Alzheimer’s
Disease (AD) is a serious illness that affects well-being of people especially
aged 65 years and above. For this population, AD is a primary cause of
dementia. People diagnosed with AD are likely to experience significant memory
declining, deterioration of language and problem-solving skills, and reduction
in the functioning of cognitive tasks that influence how an individual performs
everyday activities (McKhann et. al., 2011). Furthermore, there is a lot of capital
and social cost associated with AD that is dominant for people over the age of
65 years. A 2012 analysis of the situation by Alzheimer's Association established
that over 200 billion dollars were used annually for payments to the treatment
of the disease (Alzheimer's Association, 2013). Such a high cost indicates that
there is a huge effect for affected families in regard to retirement savings,
food budget, and restricted health spending on other preventive medical
practices. Such an indication raises a concern for understanding and preventing
dementia-related costs that stem from the AD.
In
2016, AD is estimated to be attributed to the deaths of approximately 130,000
people in the state of Georgia. According to a report by the Alzheimer's
Association, (2016), this state had 50,000 people, aged 85 years and above who
had been diagnosed with AD in 2016. This number reflects almost 38% of the
total elderly population in the state of Georgia (Alzheimer’s, Association, 2016).
The projected statistics have shown that by 2020, the number of AD patients in the
state of Georgia will increase by 15.4 percent; by 2050, 46.2 percent of the
population will be affected by AD (Alzheimer's Association, 2015). In the
United States of America, it is estimated that a population of 5.4 million
Americans have Alzheimer's Disease, with the number expected to grow rapidly to
the point that by 2050, a new case of AD will be developed after every 33
seconds (Alzheimer’s, Association, 2016).
Due to
the significant burden on older people, there is an urgent need for health
professionals to examine the outcomes and factors associated with AD (Prince
et. al., 2015). Furthermore, there is a further need to understand how a
quality of care provided by caregivers working for AD patients influences
health outcomes among AD patients in that caregivers are persons who directly
interact with the patients at care facilities (Allen, Dublin, & Kimmerly,
2012). This chapter looks into the AD and its impacts on patients, as well as
caregivers working with the patients.
Statement of the
problem
AD is common
among the aging population of people over 65 years in the United States, but it
is not a distinctive characteristic of the aged (Karasek, 2004). In its initial stage, AD starts on one
side of the brain. It then slowly extends to other parts, including sections dedicated
for the retention of the memory (Whitehouse et. al., 1982). Even though medication does not cure this
disease, medication helps in improving the destructive consequences, by reducing
its progression and relieving patients from some of the severe symptoms
(Citron, 2002). According to Dave, Mary, Dawn, and Char (2001), Alzheimer’s is
a complicated disease because its consequences are so severe.
Research
has shown that AD is associated with various negative health outcomes. With
time, AD causes nerve cells to be disconnect from the brain, leading to its shrinkage
(Weiner & Frenkel, 2006). During the final phase of AD, this shrinkage was
evident throughout the whole brain, and its tissues appear to shrink to
significantly low numbers (Wlody, 2014). Memory loss was especially pronounced
among AD patients. It had negative consequences for the victims as they develop
problems getting lost, taking unusual long times to complete simple tasks, and
repeating statements and questions (Alzheimer’s, Association, 2016). Memory
loss may also lead to forgetting people, paranoia, hallucinations, and an
inability to learn new things (Kotilinek et. al., 2002). In addition, losing brain tissue tend to influence
the language function of a patient and how he or she constructs meaning when
communicating with others. At the last stage, the brain shuts down completely,
and the patient was forced to stay in bed (Albert et al., 2011).
Moreover,
another factor associated with AD is age; AD is a kind of dementia that mostly
affects the elderly (Bertram & Tanzi, 2011). Although AD is a form of
dementia, it is not necessarily like other forms of mental disintegration such
as delirium. Dementia leads to loss of the mental and intellectual abilities,
intelligences, and social skills. Studies showed that about 10 percent of
people who suffer from dementia are “dementia pre-aging” or prehensile dementia
(Bertram & Tanzi, 2011). If the patient is over the age of 65, it is called
“senile dementia.” However, existing literature has reported the importance of lifestyle
which is a primary factor associated with AD among older people. Research
showed that AD is associated with the diet, social engagement, and physical
activities for older people and maintaining a healthy lifestyle is likely to decrease
the risk of developing and suffering from AD (Bertram & Tanzi, 2011).
Social
relationships have been investigated and found to have an impact on the health
of an individual. According to Cohen, (2004) maintaining a good relationship
helps an elderly patient maintain a healthy life at a prolonged time. Good
relationships indicate better care for the ailing relatives hence increasing
their chance of feeling better or recovering from the effects of the disease.
Better relationships also retain good memories for the patient and it increases
the possibility of them feeling better and being responsive to treatment (Kawachi
& Berkman, 2001).
