Alzheimer\'s Disease Is a Fatal

Alzheimer's disease is a fatal neurological condition that typically appears first in elderly individuals; it is a progressive disease with no cure that causes the gradual deterioration of cognitive functions, eventually rendering patients completely incoherent and unable to process cognitive information or to communicate (Taylor, Lillis, & LeMone, 2008). The only definitive way to formally diagnose Alzheimer's disease is through a post-mortem identification of tangled neuron bundles and amyloid plaque at autopsy. However, the symptoms of the disorder are distinctive enough that they permit a practical diagnosis for the purpose of treatment (Taylor, Lillis, & LeMone, 2008).

While there is no way to stop the progression of the disease yet, early diagnosis is a benefit because it permits caretakers and patients to mitigate some of the negative consequences by adopting behavioral adaptations conducive to the comfort, safety, and health of patients and to the minimization of the burden the disease typically places on loved ones and other caretakers (Taylor, Lillis, & LeMone, 2008). Generally, Alzheimer's begins after the age of 60, although there are also less frequent cases of early-onset Alzheimer's among much younger individuals.

The disease begins and progresses very gradually, so much so, that it's earliest symptoms of mild forgetfulness and other cognitive decline are very often assumed to be functions of advanced age without any clinically relevant pathology (Taylor, Lillis, & LeMone, 2008). In fact, there are so many similarities between ordinary age-related cognitive decline and Alzheimer's that it is now believed that, for decades, millions of cases of Alzheimer's went unrecognized with the symptoms of the disease blamed on senile dementia. In many Alzheimer's patients, the disease may continue to progress over the course of approximately seven years from first onset of symptoms to death (Taylor, Lillis, & LeMone, 2008).

Initially, Alzheimer's begins with mild symptoms that are indistinguishable from ordinary age-related cognitive decline such as memory problems and general reduction in awareness and ability to care for one's self independently (Taylor, Lillis, & LeMone, 2008). Thereafter, Alzheimer's patients experience a continual decline in their memory, ambulation, balance, and their ability to communicate with others. Unfortunately, if the patient is otherwise healthy, Alzheimer's disease ultimately progresses to complete cognitive incapacity, inability to communicate or understand others, and frequently, even the ability to recognize loved ones, including even caretaking spouses. Physical symptoms of the disease include loss of vestibular integrity, inability to walk, and incontinence. By the time of their death, most Alzheimer's patients require complete care that usually exceeds the capacity of loved ones to provide without professional assistance (Taylor, Lillis, & LeMone, 2008).

Reference

Taylor C, Lillis C, and LeMone P. (2008). Fundamentals of Nursing: The Art and Science of Nursing Care. Philadelphia: Lippincott, Williams, and Wilkins.

CIRCADIAN RHYTHMS and SHIFT WORK SAFETY

In the contemporary age of modern industry and production, it has become quite common for work to continue round the cock, typically in connection with three 8-hour work shifts often referred to as first, second, and third shift (Lamond, Dorrian, Roach, et al., 2003). The last shift is nearly universally referred to as the "graveyard" shift, presumably because in many industries, the overnight hours can be as quiet as the proverbial graveyard. Numerous studies have documented that shift workers (i.e. those who regularly rotate work shifts from one schedule to another) suffer much higher incidence of many medical problems; likewise, the third shift is widely considered to be the most dangerous in terms of workplace accidents and industrial injuries (Lamond, Dorrian, Roach, et al., 2003).

Researchers have determined that there are several specific causes of the negative consequences associated with shift work, some of which are functions of circadian rhythm disruption while others are directly related to other factors, such as the quality and quantity of daytime sleep (Pauley, 2004). In most biological organisms, there is a complex circadian rhythm mechanism that is not yet understood precisely. In principle, that mechanism coordinates various biological processes, such as the secretion of various hormones, during sleep. According to evolutionary biologists, circadian rhythms evolved as means of adaptation to the natural 24-hour cycle of light and dark attributable to the rising and falling of the sun on the earth's horizon (Lamond, Dorrian, Roach, et al., 2003).

Researchers recommend the following three approaches to mitigating the potential consequences of night-time work shifts: (1) Regular rather than rotating work shifts; (2) Behavioral practices conducive to sufficient sleep; and (3) Light avoidance before and during daytime sleep (Lamond, Dorrian, Roach, et al., 2003; Pauley, 2004).

More specifically, it is not necessarily working overnights that is the root of the problem; rather, it is the continual rotation from one shift to another that prevents the circadian rhythm from adjusting in a manner that allows long-term adaptation of circadian functions. Therefore, rotating shifts should be avoided to make night shifts safer and healthier (Lamond, Dorrian, Roach, et al., 2003; Pauley, 2004).