Intervention Program to Overcoming the Barriers of Utilizing Adult Day Care for Alzheimer Patients Research Proposal

Excerpt from Research Proposal :

Intervention Program to Overcoming the Barriers of Utilizing Adult Day Care for Alzheimer Patients

It's like getting your first toy or first book -- the excitement, the feel of the steel, or the smell of the new un-turned pages or the adventure of making new discoveries about it every day -- that is what keeps things new and fresh. However, if that experience is not a choice but a burden where every day one wakes up and has to go through that experience in every aspect of their life -- that is when the experience becomes a disease and one that is without cure. Alzheimer's disease forces a new experience and makes everything anew. Those individuals suffering from Alzheimer's have no recollection of the past beyond a certain point based on the extent of their disease.

In the proposed program here, the practices of care for Alzheimer's will be the focus. The proposed program will be called Alzheimer's Care Facility (ACF). One of the most promising practices in this particular program will be the defined interventions, which have beneficial impacts on a wide number of participants. Moreover, a certain form of evaluation or assessment will be made readily available in this program through a certain accessible source. Irrespective of the type, the innovations that are discussed and will be included in the program must be proven to have being effective in the past with the sample having a minimum of 10 (either 10 persons with Alzheimer's disease or 10 caregivers). Some of the interventions that will be presented in this program have been conducted in institutionalized settings, but they can be perceived to be held in community settings.

There are a number of approaches that this program will aim to use for intervening for people that are suffering Alzheimer's disease and related dementias. Therapy and cognitive training will focus on helping the individual remember previous information, finding the way, and memory recall. Some approaches will also use the person's memories, and, imagination will also be utilized for involving them in certain activities that have numerous benefits. Music therapy and exercise interventions will utilize certain therapies for maintaining both cognitive and physical health as well as addressing behaviors that are considerably difficult for the caregivers of the affected individual. Another avenue that this program will focus on will involve technology, and this will be far more applicable in cases where involvement and direct assistance might become difficult, for instance individuals located in remote geographic areas or living alone.

Aroma and touch will also be some elements that can be considered by some interventions chosen in this program that have a clear focus on specific sensory dimensions. Moreover, there will be numerous benefits of support groups for all those individuals who are suffering from Alzheimer's disease and related dementias and most of the interventions thus used will also use a combination of several approaches (Tilly and Freiman, 2010).

For this program, the interventions will be grouped into the following categories:

• Cognitive Preparation and Treatment

• Nostalgia/Life Analysis

• Exercise Interventions

• Music Treatment

• Interventions that involve Technology

• Sensory Interventions

• Multi-Dimensional Interventions

• Support Groups

The primary focus for the ACF program will be to analyze whether or not the use of interventions in day care facilities by caregivers delay or prevent barriers for Alzheimer patients.

Most of the interventions that have been included in previous program with similar aims have a focus on improving the caregiver's life. Numerous techniques are used in these approaches and many also have more than a single objective. Thus, it becomes an imprecise process to assign a certain intervention to a particular category. However, some approaches have a clear focus on psychological counseling while others majorly focus on education. Support groups are now being widely used. There are also certain interventions that involve the use of technology for providing such therapies, training, and services to the caregivers. Monitoring the caregivers is another objective of some technologies that are utilized. In this program, the focus will remain on the caregivers this and the following categories will be intervened by the groups' caregiver: Caregiver Education, Caregiver Maintenance of Care, Caregiver Therapy as well as Support Groups. The focus of this particular program will thus be how the respective interventions that are carried out for the caregivers are effective and how they remove all the barriers that might emerge in Alzheimer patient care (Tilly and Freiman, 2010).

In this program, we realize that there is a visible requirement for possible interventions between the individuals suffering from Alzheimer's disease and their respective families. The individuals that are suffering from this disease are greatly affected and their capabilities of interaction and communication are severely affected, which leads to a lot of discomfort for the families of such patients. Interventions in this program will thus have a constant focus on purpose and personhood is expected to become incredibly important in the final stages of Alzheimer's, as the dysfunction and deterioration is quite high (Cohen, 2001). The personhood will to an extent be retained though the memories that an individual has with his or her loved ones even though the disease has made it incredibly difficult for the individual to possible convey experiences of personhood (Cohen, 2001). Considering such findings, there are certain interventions that focus on the symptoms and signs only as such a measure does not help in addressing the issue of personhood and the respective quality of life in regard to Alzheimer's (Cohen, 2006). It was suggested by Cohen (2006) that more should be done than just the "two-S patient-centered problem focus and it should rather be a four-S approach that has a visible person oriented focus on the potential" and has an emphasis on "skills (or strengths) that have been maintained to certain extent over the life of the affected individual as well as the level of satisfaction" (p. 13-14). Such a perception or approach will be considered to be a fraction of the overarching perception of non-pharmacological interventions within the ACF program.

Whereas such non-pharmacological interventions are usually based on a number of theoretical concepts, the ACF program will mutually consider the interactions that occur between the individual who will be suffering from Alzheimer's, the environment, the care system, and the caregivers instead of only focusing on the disease to be the patient's problem (Cohen-Mansfield, 2005). For various other progressive and chronic disorders, there will be certain pre-conditions for instance if the disease is as such that there is no cure, prevention, or ultimate stopping of the disease, certain effects and symptoms of the disease can still be alleviated by treatments (see, Cohen, 2001).

Creative approaches are highly recommended by Cohen-Mansfield (2005), as they believe that such interventions provision more personalized care with such affected individuals through appropriately catering to all their needs and thus treating and preventing inappropriate behaviors (p. 140). That will be the approach for the proposed ACF program. However, it should be also kept in mind that there is no certain evidence in regard to the respective effectiveness of non-pharmacological interventions even though a number of measures have been taken into account and even carried out successfully (Cohen-Mansfield, 2005). This will nevertheless be done despite the various obstacles that emerge because of carrying out research in such a population. These particular approaches might involve personal interactions for providing contact and social support, the engagement of people suffering from such a disease through sensory stimulation, utilizing memory books, or self-affirming interventions for instance reminiscence therapy (Cohen-Mansfield, 2005). A few of the various alternatives that are available to such affected individuals will also be included in the ACF program.

Many such interventions implemented in this program will have a clear focus on sensory stimulation as to engage people. This would be in the context of visits as well as in general. A certain approach of this kind will involve the use of Snoezelen Multi-Sensory Environments, where products and materials will be incorporated that offer numerous sensory experiences to the affected individual (Snoezelen). This name "snoezelen" is a contraction of two specific Dutch verbs, "snuffelen" and "doezelen" that imply explore, to relax, and seek out respectively (Snoezelen). Dependent upon what kind of experience is wanted, different configurations and arrangements might be made with the numerous snoezelen items, which could possibly extend from multi-sensory ones to those that concentrate on a single sense (Snoezelen). In spite of the fact that Snoezelen Multi-Sensory Environments are intended for individuals of all ages and capabilities, its extended use with the older people with dementia (Snoezelen) is an essential territory of research in regards to this approach within the ACF program. Snoezelen in the ACF program will aim to offer the perspective for those with Alzheimer's to unite with friends and family or guardians (Cohen, 1999) while likewise aim to have a smoothing impact on the individuals who use them by stimulating primary senses. The experience is intended to be stimulating, while not overwhelming, and is customized to the…

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