Persons with Down Syndrome Persons with Down Syndrome and the Alzheimers and the Alzheimers

ConnectionConnection

MemoryMemoryJust a line to say I’m living, that I’m not among

the dead; though I’m getting more forgetful and mixed up in my head.

For sometimes I can’t remember when I stand at the foot of the stairs if I must go up for something or I’ve just come down from there.

And before the refrigerator, so often my poor mind is filled with doubt, have I just put food away or have I come to take some out?

I’ve got used to my arthritis, to my dentures I’m resigned, I can manage by bifocals, but, Oh God, I miss my mind!

What is Alzheimers?What is Alzheimers?

DefinitionDefinition Progressive, degenerative disease of the neurological

system Irreversible deterioration of the intellect and emotions It affects over 4 million American adults It is the fourth leading cause of death in adults after

heart disease, cancer, and stroke Pre-senile and senile dementia are used to describe

any diminished capacity to think and to understand

SymptomsSymptoms Cells of the brain are affected, causing

severe intellectual impairment and changes in mental and neurological functioning

Changes occur in the cerebral cortex – the outer layer of the brain

An accumulation of protein called “tangles” occur in the area of the brain that control recent short-term memory. This area of the brain is the “hippocampus”. This protein is located in the skin and intestines as well as the brain.

Synapse

Axon

NucleusCell Body

Bendrites

Healthy Neuron

Plaques

Granulovacuolar

Degeneration

DISINTEGRATION

StagesStages

stages for the generic population

There are Stages for persons with Down Syndrome

There are

Each stage can last up to years

Stage OneStage One

Anxiety or depression over memory loss

Decreased efficiency in performance

Defensiveness

Stage TwoStage Two

Marked disorientation

Reduced capacity for speech

Decreased motor dexterity

Stage ThreeStage Three Loss of self-help skills

Incontinence

Seizures develop

Delusional, persectory and hallucinatory behavior is exhibited

CausesCauses The cause is unknown

Suspected causes are:

A gene in the 21st gene

Slow virus or other infectious agent

Accumulation of aluminum or other toxins

Changes in immune system relating to aging

DiagnosisDiagnosis There is no single clinical test to identify

Alzheimers

Other conditions must be ruled out:

Depression

Head injuries or brain tumor

Adverse drug reaction

Nutrition deficienciesMenopause

DiagnosisDiagnosis

A diagnosis of Alzheimers can be confirmed only after death by performing an autopsy

Alzheimers LossesAlzheimers LossesShort Term Memory

New learning ability

Reasoning and abstracting

Judgment, planning and foresight

Language skills

Inhibition/impulse control

Sense of intimacy

Behavioral ChangesBehavioral ChangesPacingRummagingHand wringingAgitation

InsistencePublic Masturbation

FearfulnessSexual commentsHallucinations/DelusionsWithdrawal

Repeating questions

Physical FactorsPhysical Factors

Urinary tract infections Bowel impaction Dehydration Seizures Pain/discomfort Mood swings

StrategiesStrategies

Provide quiet time Alleviate boredom Avoid many changes Keep choices simple keep consistent schedule Reduce stimuli Provide decaf beverages Limit length of conversation

Communication TechniquesCommunication Techniques

Identify yourself Use calm, clear voice Eliminate background noise Use short, simple sentences Use one-step commands Ask yes/no questions Use word cues

Make direct eye contact

Written Communication

Label the environment

Keep a schedule of the day

Use notes as reminders

Non-Verbal Communications

Use an open, gentle approach

Hold out items

Wave goodbye

Use expression of concern

Nod your head

Increasing Quality Increasing Quality of Lifeof Life

Use the R’sUse the R’s

Remain calm Respond to feelings Reassure the person Remove yourself Return later

And Also:And Also:Be aware of client needs, information and

resources available

Identify aspects of disease and screen their problems

Provide treatment through program development

Advocate and refer for further treatment

ProgrammingProgrammingReality Orientation: Brings information

regarding time, place, person, and things

Sensory Stimulation: Activities are presented to accentuate a particular sense

Re-socialization: Uses group techniques to stress interpersonal relationships

Attitude!

Attitude!