Sociology

Old age is a global experience that affects everyone since nobody stays young forever and at one time, everyone will grow old. In the modern times where families have become nuclear, taking care of elderly has become a major concern both publicly and privately. In a domestic environment, elderly people enlighten the family by their spirit of existence. However, at a certain age when they can no longer contribute actively to normal jobs or decision-making they are regarded as redundant. At this stage the rest of the family members have to take care of their physical as well as emotional needs (Tierney, McGhee Papadakis, 2001). Taking care of an elderly person is not an easy task as it requires skills, values and attitudes such as immense understanding, patience and composure at all times.

Alzheimer is a disease that affects the brain cells and causes forgetfulness that is not the normal everyday forgetting. Alzheimer is mostly associated with older people and makes them forget basic things and even forget how to do basic chores. Alzheimer permanently affects the brain and over time, the old person forgets hisher name forgets faces and names of the family members. Research shows that Alzheimer affects old people particularly over 65 years age, and does not affect kids (Kawas, 2003). Since the disease affects the brain cells progressively, it is irreversible. Alzheimer symptoms mostly affects people when they reach the age of 60. Dementia is associated with Alzheimer. Dementia is a condition whereby a person loses the cognitive functions such as reasoning, thinking and remembering (Jellinger, Polvikoski Haltia, 2002). Statistics shows that, approximately 5.1 million of Americas old people population has Alzheimer.

Dr Alois Alzheimer discovered the disease in 1906, and thus the reason why it is named after him. The doctor was examining the brain tissues of a woman had died of an unusual mental illness when he noticed some changes. The woman had portrayed unpredictable behavior, memory loss and language problems (Blass, 2002). The doctor observed abnormal clumps also known as amyloid plaques in the diseased brain and found tangled bundles of fiber currently referred to as neurofibrillary tangles (Blass, 2002). The two features (tangles and plaques) recognize Alzheimer disease as well as loss of neurons (nerve cells) connections in the brain.

Case Study
Annette is a 63-year-old woman, she keeps on forgetting things, she forgets how to wear her shoes, she forgets the grandchildren names and sometimes she does not even recognize her son. Sometimes she goes to the grocery story, forgets what she was going to buy, and comes home empty handed. Her family members are worried because of her constant forgetfulness. They are also worried because after visiting the doctor, he said that the disease could not be treated only special attention should be given to Annette. The family members have the role of ensuring that Annette is not left alone because she can wonder away from home and forget her way back. They are contemplating of employing a person to take care of her during the day when everyone is at work or take her to a nursing home.

Literature Review
The most common ailment that elderly people suffer from is loss of the cognitive ability also known as Alzheimer. This condition declines an elderly person reason and loss of memory in such a way that heshe is unable to carry out the normal activities such as personal care (bathing, feeding and dressing), household chores or even driving. Alzheimer is known to cause a condition regarded as Dementia.  Dementia although abnormal behavior is a normal part of aging that was initially regarded as senility. Dementia can sometimes be reversed if the patient undergoes proper medical treatment but at times, it can get worse with time and become permanent. Dementia can lead to decline in physical health leading to situations such as poor hygiene and self care, malnutrition, risk of falling and aggravated condition incase of another health-related problem.

A human brain working by transmitting signals to various part of the brain. The neurotransmitters are the chemical messengers responsible for allowing communication among the brain cells. A person with Alzheimer suffers communication breakdown because the neurotransmitters are minimal. People with this disease suffer from fiber and protein deposits as well that hinder the cells from working properly. Due to the hindrance from the deposits the cells fails to send the right signals to the brain. Once the Alzheimer disease affects the brain cells, some cells shrink and die over time.

The causes of Alzheimer disease is yet to be discovered. Although a lot of research has been done to establish the cause, researchers have not come up with a reason why people get Alzheimer. As people grow old, the risk of getting Alzheimer becomes higher (Tsai, Green, Benke, Silliman Farrer, 2006). For example, Judith who is 85 years old has a high risk of getting Alzheimer as compared to Annette who is 63 years old. Study also shows that women are at a higher risk of getting the disease compared to men of the same age. Researchers suggest that Alzheimer sometimes can be genetically transmitted. The likelihood of genes passing from family members is high. Other factors such as high cholesterol, head injury, high blood pressure and Down syndrome coupled with genes may cause a person to get Alzheimer. Research shows that constant brain exercise such as doing exercise and filling crossword puzzle coupled with a healthy diet may delay the Alzheimer disease onset.

