Functional Assessment Report Summarization of Case

Luther, 80 years of age, was admitted to a nursing hospital due to Alzheimer's disease complications. As a farmer, Luther spent most of his life moving freely unlike what he was experiencing in the nursing home. However, he had to adapt to the new life. Despite his impairment memory problem, Luther was psychically fit as he managed to walk around the nursing premises. Later, he started experienced a problem in that he walked alone. For safety reasons, he was not allowed to go outside alone. Despite the warnings, he managed to walk go outside alone, even during cold periods without a coat. Each time he went out, the nursing staff had to bring him back. The architecture of the nursing home depicts one main door at the station, another one near the business office, and three fire doors at the sides and back of the building. The four wings of the building form a square, enclosing the courtyard at the center of the building.

Interview Summarization

After the interview with the staff members who work closely with Luther, I realized various that most of his actions were because of the Alzheimer's disease. Before visiting the hospital, Luther's wife ascertained that he experienced issues dealing with memory loss, an aspect that made it difficult for him to remember newly learned information. Staff members also acknowledged the condition was not because of old age, as he was not old. Luther actively conversed with staff members and managed to walk depicting his physical fitness. The recent behaviors were associated with the deepening condition of Alzheimer's disease.

Even before he was transferred to the nursing home, staff members observed signs of increased forgetfulness on the instructions given to him. One staff member acknowledged that the structure of the nursing home made it difficult for Luther to adapt to the new environment. The four hallways forming a squared structured may have occurred as confusing events regarding the aspects of time and place within this home. Under the new environment, staff members acknowledge the possibility that the structure may have deepened his confusion about the place, an aspect that explains his behavior of frequently walking out of his room. However, another interviewed staff member related Luther's behavior of frequent walking out from him room to the new environment, as he tried to learn and understand it.

ABC Data

A prominent aspect of Alzheimer's disease depicts cognitive decline, a common sign of memory impairment. In Luther's case, it is evident that AD's symptoms such as confusion, serious memory loss, disorientation, mood and behavioral changes have become common (Lu & Bludau, 2011). With the progress of time, the symptoms seem to worsen as Luther frequently leaves his room, even at the cold period, forgetting the need of a coat. The symptoms clearly depict failing brain cells. Changes in the cerebral cortex result in memory, language, visual, and learning deficits. Cognitive dysfunction explains the distribution of AD pathological changes. The changes vary based on the severity of AD. Further, the changes depend on the position of the disease regarding the spectrum of dementia.

AD related disorders such as the Parkinson's disease and Lewy body dementia (LBD) depicts similar symptoms of cognitive decline. Additionally, the disorders also share pathological features that including the degeneration of cortical cholinergic (Lu & Bludau, 2011). Unequal distribution of cognitive deficit in vascular dementia (VaD) reflects the severe impairment of some body functions. Physiological correlates of cholinergic dysfunction in the brain encompass regional glucose metabolism and cerebral blood flow. Vital efficacy parameters in AD include direct assessment of cognitive improvement and stabilization. Efficacy in the treatment of AD has encompassed studies in ChE inhibitors that carry along benefits in long-term treatment on the improvement of cognitive failure of AD (Lu & Bludau, 2011).

Section 2

Hypothesis

Amyloid precursor protein (APP) is a common protein found within the bodies of humans. The amyloid hypothesis depicts that a fault in processing the amyloid precursor protein (APP) within the human brain propels the production of the beta-amyloid, a short fragment of APP (Lu & Bludau, 2011). Accumulation of the beta amyloid in the brain triggers disruption and destruction of nerve cells. As a result, Alzheimer's diseases occur. Amyloid plaques refer to the accumulated clumps of beta amyloid. Fault regarding the overproduction of beta-amyloid results in the occurrence of AD. Additionally, the fault in the mechanism that clears beta amyloid from the brain also explains AD.

Functional Analysis Conditions

In this analysis, we utilize an "alternative design," also referred to as a "multi-element design" (Miltenberger, 2015). The design depicts the utilization of one particular type of manipulation for a given day or session. Consequent...

