Case Study - Early Alzheimers Essay Example for Free

Case Study Early Alzheimers Essay This paper reviews the use of cognitive rehabilitation treatment of early stage of dementia Alzheimer’s type. The case study examines a 72 year old male patient diagnosed with early stage dementia of Alzheimer’s Type. This study used visual imagery, as well as cues and expanding rehearsal during the cognitive rehabilitation. The evaluation of cognitive rehabilitation treatment included the psychological, physiological, neurological assessments and self-reports. Results suggested that extended use of cognitive rehabilitation treatment ensued longer lasting improved cognitive functioning.  With the results of the study discussed, implications suggest that combining longer treatment of cognitive rehabilitation could help reduce the progression of early onset dementia of the Alzheimer’s Type. Case Study Clare, Wilson, Carter, Hodges, and Adams (2001) studied a 74-year old single man, named â€Å"VJ† who lived with his sister in a single case study. VJ was formerly employed in the construction industry. VJ started to attend the memory clinic in 1993. He was then diagnosed having an early stage of dementia of Alzheimer type (DAT). His sister joined him at the clinic. The researchers started with a process called, cognitive rehabilitation (CR) intervention. Cognitive rehabilitation (CR) focuses on memory functioning. Although CR was at first developed for patients with traumatic brain injuries, it was proven to be efficient for people experiencing cognitive difficulties (Savage, 2009, p. 31). In order to define CR, it is necessary to define cognition. Katz and Hadas (1995) quote Lidz in defining cognition, â€Å"†¦as the individuals capacity to acquire and use information to adapt to environmental demands† (p. 9). Sigelman and Rider (2012) say that cognition is, â€Å"the activity of knowing and the process through which knowledge is acquired and problems solved† (p. 210). Cognitive rehabilitation is quoted by Katz and Hadas (1995) â€Å"†¦the therapeutic process of increasing or improving an individuals capacity to process and use incoming information so as to allow increased functioning in everyday life, this includes both methods to restore cognitive functioning and compensatory techniques (p. 29). Interventions aimed in CR are divided into remedial and adaptive/functional strategies (Katz Hadas, 1995). The main aim of the remedial strategy is the individuals impaired capabilities. The functional strategies are aimed to enhance the strengths of the individual for functioning. The assumption these two strategies are built upon is, â€Å"†¦that functional activities require cognitive perceptual skills†¦Ã¢â‚¬  (Katz Hadas, 1995, p. 30) and cognitive impairments can be modified and treated in the adult dysfunctional brain which will enhance reorganisation or recovery of the brain. Based on these assumptions the remedial strategy is directed towards functional abilities by retraining perception skill components of behaviour, while the functional strategy in contrast assumes that the affected adult brain has limited recovery potential and that retraining of the brain should be focused on specific activities as required (Katz Hadas, 1995). The unique feature of all occupational therapy models, are the emphasis that treatment is based on purposeful activities that are analyzed and adapted to the patients cognitive and functional ability level. This therapy is not without controversy. As the critics of CR indicated, memory training for people with DAT increases frustration for the patients, because the improvement in cognition is short term (Clare et al. , 2001). Sigelman and Rider (2012) agree by saying, â€Å"†¦over time, individuals cannot recall even with the aid of cues and become increasingly frustrated† (p. 541). Neuroplasticity is possible before or in the early stages of AD, but diminishes in later phases of AD. Clare et al. 2001) found empirical research to prove that CR is an effective method of slowing the decline of cognitive functions in early AD. Questions about CR which remain to be answered include impact of CR on well-being and life quality, the ability to sustain longevity of gains in cognitive therapy and what type of contributions can CR make in AD? (Clare et al, 2001). Lately, â€Å"identifying cognitive markers of a preclinical phase of Alzheimer’s disease (AD) has been a major research focus in neuropsychology† (Jacobson et al. 2009, p. 278). Cognitive Rehabilitation Intervention Clare and colleagues, (2001) predicted in theory, that the possibility cognitive rehabilitation may be responsible for the maintenance of memory gains over time. The researchers set to prove through long-term follow-up data that memory retraining had lasting effects and showed gains beyond the treatment sessions as demonstrated by previous cognitive rehabilitation studies. The