Furthermore,
many studies have highlighted a significant impact of quality of care delivered
by caregivers working for AD patients especially at long-term care facilities
on health outcomes for AD patients. For these caregivers, they have more burden
caring for the patients because of the associated memory loss (Etters, Goodall
& Harrison, 2008). Caring for a close relative with AD-associated dementia
means that they do not even recognize you as they used to, hence causing a
psychological trauma to the caregiver. If they are not informed on what to
expect with an AD patient, they might end up retracting from caring for them. Most
of the caregivers to AD patients have been diagnosed with anxiety and
depression, especially when the patient is a close relative (Mahoney, Regan,
Katona & Livingston, 2005) As suggested by Bourgeois, Schulz and Burgio, (1996)
caregivers for AD patients should be equipped with immense knowledge regarding
the disease in order to raise their awareness of care to the patients and also
increase the interaction they make with them.
Purpose of the Study
This
study aimed to explored knowledge, perceptions, and attitudes of AD among
caregivers working with AD patients and their working experiences at the
facilities. Particularly, this study focused on investigating how knowledge, perceptions,
and attitudes of AD among these caregivers are associated with their working experiences
at the facilities. According to earlier studies, maintaining healthy social
relationships enhance elderly memories; therefore, maintaining healthy social
relationships aid in lowering the chances of suffering from the disease.
Research Questions
According
the study purposes mentioned, this study established the following two research
questions:
1.
What are levels of knowledge, perceptions, attitudes,
of AD and levels of perceived experiences of AD caregivers?
2.
Is perceived experiences among AD caregivers associated with knowledge, perceptions, and altitudes of AD.
Hypothesis
The corresponding hypothesis for
this study was generated to test the associations between knowledge, perceptions, and attitudes of AD
and perceived experiences of working with the AD patients among caregivers at
long- term care facilities:H1:
Caregivers working with AD patients will have high scores of knowledge,
perceptions, and attitudes about AD.
H2: The caregivers’ high scores of knowledge, perceptions, and attitudes
about AD will be correlated with their positive experiences of working with AD
patients at long-term care facilities
Significance of the Study
Researchers have established a dramatic increase
of AD among older people. Previous studies showed the multiple negative impacts
of AD on a quality life among older people (Prince et. al., 2015). These elderly AD patients
also face many psychological problems (Whitehouse et. al., 1982). Researchers have also shown
that Alzheimer’s disease was growing at a high rate and expected to increase
still more, in the near term. Based on these facts, this study was significant
because it offered information for strategies for diagnosis, prevention and
treatment of Alzheimer’s disease. The government is spending billions of
dollars each year on Alzheimer’s disease. The current expenditures stand at
approximately $183 billion in the state of Georgia per year (Albert et al., 2011).
Another significance of this study is that financial resources expended by
government to deal with AD will diminish, which directly influence cares for AD
patients and their family.
This study is also significant because it
addressed the importance of knowledge, perceptions, and attitudes of AD for
improving a quality of care among caregivers and a quality of life among AD
patients and their family.
To overcome all the problems associated with
the Alzheimer disease, there was a need of continual research, throughout
medical, allied medical, psychiatric-psychological, and sociological
disciplines as well as social work, involving all of them in multidisciplinary
and interdisciplinary approaches to improving a quality of care for AD patients.
This study aims at increasing the knowledge of AD in today’s society to aid in
the continued search for better recommendations and knowledge in the disease.
Understanding how the communities and patients deal with AD is important in
developing health education content for the disease (Mastwyk et al., 2002).
There are many myths and doubts about AD.
Thus, there is a need to conduct a study that removes many of the illogical
myths and doubts, such as: having a relative with the disease does not
necessarily mean one will develop the disease. People will gain the knowledge
of the risks factors associated with Alzheimer’s such as diabetes,
hypertension, drinking alcohol and cigarette smoking. By delineating known risk
factors, this research helped people adjust their lifestyles and reduced or
eliminated many known risk factors. The study also helped people learn about
the symptoms associated with the disease and recognized significance of early
detection and diagnosis, since there was currently no remedy. Finally, the
study expanded the knowledge that people have about Alzheimer’s disease. With
an increased base of knowledge, people will have new and meaningful ways to protect
themselves against Alzheimer’s disease (Fowler, 2001).
Summary
This
study examined the relationship of knowledge and perceptions/attitudes of
Alzheimer’s disease with perceived experiences of working with the AD patients
among caregivers. Chapter two discussed the appropriate literature related to
AD and Afrocentric Perspective as theoretical frameworks for the study. Chapter
Three described the research methodology that provided answers to the specific
aim and research question. Chapter four reported the result of the study.
Chapter Five illustrated the study finding, limitation, suggestions for future
study and clinical implication for Social Work.
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