Despite the alternations, the functional analysis will cover varied sessions including hourly, half-day sessions, amongst others.
Day 1: Attention Condition

In this case, the health practitioner pays attention to Luther every time he leaves his room. After observation, the practitioner records the frequency of times Luther gets out of his room contrary to accorded instructions given to him. If the behavior depicts a high level of frequency, then it is evident that the symptoms of AD have spread fast. During this condition, he gets out of his room ten times a day contrary to instructions prohibiting him of movement without supervision.

Day 2: Alone Condition

Luther would be observed on his own. The frequency of leaving his room without supervision is higher to up to fifteen times. Automatic reinforcement explains the frequency of Luther's behavior of leaving the room without the supervision of the nurses. Deepening memory loss accompanied by changes in behaviors explains the cognitive failures depicting the symptoms of AD.

Day 3: Free Play Condition

In this case, a nurse joins Luther in his room as they converse on various topics, depicting a friendly conversation. The patient, Luther, has freedom in freely expressing himself. The condition is used as a control for other conditions. It enables the client to receive all his needs and demands, giving him all the necessary attention. In this case, the frequency of getting out of the room may reduce as the patient is involved with another person. The shift in attention causes the brain to concentrate on the 'friend', despite a few cases that Luther leaves the room.

Day 4: Escape Condition

Under this condition, the practitioner can leave Luther to conduct his behaviors without supervision from anyone. Results from this case indicate that Luther continues to leave his room frequently without the supervision of the nurses. The frequency also depicts similarity with that of the attention condition. It is evident that the behavior of leaving the room occurs more like the symptoms of the disease and not Luther's true behavior.

Treatment Procedures

Administration of drugs referred to as cholinesterase inhibitors. The drugs boost the levels of the cell-to-cell communication chemical depleted by AD. Commonly prescribed drugs include Razadyne, Exelpn, and Aricept. Memantine (Namenda) drugs work to slow the progression of AD. At times, Namenda drugs are combined with cholinesterase inhibitors (Lu & Bludau, 2011). Researchers have also tested the current drugs utilized in managing AD and found out that Reminyl occurs as a remedy that blocks beta-amyloid from sticking together. Preventing the accumulation of beta-amyloid occurs as the effective remedy in managing AD (Lu & Bludau, 2011).

Section 3

Risks

Risks associated with the drugs utilized in treating AD may include harmful loss of weight. Patients under the dosage of these drugs may experience significant weight loss due to the effects of cholinesterase inhibitors' effect on body cells. However, researchers have failed to explain the loss of weight resulting from administration of these drugs.

Results Expected

Cholinesterase inhibitors come in handy to enable AD patients to manage symptoms that include reduced concentration, deepened memory loss, anxiety, and behavioral changes. Administration of the drugs endeavors to help AD patients to remain calm and have improved concentration and memory levels.

Result Outcomes

Research has indicated that less than half of patients under cholinesterase inhibitors manage to keep their symptoms at bay. The inefficiency of this drug may hinder a majority of patients from realizing the reduction of the effects of AD. Other side effects of the drugs include sleep disturbances, nausea, and diarrhea.

Strategies to promote generalization

I. Teaching 'functional behaviors' aimed at improving the life of the patient (Cooper, Heron, & Heward, 2007). The behaviors should bring about the reinforcement of behaviors, an aspect aimed at improving the cognitive skills of the patient. For example, repeating a particular task after some time facilitates the reinforcement of the patient's behavior towards a certain norm.

II. Generalizations should occur frequently and not necessarily within the planned periods. Every moment that the patient is awake presents an opportunity for learning about their natural environment and fundamental events to reinforce their memories.

III. Conducting troubleshooting to identify the cause of the problem. It is not appropriate to blame the patient based on evident symptoms of memory loss and change in moods and behaviors. On the contrary, the condition presents others a platform to employ a systematic approach to solving the issues at hand. Consistency and hard work occur as vital elements that spur…