"How Dementia and Alzheimer’ s Disease Is Diagnosed in the Medical Community? " is a delightful example of a paper on neurology. The focal point of this paper is to present the burning clinical question that will be a focal point and part of further research during this course. The question is how dementia and Alzheimer’ s disease are viewed and diagnosed in the medical community and how this affects legal issues and the patient’ s family. As the last few decades have provided a generation of older adults, living well into their 80s, there is also the problem of how to handle this situation through medical diagnosis, legal supervision by lawyers, and how families are supposed to deal with the varied outcomes that can occur.
It is important to also know how older people and their families can also help themselves in a number of ways, including living a more healthy life. The Burning Clinical Question Introduction As our population now lives longer than ever before, there are issues that have become more in evidence that concern the elderly, particularly past the age of 70 years of age, sometimes sooner.
The diseases of dementia and Alzheimer's have become a larger issue in recent decades as the medical community conducts more research into the problems these diseases cause, both to the health of the elderly, and the families involved. There are also a number of legal issues involved as well (NINDS 2014). Background The largest issue with dementia and subsequent Alzheimer diagnosis is that, in most cases, they are hard to monitor for the simple reason that many elderly people do not want to be considered as mentally incapable of handling their own affairs, and have a fear of being sent to rest homes, shut away for the rest of their lives (NCB 2009).
It is also hard on the families involved because they may want to take their elderly parents to the doctor but if elderly parents decide to remove their children from a caretaker position as well as from a guardianship position, then families have no recourse to providing help and suddenly find themselves left out in the cold. The parents’ doctors will not speak to them and lawyers involved in the situation, may also set up legal barriers, so that children have no legal recourse to assist parents who, for reasons of dementia, have turned against them. There needs to be an arrangement between the medical community and the legal community that provides services to assist all members of the family as elderly parents become older and have medical issues, both physically and mentally.
This also includes the ability for the medical professionals to make an official diagnosis of dementia, which determines that an elderly parent is not considered capable of taking care of their own financial situations but that they can still live in their homes if they are considered able to still physically get around, rather than being regulated to a nursing home.
It is important to know how the clinician will make an official diagnosis of dementia and potential Alzheimer’ s disease, using current medical guidelines, which provides a definitive status that also requires the next level of medical and legal assistance (Titler 2008). The Burning Clinical Question Consequently, the burning clinical question in the PICOT format for this paper is: “ In elderly people (P=70+), how are cognitive skills measured in dementia and potential Alzheimer’ s disease (I=Issue), as compared to younger adults (C), affect the lifestyle of those diagnosed (O), and how long before a diagnosed patient is no longer legally or medically functional (T)? ” (Melnyk & Fineout-Overholt 2011). This question was selected because it is becoming a bigger issue in almost everyone’ s lives as either their parents live longer into old age, or even as they are growing older themselves.
How an elderly person is viewed in the medical community and diagnosed with certain mental illnesses, affects how the legal system must also be applied to protect the elderly (NCB 2009; Webb 2011).
The other side to this is to have a process in place which provides the elderly with their last years in peace and happiness in their own home, without fear of losing their homes because of medical bills or other legal issues (NCB 2009). At one time, families were more able to stay home with the elderly person and help them through the day. In today’ s environment, many people are working longer which means that less care can be given by family members to assist with the needs of elderly parents. Research Methodology The important part of this research is finding previous research that has been done on how dementia and Alzheimer’ s disease is tracked over a series of years and how it is diagnosed, either at the beginning of tracking and clinical testing or diagnosed at the end of the research.
In reality, this is still a new area of research and while there are plenty of websites, maintained by the medical community, that provide examples of symptoms and treatments, there is not that much research done over decades of following the elderly as they get older, from first tracking to the last testing (NINDS 2014). There are two parts to the issue of dementia and how it can be diagnosed: testing cognitive skills, and testing of non-cognitive skills.
There are also physical symptoms which may provide a clue to dementia such as an underactive thyroid, infections, depression, and poor concentration. At the onset of Alzheimer’ s disease, there is a certain amount of brain shrinkage, brain chemicals can be reduced, thus barring the necessary messages that typically move between brain cells (Patient 2014).
Other physical issues are multi-infarct dementia whereby small blood vessels are blocked due to small strokes. Daily habits such as smoking, drinking, a lack of exercise, can also affect these blood vessels and cause them to shrink. In about every 15 cases out of 100, abnormal protein deposits, called Lewy bodies, can develop in brain nerve cells and cause slowness of movement or stiffness, a shuffling walk, and inability to retain one’ s balance during starting to walk, stopping, or turning (Patient 2014).
Changes in personality can also occur, such as moodiness, distrust of those around the person, uncontrolled angry outbursts, and unusual actions that are embarrassing and unpleasant for family members to endure. Objective The objective of the research is to find ways to begin testing and documentation of older adults at an earlier age, such as 50 years and older. Most people are still fairly cognizant at that age and testing would be very revealing as an initial contact point when again testing over the years to the age of 65.
Differences in mental cognitive skills would be more noticeable if it has been tracked. At this point, it is not clear whether that has been done and this would be invaluable information that could be utilized later in EBP (Melnyk & Fineout-Overholt 2011). Conclusion The area of dementia and Alzheimer’ s disease will be very active for many years as more documentation is done with the aging longer-living populace. It will also provide wealth in EBP research which could help many people in the future.
Melnyk, B.M., & Fineout-Overholt, E. (2011). Evidence-Based Practice in Nursing & Healthcare (2nd ed.). Baltimore, MD: Wolters Kluwer Health. (Melnyk & Fineout-Overholt 2011)
NCB. (2009). Dementia: Ethical Issues. Nuffield Council on Bioethics (NCB). Retrieved from http://www.nuffieldbioethics.org/sites/default/files/Nuffield%20Dementia%20report%20Oct%2009.pdf.
NINDS. (2014). The Dementias: Hope Through Research. National Institute of Neurological Disorders and Stroke (NINDS). Retrieved from http://www.ninds.nih.gov/disorders/dementias/the-dementias.pdf.
Patient. (2014). Memory Loss and Dementia. Patient.co.uk Online. Retrieved from http://www.patient.co.uk/health/memory-loss-and-dementia.
Titler, M.J. (2008). The Evidence for Evidence-Based Practice Implementation (Chapter 7). In R.G. Hughes (Ed.), Patient Safety and Quality: An Evidence-Based Handbook for Nurses, Vol.1. (pp.1-113). US: Agency for Healthcare Research and Quality. Available at
Webb, J.J. (2011). Nursing Research and Evidence-Based Practice. Chapter 6. In Cherry, B. & Jacob, S.R. (Eds.), Contemporary Nursing: Issues, Trends & Management (5th ed.), (pp. 104-124). St. Louis, MO: Elsevier/Mosby. Available at http://www.coursewareobjects.com/objects/evolve/E2/book_pages/cherry/pdf/SAMPLE.pdf