Dementia

Cheston and Bender have outlined how dementia is currently understood or ‘formulated’. It can be argued that dementia is a generalised cognitive (information processing) and intellectual deterioration within the individual produced by ‘brain dysfunction’. Whereas ‘senile dementia’ refers to a dementia syndrome that develops after the age of 65, ‘presenile dementia’ refers to the occurrence of dementia prior to the age of 65. The form of dementia that has become most popularised is known as Alzheimer’s syndrome. Alzheimer’s is a form of brain dysfunction named after its discoverer, Alois Alzheimer, in 1907. The disease causes changes in thinking and behaviour from ‘normal’ patterns to bizarre and disorientated confusion.

Individuals with Alzheimer’s may act in confused, paranoid, tired or depressed ways. Sometimes they can appear ‘normal’ and in the early stages of the disease there is often denial of the condition. Personality changes such as depression, anxiety, inability to concentrate and denial may be the first signs of the beginnings of the disease. Memory loss is considered to be the major symptom and this may be the cause of many of the personality and behavioural changes we see in the early stages of the syndrome. From being ‘absent minded’, Alzheimer’s develops to the point where the individual loses their memory for everything, including their own name. As a consequence daily life is likely to become

chaotic and confusing.

At one time it was thought that Alzheimer’s was synonymous with ‘senility’ and that everyone would suffer from the condition if they lived long enough. Now it is accepted as being a specific syndrome and not simply a consequence of normal ageing. Although the exact cause of the condition may be a matter of debate, authors such as Grey-Davidson draw attention to what ‘facts’ are known about Alzheimer’s. At least five possible explanations might account for the origins of the syndrome:

• a deficit or imbalance of neurochemicals, particularly of an enzyme known as choline acetyl transferase. This enzyme is central to the production of acetyl choline, which is a neurotransmitter and thus of great importance to the normal functioning of the brain;

• excessive accumulations of toxins such as aluminium in the brain;

• there might be a genetic component in the development of Alzheimer’s disease;

• a unique viral infection that does not show the usual symptoms such as a fever or a raised white blood-cell count, and therefore goes unnoticed and untreated;

• a significant decrease in blood flow to the brain, as well as a reduction in the amount of oxygen and glucose present in the blood.

Although it might not be possible to identify the precise cause of Alzheimer’s what is conclusive is the effect the disease has on those who are affected by its consequences. This means that if you are going to work with older people in social services it is important to consider how you might make your professional practice as effective as possible. As we have already emphasised it is important to ensure that the wider skills of the multidisciplinary team are utilised so that holistic therapy that is a combination of health and social care is offered to older service-users.IVITY 6.8

If you are working with service-users who have Alzheimer’s it is important to remember that their ‘cognitive map’ is likely to be different from that of other people. This means that you may need to use alternative strategies for communicating. You may find that using simple repetitive language enhances interaction. It may be the case that more awareness of non-verbal communication is necessary for service-users with Alzheimer’s who are likely to become confused about verbal interaction. One suggestion is that your practice may benefit from considering alternative strategies of communication that utilise the interpersonal strengths of your service-users.

Task 2. Find the English equivalents for:

Описать в общих чертах; ослабление интеллекта; старческий; относиться к; аномальный; спутанность сознания; отрицание; амнезия; рассеянный; последствие; служить причиной; повышение уровня лейкоцитов; уменьшение, снижение (2 варианта); неоспоримый; подчеркивать; выигрывать, извлекать пользу; сильные стороны.

Task 3.

A. Read the information on the concept of holistic therapy below.

Holistic therapy is a common term for any treatment that is intended to treat the individual as a whole (mind, body and spirit). Holistic health includes many of the various treatments that come under alternative medicine and complementary medicine.

Types of Holistic Healing Therapies and Treatments: •aromatherapy •Ayurvedic medicine •natural diet •exercise •counselling •herbal remedies •homeopathy •acupuncture •naturopathic medicine •energy-based therapies •Chinese medicine

Say which of the holistic therapies can the geriatric social worker’s practice benefit from?

B. Read the information on the concept of cognitive map below:

Cognitive map is the term used to refer to one's internal representation of the experienced world. Cognitive mapping includes a series of psychological transformations by which an individual acquires, codes, stores, recalls, and decodes information about the relative locations and attributes of phenomena in their everyday spatial environment. Cognitive maps are invariably incomplete and partially distorted.

Say if these statements are true or false. Give your reasons:

1. Cognitive map is a mental image of the outer world.

2. Cognitive mapping is the means through which people process environment, solve problems and use memory.

3. Cognitive maps are uniform and unchangeable.