Worldwide, forty-eight million people have been diagnosed with Alzheimer’s, a chronic neurodegenerative disease, resulting in 1.9 million deaths just in the year 2015. (Khyade, Khyade, & Jagtap, 2016) There are medications that reduce symptoms for some patients, but these medications only work for a short-term period of time, at which point the patient reverts to the cognitive level they would currently be at had they never taken the medication and there are no medications that reduce the risk of getting the disease. There is no cure for Alzheimer’s.
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Ultimately, everyone with the disease requires round the clock care at some point, but there are limited options, which forces families into crisis as the disease progresses. It is for this reason that I chose to do my research project and job shadowing on the population of Alzheimer’s patients in long-term skilled nursing care.
The term Alzheimer’s disease originated in 1906, when psychiatrist and neurologist, Dr. Alois Alzheimer, met Auguste Deter, a fifty-one year old woman suffering from an unknown mental illness causing unusual behaviors and increasing short-term memory loss. Her condition became his obsession. Following her death, he performed a brain autopsy and discovered a shrunken cortex, clumps, now know as amyloid plaques, and tangles of fibers, now known as neurofibrillary tangles, in her brain tissue. These conditions were distinctive enough to diagnose a new form of dementia, which became known as Alzheimer’s disease. During the next five years, eleven similar cases were reported in medical literature, interchangeably using the term pre-senile dementia, a subtype of senile dementia due to the age of the patients. (Khyade, Khyade, & Jagtap, 2016) Studies later concluded that pre-senile and senile dementia were the same, differentiating the diagnosis of Alzheimer’s disease and recognizing that age did not play a part in the diagnosis. This early version of the disease is now called early on-set and affects patients under the age of sixty-five. Eventually, Alzheimer’s disease became a blanket term to describe people of all ages exhibiting the same symptom patter, disease course and neuropathology.
Alzheimer’s is one of the most expensive diseases in the United States. There are currently more than five million Americans with Alzheimer’s disease, absorbing twenty percent of all Medicare costs. The annual cost of caring for Alzheimer’s disease varies from $42,049 for institutionalized patients to $12,572 for patients living in the community, (Dharmarajan, 2009) not including the lost wages of a caregiver. On average, the cost of care is $330,000 in a patient’s lifetime. As the baby boomers age, it is anticipated that the rate of diagnosed seniors will grow dramatically, causing a very large social problem and economic burden. There are some medications on the market that have shown symptomatic benefit, and ultimately, any reduction of behavioral disturbance and cognitive decline reduces the needs of a caregiver,
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