Treating Alzheimer’s Disease

1 Treating Alzheimer’s Disease Clinicians attend to patients with diverse mental health conditions each day. Most of these conditions are hard to diagnose due to the similarity of symptoms. When dealing with clients showing symptoms of mental health disorders, the clinician must conduct relevant psychological assessment tests to make the right diagnosis. Importantly, the clinician must create a treatment plan that incorporates the client’s needs and promises positive results (Jha & Mukhopadhaya, 2021). This discussion reflects the treatment plan for an older adult with Alzheimer’s disease.

Summary of the Case The client is a 76-year-old male with symptoms ranging from impaired judgment, poor eye contact, restricted affect, disoriented to time, to impaired impulse control. The client makes inappropriate movements during the interview but states he is not aware of such movements.

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2 Decisions Point 1: Choice: client to begin Begin Exelon (Rivastigmine) 1.5 mg, orally BID with an increase to 3 mg within two weeks Reason: Rivastigmine is a potent reversible cholinesterase. It effectively treats dementia and other related conditions by elevating the acetylcholine levels in the CNS (Belwal et al., 2021).

The therapeutic impacts of this medication include improved memory, arousal, and learning.

Targeted results: The therapist intended to improve behavior, communication, memory, and interest in social activities.

Achieved results: The medication did not improve the client’s condition. The client was still uninterested in social activities. His MMSE score was 18/30, with significant deficiencies in attention, orientation, memory, and calculation.

Decision 2: Choice: Increase Exelon to 6 mg orally BID Reason: There were no indicators that Exelon needed to be discontinued at this point. The current dose had achieved significant improvements in symptoms. While psychopharmacology guidelines discourage abrupt medication replacement, they recommend dose increment to achieve better outcomes (Town & Hoffman, 2019).

Targeted results: The clinician wanted to alleviate dementia symptoms further, increase social activities, and improve memory.

Achieved results: The client’s behavior is still unchanged. He discontinued the medication due to severe abdominal symptoms, including diarrhea and vomiting. The abruptly increased Exelon dosage contributed to these side effects.

3 Decision 3: Choice: Augment with an appetite stimulant, Nemanda.

Reason: The main concern at this point is that the client has completely lost his appetite and developed abdominal symptoms like diarrhea and vomiting. The clinician should not replace the current medications or add other medications to treat side effects (Jha & Mukhopadhaya, 2021).

Lowering the Exelon dose and augmenting it with an appetite stimulant would help address the side effects.

Targeted results: The clinician’s projected results include improved appetite and decreased abdominal symptoms.

Achieved results - The treatment plan was effective since it helped improve and sustain the accomplished therapeutic outcomes, including better memory, improved appetite, and increased interest in social tasks. The client’s self-care had improved, and his MMSE score had improved.

The client did not show signs of disinhibition.

Ethical issues Bioethical principles call for the respect of dementia patients. The clinician must adhere to autonomy, beneficence, and maleficence. Notably, the client must consent to treatment, and the clinician must accurately inform the family members of the treatment plan (Town & Hoffman, 2019). The clinician cannot disclose the client or family data to unauthorized individuals without the owners' consent.

Conclusion Older adults are likely to present with Alzheimer's and other forms of dementia.

Treatment involves administration with acetylcholine inhibitors such as Rivastigmine. These

4 medications improve neurotransmitter concentrations, subsequently improving memory, language, and concentration.

5 References Belwal, T., Nabavi, S. M., Nabavi, S. F., Dehpour, A. R., & Shirooie, S. (2021). Naturally occurring chemicals against Alzheimer's disease. Academic Press.

Jha, A., & Mukhopadhaya, K. (2021). Alzheimer's disease: Diagnosis and treatment guide.

Springer.

Town, L., & Hoffman, K., (2019). Dementia, Alzheimer's disease stages, treatments, and other medical considerations. Omega Press.