Physical Activity for Alzheimer's Patients
The topic I have chosen is mostly based on my personal experience working in about six Emergency Department. My PICOT choice is personal to me because I see this problem frequently and I feel it’s unethical and needs to be adequately addressed. The population I am referring to is our senior citizens with Alzheimer’s disease. The intervention that I would like to see introduced is the use of improved therapeutic physical activity to treat their anxiety while in a hospital setting. The comparison would be to see how using physical therapy opposed to only medications can reduce anxiety levels with Alzheimer’s patients. The outcome is based on seeing the patient’s levels of interaction and mood following therapy after a weeks time.
At the hospital where I work, I constantly see elderly patients come in via rescue that are very drowsy and many times unresponsive. When I ask the paramedics for their chief complaint it is always the same answer, “the nursing home states that the patients isn’t acting like themselves.” Then the emergency room physician does a quick assessment and gives the diagnosis of Altered Mental Status. Labs are drawn and CT, X-Ray scans are completed to determine a cause for the behavior of these patients. More often than not we get the same results from the lab that yeild critically high levels of benzodiazes in these nursing home patients that present with drowsiness, slurred speech, with very little motor movements.
Our seniors with Alzheimer’s are being over medicated at the facilities they call home in order to keep them from being a physical burden on staff. The caregivers often become annoyed with the patients’ behaviors and instead of giving them a form of distraction (e.g. letting them walk, coloring books, puzzles, or a doll) they simply medicate them and put them to sleep. These patients over time become very aggressive because they can figure out what is being repeatedly done to them. In a Medline study using Alzheimer’s disease as my search, a Meta-analysis states that Hippocampal atrophy has been linked to increased risk of progression from Mild Cognitive Impairment to AD, and the reversal of cognitive status from MCI to normal cognition has been linked to greater hippocampal volume (Makizako H, 2015). A meta-analysis by Smith et al revealed that interventions consisting of aerobic and strength training activities improved attention, processing speed, and working memory to a greater extent than aerobic exercises alone in both people who were healthy and those with mild cognitive Impairment, this effect likely was mediated by alterations in hippocampal volume( Erickson KI, 2011).
We as health care providers need to understand and educate those who are ignorant to the fact that patients with Alzheimer’s still can understand what we says to them. They may have memory loss, but they are still human beings that feel and get depressed with their confusion of thoughts and frightened when they forget things they should remember. Caregivers need to be properly screened and educated on the patient population with Alzheimer’s so they can better care for them and know what to expect. Given the high demands on caregivers of AD patients, they may experience physical, psychological, social, or financial consequences as a result of caregiving (Cole JC, 2014).
We as nurses need to also be more patient and listen to our patients needs and help them sort out any confusion or question they may be asking us about. We are professionals and need to take the responsibility of making sure our Alzheimer’s patients are properly treated by every staff member that they may encounter.
In conclusion, physical activities should be used with Alzheimer’s patients to improve their cognition, motorization and mood. Individuals whom had a greater number of total daily physical activity hours showed improved physical functioning and enhanced safety and balance (Buchman A, 2012). Providing our Alzheimer patients with activities such as walking, coloring, playing board games will not only improve their cognitive functions but also make them stronger which will ultimately keep them out of the hospitals. Medications should only be administered to calm anxiety in severe cases, not just to keep a patient quiet for our benefit.
P = Population – elderly patients with Alzheimer’s disease
I = Intervention or issue interest – using physical activity treatments for their anxiety
C = Comparison intervention or comparison group – only using medications opposed to physical activity for anxiety
O = Outcome – seeing improvement in patients’ mood and function
For study 4 and 5
P – population – old people aged from 45 years
I – issue of interest or intervention – using questions and physical activity to stimulate treatment of the condition.
C – comparison intervention or comparison group – participants using medication without any physical therapy
Outcome – improvement in the patients’ physical activity and change of health to a more desirable state of health.
PICO Question – what is the population size of the sample selected
What is the major intervention carried out in the project?
Comparison – what are other international organizations doing?
What is the expected positive result about the treatment of a person suffering from Alzheimer’s condition.
Research Articles
Voluntary exercise decreases amyloid load in a transgenic model of Alzheimer’s disease.
The article offers research on the various activities that are both physical and mental that help in decreasing the effects of Alzheimer’s disease as one grown old. The article carries out research among a sample of old people to come up with conclusions from which the researchers draw their inferences and recommendations on what exercises should be done.
Midlife vascular risk factors and Alzheimer’s disease in later life: longitudinal, population based study
The article is a study that focuses on research of mid-aged people to determine whether they will have the potential of developing Alzheimer’s disease as they grow old. The research article uses different methods in the research or study including longitudinal population study to bring out a sample that is equivalent to the entire population. The study uses the sample as a representative of the entire population.
Non-Research Articles
Boyd, M. (2012). Psychiatric Nursing: Contemporary Practice. Virginia : Lippincott William and Wilkins.
The article is a description of the general practices that need to be carried out when handling the elderly people and those of middle age suffering from Alzheimer’s disease. It offers a description of how different physical activities help in reducing chances of one contracting Alzheimer’s disease.
Vlok, M. (2015). Manual of Community Nursing and Communicable Diseases. London: Juta and Company Ltd.
The article is a guide to nurses who are offering care to people suffering from different diseases including Alzheimer’s disease. The article fives direction on the steps and processes that should be engaged in the course of offering medical aid and assistance to patients suffering from Alzheimer’s disease.
References
Adlard PA, Perreau VM, Pop V, Cotman CW. Voluntary exercise decreases amyloid load in a transgenic model of Alzheimer’s disease.
Cole JC, Ito D, Chen YJ, Cheng R, Bolognese J, Li-McLeod J. Impact of Alzheimer´s Disease on Caregiver Questionnaire: internal consistency, convergent validity, and test-retest reliability of a new measure for assessing caregiver burden. Health Qual Life Outcomes. 2014; 12:114. doi: 10.1186/s12955-014-0114-3
J Neurosci 2005;25:4217–4221.Buchman A, Boyle P, Yu L,Shah R, Wilson R, Bennett D.Total daily physical activity and
the risk of AD and cognitive decline in older adults. Neurology.2012; 78(17):1323-1329.
Kivipelto M, Helkala EL, Laakso MP, et al. Midlife vascular risk factors and Alzheimer’s disease in later life: longitudinal, population based study. BMJ 2001;322:1447–1451.
Makizako H, Liu-Ambrose T, Shimada H,et al. Moderate-intensity physical activity, hippocampal volume, and memory in older adults with mild cognitive impairment.
J Gerontol A Biol Sci Med Sci.2015:70:480-486.