researchers used 11 Polaroid photos of VJ’s club members to teach the face-name associations. This was performed by the method of combining visual imagery, vanishing cues, and expanding rehearsal (Clare et al. , 2001). The researchers took VJ to the familiar environment of the club to do generalisation sessions using the photos and found the initial recall was 20% and raised to 98% over time and became 100% at the one, three, six and nine months follow-up sessions. VJ practiced every day using the photographs. â€Å"In the early stages of Alzheimer’s disease, free recall tasks are difficult but memory is good if cues to recall are provided†¦Ã¢â‚¬  (Sigelman Rider, 2012, p. 41), like the photos in this case study. After the ninth months, the researchers took the photos away to use them only once a month, at the club with VJ. VJ was to recall the first names of the people in the photos with zero feedback given to VJ. After the first and second year, magnetic resonance imaging (MRI) was completed. At the same times neuropsychological assessment were completed to evaluate the results of changes in cognitive functioning compared to the initial and post-intervention assessments. Several tests were used in the neuropsychological assessment such as the Mini-Mental State Examination (MMSE); National Adult Reading Test (NART); Standard Progressive Matrices (SPM); Speed and Capacity of Language Processing (SCOLP); Visual Object and Space Perception Battery (VOSP); Unfamiliar Face Matching; Digit span, forwards and backwards; Rivermead Behavioural Memory Test (RBMT); Doors and People; Famous Faces and Famous Names. Self-report measures were used as well to assess VJ’s perceptions of memory problems, behaviour, affect and VJ’s sister on caregiver strain. The following measures were used: Memory Symptoms Questionnaire; Hospital Anxiety and Depression Scale (HADS); Caregiver Strain Index (CSI) VJ’s sister rated herself on strain experienced (Clare et al. , 2001). The initial and post-intervention neuropsychological assessments shown VJ’s general cognitive abilities before he contracted DAT were in the high average ranges, his post-intervention scores were above average, though speed of processing was slower. VJ’s perceptual skills and processing of unfamiliar faces were in normal ranges. Memory was severely impaired, having difficulty recalling names of famous people. Overall there was not much of a change between the initial and post-intervention assessments, but only a mild decline in abstract reasoning and speed of processing information. While some of VJ’s cognitive functions remained the same, â€Å"†¦a gradual decline in abstract reasoning, speed of information processing, working memory, episodic memory, and semantic memory over the study period was evident. MMSE scores, too, showed a mild decline†¦assessment of coronal T1 images (MRI) revealed mild, but definite, bilateral hippocampal atrophy as indicated by enlargement of the temporal horn of the lateral ventricle and reduction in height of the hippocampal formation† (Clare et al. , 2001, p. 486-487). After all the results were taken in consideration it seems that this case study provides the evidence that long-term maintenance of specific gains can be achieved with a CR procedure. The use of CR in dementia was criticised as not being an intervention that can assure any gains beyond the treatment sessions. It is clear from the results of this study that this claim is untrue. Another case study in 2003 was done with the same interventions. The same results were found and support the finding that CR maybe a valuable comprehensive intervention for persons with early identified dementia of the Alzheimer type (Clare, Wilson, Carter, Hodges, 2003). Conclusions The results of this case study indicate the importance of length in cognitive rehabilitation for individuals diagnosed with early staged dementia of the Alzheimer’s type. The use of cognitive rehabilitation over an extended period of treatment allowed the researchers to evaluate the importance of visual imagery, recall and extended rehearsal strategies in treatment. The positive results indicated possible development in the treatment of diagnosed patients, as well as duration and techniques applied. Future studies will need to focus on the exact parameters of duration for treatment with cognitive rehabilitation in patients diagnosed with early stage dementia of Alzheimer’s Type. Implications arrived from the longevity of treatment could also improve the overall quality of treatment, evidence to substantiate financial support/funding for treatment and improve motivation and expectations from patients and family members. The importance to involve cognitive stimulation with patients diagnosed with early stages of Alzheimer’s disease is apparent in subsequent research and continues to be implicated in other similar cognitive dysfunctions.

