Term Paper on "Depression and Dementia Alzheimer S In the Elderly"

Term Paper 10 pages (4640 words) Sources: 16

[EXCERPT] . . . .

This is obviously much truer when it comes to dementia and Alzheimer's. Further, dementia and Alzheimer's are much easier to monitor and keep an eye on given that the patients afflicted by the disorder are usually in a nursing home or some other controlled environment (Bokberg et al., 2015). A downside to measuring the mental acuity of the elderly comes more into play with depression but could really be applicable to any mental measurement paradigm. Indeed, truly getting to the bottom of what is wrong with a person from a mental standpoint requires their participation. This is especially true when speaking of disorders like depression, anxiety and so forth. Even if their mood and emotions are a little messy, they often know what is right and wrong and what is true or false. Given that, they can absolutely participate in the process and give full and complete answers to the questions stipulated and expected as part of using the DSM criteria (Goldstein et al., 2014).

Where things get a little messy and difficult is when the patient is not an honest and complete participant in the process. Indeed, if a patient is purposefully giving incomplete or false answers to the questions, not giving complete answers, not giving honest answers or just refuses to participate in the process altogether, this would obviously make it very difficult to get an accurate, timely and complete diagnosis. Indeed, validity of assessment outcomes is very important (Henry, 2010). Further, there are a great many elderly patients that are rather dejected and even hostile when it comes to being in a nursing home. Many people in nursing homes are in that situation because they have family members that are unable or unwilling to provide care and/or the patients have conditions that require a nursing home situation or something like it. Indeed, a dementia patient should not live in a standard home because their odds of wandering off are much higher. Further, they cannot be chained to their bed or chair when the other adults in the home are at work or shopping (Kaya et al., 2014).

Even so, it can be a very sobering and depressing experience to be in a nursing home. It can very much feel like a prison to someone that is present there and this can create depression and other mood/emotional issues to put it lightly. Rather than being a mental acuity issue, it is more an issue of hostility, rejection and a non-acceptance of one's eventual fate in said nursing home. Indeed, the nursing home is an end-of-life care situation. A person may be there for a short time or they may be there for a good number of years. As such, depression and other mood issues are almost to be expected. Further, the doors and windows are secured and monitored in these homes for good reason as some patients, whether they have their mental faculties in place or not, will tend to wander (Kaya et al., 2014).

Question Two

As for the second question, there does indeed need to be a balance between what manifests from an overall group when it comes to a given disorder or group of disorders (Zeiders, Umana-Taylor, Updegraff & Jahromi, 2015). However, a gifted clinician also needs to keep in mind that each person will manifest a bit differently than others and this is obviously possible even with the same disorder. Just as one example, bipolar disorder is a crippling and severe mental disorder that is typified by manic and depressive states. However, some people trend more towards the manic states rather than the depressive while others are on the other end of the spectrum. Others still are sort of in between and are not on either extreme at any given time (Janiri et al., 2015). Depression, dementia and Alzheimer's are no different. Some people are losing their mental acuity while some people are just generally forgetful. Any good clinician needs to understand that and diagnose accordingly (Babu-Sandiyan & Dening, 2015). Unfortunately, it not like diseases and viruses where it can often be verified with certitude whether a person has the virus or bacterial infection in question. For example, the detection of diseases like tuberculosis is pretty cut and dry. However, mental disorders are often manifested as differential diagnoses a lot of the time and there sometime has to be some troubleshooting or trial and error. Sometimes the first diagnosis works and sometimes other theories have to be tried. For example, attention issues could be an ADD/ADHD issue or could be an anxiety issue, among other possibilities. Given that, Ritalin could be the answer or it could be something like Zoloft or Xanax (Morais, Rodrigues & Sousa, 2009).

Question Three

Building on the response just offered for the second question, even with the varying nature of people, even when it comes to the same disorders, one has to keep in mind that the diagnoses and treatment arcs need to follow the broader treatment regimens and patterns of the broader medical practice for those disorders (Apostolo, Cardoso, Rosa & Paul, 2014). Obviously, things like human intelligence and achievement are certainly factors when it comes to mental health issues. Some people bend and shape their mental challenges in a way that allows them to do great things. They are able to pull this off through great coping skills. However, there is also probably a lot of medicine and other treatments involved as mental health and loss of mental faculties in general are not things that one just shrugs off. Indeed, it is ignorant to say that mental illness can just be "dealt with" and shrugged off. It is easy for a mentally balanced person to say "man up" but they would not be so bold (or obtuse) to say that if they know the slow hell that mental illness can be (McGinty, Goldman, Pescosolido & Barry, 2015). With that said, intelligence (or lack thereof) obviously changes the lens that needs to be used when diagnosing for a certain condition. Some people have great self-awareness and/or are well enough to know they are off-kilter. On the other hand, there are those that are a bit lost in their world of mental dysfunction and this is certainly not limited to those with dementia and Alzheimer's. One might think this is limited to true sociopaths and psychopaths but this is simply not the case. Some people can obtain perspectives that are skewed and out of phase and they just might not realize just where they are mentally. This would probably be rare but it certainly happens (Morais, Rodrigues & Sousa, 2009).

Question Four

When it comes to clinicians that are making "inferences" about real-world situations and dynamics based on the results from situations that are "test-taking" in nature, this is obviously unwise and improper. Indeed, the least of the issues involved would be what is called the Hawthorne Effect (Jung & Lee, 2015). This is when a person is being studied and they know they are being studied. As such, there is a much larger propensity to behave in a manner that is different than what would occur in a spontaneous and non-monitored situation. This is even truer when speaking of things that a person may be sensitive or more cautious about. Easy examples that come to mind are studies or questions about racism, sexism, sex and other things involving moral or religious values. For example, if someone is asked by a survey taker if they would ever cheat on their wife, they are probably (if not certainly) going to say no even if the answer to the question is really in the affirmative (Jung & Lee, 2015). There are ways to deal with that such as anonymous surveys and such. However, there is still the dichotomy that is posed by the question and that would be whether a person would think and react as they say they would in a survey or "test" when they are faced with the same issue in real life. True enough, there is a good chance that there would be a lot of correlation between the two environments. However, there would also tend to be a lot divergence. Sociologists and economists know this full well. Further, testing a sociological theory or economic theory in a controlled environment is something many scientists attempt to pull off but it can be extremely difficult to do so in a way that matches real-world conditions and how people react in a non-controlled environment (Espeland et al., 2014).

To come back to the subjects of this report, a person with dementia or Alzheimer's is not in the proper state of mind regardless of whether they are taking a test or not, so perhaps those tests would be more consistent. However, for someone that is depressed and knows they are "not… READ MORE

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