPSD) and Alzheimer’s disease. PLoS One, 15(1) doi:http://dx.doi.org.americansentinel.idm.oclc.org/10.1371/journal.pone.0226021

367 words

In reply to Eichner

Re: Discussion 4 – N512-19A Module 4 Disorders of the Nervous System Across the Life Span DQ

by Faye  – 

Hi Eichner,

Thanks for your post. It’s good that you talked about what you would do for determining differential diagnoses of AD. Blood and imaging tests should be conducted to assess potential causes of symptoms. Cognitive assessments should also be conducted (Pearce, 2020). If a patient has a highly atypical presentation or rapidly progressing (potentially not AD and may be other causes of dementia), it is important to do specialized image testing, such as single photon emission computed tomography (SPECT), thyroid peroxidase blood tests, genetic testing and counseling, cerebrospinal fluid analysis (CSF), and others (Pearce, 2020).

-Dr. Rey

Reference:

Pearce, E.N. (2020). Alzheimer dementia. Dynamed Plus. https://www.dynamed.com/condition/alzheimer-dementia#DIFFERENTIAL_DIAGNOSIS

115 words

In reply to Faye 

Re: Discussion 4

by Lisa-Kay – 

Hi Eichner, enjoyed your discussion. I knew that managing a family member with Alzheimer’s dementia was probably very difficult. There are so many factors involved in order to create a safe environment for your loved one (Mayo Clinic, 2020). Exercise, such as walking, can help with sleep as well as maintaining healthy joints and preventing constipation (Mayo Clinic, 2018). As the disease progresses, a patient may no longer remember to eat or enjoy preparing meals as they once did (Mayo Clinic, 2018). It is important for the care giver to ensure that the patient is eating and drinking healthy options to prevent constipation and dehydration (Mayo Clinic, 2020). Social interactions is also a very important part of daily living for these patients (Mayo Clinic, 2018). Above all, precautions should be taken to make sure that their environment is as safe as can be while still being comfortable (Mayo Clinic, 2020). All of these tasks can become overwhelming for the caregiver as well (Mayo Clinic, 2018). The care giver must also make sure to keep themselves in good health in order to continue to support their loved one (Mayo Clinic, 2018).

Reference

Mayo Clinic. (2018). Alzheimer’s disease – diagnosis and treatment. Retrieved from https://www.mayoclinic.org/diseases-conditions/alzheimers-disease/diagnosis-treatment/dr

209 words

In reply to Lisa-Kay

Re: Discussion 4 – N512-19A Module 4 Disorders of the Nervous System Across the Life Span DQ

by Diane  – 
Hi Eichner,
Very nice and informative posts! You had some great suggestions Michelle of how Marisol can keep her mom safe at home. You are correct unfortunately, it would be hard, but if the situation becomes worse, or if both mother and daughter are in harms way Marisol may have to utilize other housing possibilities for her mom. I was actually obtaining my drug test for CastleBranch when a woman opened up to me “teary eyed” at the facility as we were both waiting our turn. She was telling me her husband recently passed away while being in a memory care, nursing facility she had to place him in because she could no longer keep him at home for safety reasons of having his nights and days mixed up and wandering issues as well. There are wonderful local community-resources available for families through the Alzheimers Association.
Have a great holiday weekend,
DianeAlzheimer’s Association – Support Groups. (2020). Https://Www.Alz.Org/Help-Support/Community/Support-Groups. https://www.alz.org/help-support/community/support-groups

171 words N512-19A Module 4 Disorders of the Nervous System Across the Life Span DQ