Urban Legend of Bloody Mary :: Urban Legends Ghost Stories

Bloody Mary Often, the story of â€Å"Bloody Mary† is the first story of supernatural form that is told to many individuals as young children. When I was in 3rd grade, a group of friends and I got together to have a sleepover; naturally, we all went to my friend’s basement and started telling scary stories. One of my friends told me that if I went into the bathroom without any lights and said â€Å"Bloody Mary† three times in front of a mirror, a bloody figure would appear. This urban legend was told by a nineteen year old woman at the University of Maryland who is originally from West Point, New York. She is currently a sophomore majoring in architecture. On the night of March 30, 2007, a group of friends and I got together in the 4th floor lounge of LaPlata. In the midst of discussion, the topic of scary stories came up, and at about midnight, the storyteller started telling her version of â€Å"Bloody Mary.† She paused for a moment and started talking about the origins of the urban legend. She said that â€Å"Bloody Mary† is a reference to Mary Queen of Scots, a Scottish monarch. Apparently, Mary Queen of Scots would bathe in the blood of virgins in order to look young and vibrant. The storyteller said that virgins were viewed as being pure, so exposure to their blood would make an individual look beautiful. The storyteller paused and said, â€Å"Now it’s time to get to the good part.† She said that an individual needs a candle, a lighter, a dark room, and a mirror. An individual would take the unlit candle and put it in front of the mirror with the lighter in his or her hand. The individual would spin around while chanting â€Å"Bloody Mary† seven times. As soon as he or she finished, the individual would immediately turn to the mirror and light the candle. After the candle is lit, a figure with a bloody face would appear in the mirror and kill the individual! As we all looked in awe, I asked her if she ever tried it, and she said that she was never able to do it because she was too frightened. Even though many of her friends did it and came out alive, the storyteller said that she could never have the courage to do it because it was too scary for her. Urban Legend of Bloody Mary :: Urban Legends Ghost Stories Bloody Mary Often, the story of â€Å"Bloody Mary† is the first story of supernatural form that is told to many individuals as young children. When I was in 3rd grade, a group of friends and I got together to have a sleepover; naturally, we all went to my friend’s basement and started telling scary stories. One of my friends told me that if I went into the bathroom without any lights and said â€Å"Bloody Mary† three times in front of a mirror, a bloody figure would appear. This urban legend was told by a nineteen year old woman at the University of Maryland who is originally from West Point, New York. She is currently a sophomore majoring in architecture. On the night of March 30, 2007, a group of friends and I got together in the 4th floor lounge of LaPlata. In the midst of discussion, the topic of scary stories came up, and at about midnight, the storyteller started telling her version of â€Å"Bloody Mary.† She paused for a moment and started talking about the origins of the urban legend. She said that â€Å"Bloody Mary† is a reference to Mary Queen of Scots, a Scottish monarch. Apparently, Mary Queen of Scots would bathe in the blood of virgins in order to look young and vibrant. The storyteller said that virgins were viewed as being pure, so exposure to their blood would make an individual look beautiful. The storyteller paused and said, â€Å"Now it’s time to get to the good part.† She said that an individual needs a candle, a lighter, a dark room, and a mirror. An individual would take the unlit candle and put it in front of the mirror with the lighter in his or her hand. The individual would spin around while chanting â€Å"Bloody Mary† seven times. As soon as he or she finished, the individual would immediately turn to the mirror and light the candle. After the candle is lit, a figure with a bloody face would appear in the mirror and kill the individual! As we all looked in awe, I asked her if she ever tried it, and she said that she was never able to do it because she was too frightened. Even though many of her friends did it and came out alive, the storyteller said that she could never have the courage to do it because it was too scary for her.

