Alzheimer’s disease remains the most common type of cognitive disorder, accounting for more than 60% of all cognitive disorders. Alzheimer’s disease (AD) is characterized by cognitive decline and has an insidious onset, often occurring in adults 65 years and above. The early-onset disease is also apparent but highly unusual, accounting for only 10% of all Alzheimer’s cases. AD causes progressive and irreversible impairment of cognitive and behavioral functionalities, with memory, reasoning, comprehension, judgment, and language declines being pronounced. Symptom classification of AD is dependent on the stage of the disease and includes preclinical, mild, and dementia stages. Therapies utilized in AD are targeted at slowing the progression of the disease and improving the quality of life of these patients (Weller & Budson, 2018). This paper seeks to report the management experience of Alzheimer’s disease during my clinical rotation.
AD presents with complex care requirements that complicate the entire care process for these patients. During my AD clinical rotation, these complexities were apparent and often affected the overall approach to patient handling. I often felt frustrated, tensed, and guilty when handling these patients. Frustrations were majorly attributable to the unpredictable behavior of these patients. On the other hand, the feeling of guilt was due to the perception that I may not have been doing enough to make these patients feel comfortable. Some AD patients often presented with a characteristic aggressive and combative behavior that made me feel uncomfortable and rather tense when handling them.
Various prejudices were apparent during the care processes for AD patients. These included the perpetuation of misleading information on the disease, inadequate support from patient relatives, loss of self-worth, and lack of awareness, especially by the patient’s family and relatives. These prejudices impacted the patients negatively and were implicated in some patients’ poor quality of life. Biases and discrimination were also present in AD care. These biases, however, exhibited an unpredictable pattern and, in most cases, were relatable to the individual patient’s race, ethnicity, and socioeconomic background. Patients with better socioeconomic backgrounds tend to receive better care compared to their counterparts from poor backgrounds. Race and ethnic components produced specific barriers to care processes that are relatable to their cultural affiliations as well as language barriers. All these factors complicated the care processes and added to the clinical complexities that caregivers have to navigate to enhance the quality of life of these individuals.
Various strategies were employed to manage these complexities. First, I learned to understand the patients and their behaviors. Calmness when dealing with these patients was also pivotal and enabled me to understand their situation as well as care requirements. I also embraced patience and flexibility in the care process since AD patients exhibit unpredictable behavioral changes, such as mood swings. Additionally, I always avoided arguing with these patients to prevent them from being combative and aggressive. I also learned to acknowledge their requests, respond appropriately, and never take whatever they told me personally. Accepting the patients for who they are, seeing them as human beings, and not judging them by their incarcerations or backgrounds also enabled me to offer them excellent care.
Several assumptions are made during the care process for patients with mental illnesses. The first assumption I made was that the patients are likely to behave inappropriately but will still retain the right to be accorded excellent and ethical care. Another assumption was that the patients may have lost nearly all their cognitive abilities but may still respond to dignified treatment, warmth, and respect. Cognitive losses in this regard do not guarantee improper or harsh treatment from caregivers. Also, patients’ combativeness or aggression may be due to their lack of understanding of the subject matter and rather not a reaction to a caregiver’s action. Another assumption is that patients with AD require critical care and that the caregivers are very important to them. These assumptions enabled me to navigate the complexities presented by these patients.
Handling AD patients accorded me the opportunity to better understand the disease process and its overall implications for public health. During my clinical experience, I learned that knowledge of AD is still inadequate both to the caregivers and to the general public. This inadequate knowledge of the disease process has been implicated in disparities in healthcare provision as well as discrimination and stigmatization of the disease. I also learned that significant differ