Ethical Decisions Scenario

Assignment: Ethical Decisions Scenario Analysis Melissa McClellan Appendix C Ethical Decisions Scenario Analysis For each of the following scenarios answer the questions and explain whether your answers fit with traditional or modern ethical thinking. After you have finished responding to the scenarios, discuss whether you generally make ethical decisions using a traditional or a modern ethical model. Provide an example using an experience you have had in your daily life.    | |Scenario One | |You are a manager at your current company. You receive a call requesting a character reference for an employee you know to be | |unreliable and dishonest but who has not broken any rule directly. | |a. What should you tell the prospective employer? | |b. What type of information would you tell the prospective employer? | |c. How would what you share be to your advantage or disadvantage? |   | |   | |Response to Questions | | | |a) As manager of this employee, I would have to tell the pros pective employer only what is factual and not elaborate on my | |suspicions.Meaning that I could not state my personal opinion about the employee being unreliable and dishonest if no rules were | |broken and the employee was never reprimanded for bad behaviors. | |b) Since this is a character reference then only character type information may be given. In this case the character reference may | |include what good qualities the employee has, a good team worker, learns quickly, etc. If there were no good characteristics, then a| |polite no thank you would have to do. |c) The advantages come in the form of not being sued by anyone for badmouthing the employee and maybe the employee will actually get | |the other job, therefore not your problem anymore. This is really a damn if I do or do not situation and has to be handled in a | |competent manner. | |The only disadvantage I can see with this situation is not being able to warn the prospective employer about the bad characteristics | | of this employee but without any reprimands or facts to back up the words it is not an option. | | | | | | | | |   | |   | |   | |Scenario Two | |   | |Mike is currently enrolled in a challenging course. His personal life is also unusually complicated by his seriously ill mother who | |lives out of state. Mike receives an e-mail from an individual who has taken this course previously and whom Mike knows did | |reasonably well in it. In the e-mail, the individual offers Mike, for a fee, all the course assignments, discussion question | |responses, and Checkpoint answers. | |a. How should Mike reply to his friend? | |b. What are the positive and negative consequences of accepting this offer? | |c. What are the positive and negative consequences of refusing this offer? |   | | | |Response to Questions | | | |a) Ethically, it would be wrong for Mike to accept his friends offer and he should decline the offer with a prompt thank you but no | |thanks. | |b) The positive conseque nces are obsolete if Mike has a conscience or a sense of right and wrong. The negative perhaps come in | |greater numbers by accepting his friends offer. First, Mike would not learn much from his course and he would not gain any knowledge | |about course material.Second, school policy indicates that we should do our own work and there is a chance Mike would plagiarize or| |be expelled from school for using another’s work. | |c) The positive consequences of refusing his friends offer comes in the form of self-satisfaction and knowing he accomplished his | |work even though other areas of life are tough. In addition, Mike can be spared any bad situations with the school if he were caught| |using another’s work. The negative consequences for Mike may be minimal after refusing his friends help if he deals with each of his| |problems one-step and day at a time. Mike may have to take a temporary break from school to deal with other things but that is only | |a sacrifice that is required in life to see positive outcomes. |   | |   | |Scenario Three | |   | |You are a politician involved in a hotly contested race to retain your  seat on the city commission. The political issues are | |important to you, but allegations have been raised that your opponent is leaving his wife for a younger woman. These allegations are | |unproven. Your campaign advisors have urged you to release this information to help your campaign. | |a. What moral and ethical considerations come into play when making this decision? | |b. What are the positive and negative consequences of using the information? | |c. What are the positive and negative consequences of not using the information? |   | |   | |   | |Response to Questions | |   | |a) The moral and ethical considerations center on what is right and what is wrong when it comes to serving those that vote for me as | |a politician. If the political issues are important to me then I would want to run the race as le gitimate as possible. Ethically it | |would be wrong to exploit the other opponent in such a way that says I would stoop to any level to maintain my seat on the city | |commission. | |b) I really don’t see any positive consequence if I use the derogatory information because I will know what I did was wrong. The | |negative consequences would be various.Using the information could affect any respect my staff had for me, it could backfire and | |cause me to lose the race, and I would know what I did was wrong and it would play into future decisions. | |c) I can only relate the positive consequences of not using the information as the negative are obsolete. Sure, I could lose the | |race to my opponent by not using the information but that is not really a negative consequence because I know I did things right and | |morally. The positives know I ran the race honestly without hard balling anyone and possibly ruining my own credibility. This sort | |of behavior can follow an indiv idual for the rest of their career so it is always better to do things honestly. | Reflection Question: Discuss whether you generally make ethical decisions using a traditional or a modern ethical model.Provide an example using an experience you have had in your daily life. I truly think I am more of a traditional type decision maker where treating others with respect and honesty is most important for good outcomes. I also feel some of the modern way of thinking is helpful especially when dealing with work issues. My ethical decisions are made based on what I feel is right and wrong, which is something that has always been a strong force within me. An example of an experience I have had is recent and is something I have always taught my child. My son and I were visiting the park a few weeks ago and we found a wallet with everything intact including money.My first instinct was to look in the wallet for some sort of identification (possibly a phone number) and contact the owner. This information was available so I used my cell to call the individual and they came right down to pick the wallet up. They were so relieved that someone would actually call and return their property. I simply replied that I hoped if it were my wallet that the same would happen for me because that is the right thing to do. Not only did I make someone’s day better but I also set a very good visual example for my two-year-old son. While he may not understand what I did, he will have an example of respect and honesty which are two values and ethics I want to instill in him.

Divorce A Major Sociological Issue - 1080 Words

Rebecca Eron Mrs. Small Social Issue paper 21 November 2014 Divorce Problem Statement: Divorce is a major sociological issue. Divorce rates continue to rise annually and more and more the definition of ‘family’ begins to change. Around 40% of marriages ended in divorce in 2004 (West). This is an epidemic that at one point shocked many People. While, divorce use to be socially and for many, religiously unacceptable it is becoming more and more a social norm. Even though it is becoming more common for couples to end marital issues with the decision of divorce, it is still a major social problem. Divorce is reshaping our culture (A Sociological Analysis of Divorce and its effects). Many people do not realize that not only does divorce affect the couple, it also greatly impacts any children involved, the extended family and the society as a whole. Literature Review and Discussion: When it comes to divorce, it is common for children to be mixed up in the middle of things. In 1981 somewhere around 1.2 million kids were affected by divorce. Divorce causes major disruption within the family (Peck). When divorce begins to erupt the whole family, especially the children, is thrown off track. Many routines become estranged as the parents begin to divide households and divide the time spent with children. Other times one parent may move out, more commonly the father, and not see the kids at all. This can put a huge financial and responsibility burden on the remaining parent. WhichShow MoreRelatedSociological Imagination By C. Wright Mills969 Words   |  4 Pages C. Wright Mills defined sociological imagination as the awareness of the relationship between personal experience and the wider society. Understanding and being able to exercise the sociological imagination helps us understand the relationship between the individual and society. Mills focuses on the dis tinction between personal troubles and public issues. 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