How to take care of Alzheimer patients
Alzheimer exhibits all the symptoms common with memory problems and all other conditions affecting the brain. It is therefore hard for doctors to diagnose the disease. Doctors use CT scans and MRI to scan the brain and look for any fiber and protein deposits. They also spend a lot of time talking to the patient to gauge their memory condition. There is no cure for Alzheimer therefore, doctors sometimes prescribe medicine that would help the elderly to boost patients memory and thinking (Miller, 2008). In case of other situations like depression and dementia, some medicines are prescribed to slow down the disease.

When a family member either a father or a mother gets Alzheimer like Annette, it can be depressing to everyone. It is sad to see someone you love struggle to remember important things or face difficulties in taking care of herhim, especially if the person was independent before. Despite of the anger and the pity, family members should find a way of taking care of the elderly at this time of need. The caregivers should ensure that the elderly is safe at all times because sometimes they may stroll off the compound without being noticed. Due to their memory loss, they may be risking accidents and sometimes fail to know their directions around the house. If the elderly feed themselves, the caregivers need to establish whether it is safe to allow them to cook without causing harm to themselves. The caregivers should also ensure that they take their medicine in the correct dosage. However, since following everything an elderly person does compromises on their independence, a caregiver should find the correct way and practices that would balance between safety needs and independence.

The caregivers should make sure that the elderly do enough physical activities such as walking as it ensures stimulation of mental condition as well as physical well-being. The aged should be encouraged to play card games or board games as they stimulate the brain. The activities that allow interaction and require problem-solving skills are also good in mental stimulation. When it comes to personal care such as grooming and washing, the elderly should be allowed to do much of the work on her own (Tierney, McPhee Papadakis, 2001). The hands are manipulated by holding items and thus items, which are not easily broken, swallowed or sharp, should be provided.

Policies on old peoples well being
The global population of older people has political and socioeconomic implications that are far reaching to everyone (Hodgson  Cutler2004). Younger generations benefit from the material and immaterial contribution made by the older adults. It is therefore important for a society to take care of the older generation and increase their growing presence and longevity. The economic, research and social policies undertaken by the society should enhance the older adults well-being. The policies should ensure that ageism is eliminated so that older people should realize their potential, live with dignity and have the health required to access their resources. The socioeconomic policies should also ensure that old people are prevented from the ailments targeting them especially Alzheimer and related diseases such as dementia. In the society, social workers can co-operate with older adults and their family member in creating policies and programs that are ageing-friendly so that the services provided to elderly are culturally competent.

Statistics shows that the global populations are aging at a rapid rate with the older adults constituting approximately 13 percent of the total world population (HelpAge International, 2005). Women comprise the largest population of older adults because they outlive men. This explains the fact that women more than men, are more at risk of getting Alzheimer. The life expectancy is increasing since the world is aging differently. The fastest growing population comprise of women who are 85 years and older. It is not only necessary to consider policies that increase the longevity, but also the policies should ensure that there is a healthy life expectancy. The older adults should live a life that is free from disability, disease, illness and discomfort brought about by old age ailments.

In determining which policy best suits for the elderly adult suffering from Alzheimer there are factors that should be considered. Family structures have been highly affected by modernization, urbanization, rural-urban migration as well as epidemiological and demographic shifts. The healthcare provision, financial security, retirement and work patterns that affect the quality of care family members can give to the elderly suffering from Alzheimer. Madrid International Plan of Action for Ageing (MIPAA) was a policy introduced by IFSW with three policies of development of older persons, advancing their health and well-being as well as enabling and ensuring supportive environments to them (World Health Organization, 2003).  The policy is used to more than 151 countries world wide to deal with issues affecting the elderly.

Older Adults and Development
Older adults in the society face a great risk of marginalization despite their contribution to the communities. Once the older adults leave the labor market, they face poverty and social devaluation. The elderly people face income shortage and social insecurity despite of the employment history mostly because of financial market fluctuation in countries with transitory economies. Elderly people with ailments such as Alzheimer and disabilities especially those coming from minority groups and a migration background seeks support in order to have quality life and maintain their independence. An organization such as MIPAA helps in setting up convection that fights for elderly women with disease and disabilities rights and freedoms. Some of the conventions include Convention on the Elimination of All Forms of Discrimination against Women, Convention on the International Protection of Adults and Convention on the Rights of Persons with Disabilities (United Nations, 2008). The policies, rights and freedom of the elderly people with Alzheimer and other ailments are advocated and fought for by social workers that represent them.

The social workers fight for elderly people dignity and reduce all forms of discrimination against them from the society. The social workers ensure that the elderly are represented in all economic, social and intellectual contributions as well as ensuring that their decisions are included. MIPAA policies advocate that the elderly people should be included in the community cultural life despite their cognitive abilities and literacy. The elderly people should participate in integration activities such as learning computer skills since it would sharpen their knowledge and enhances social cohesion.

Research has shown that social marginalization contributes to poor physical and mental health in elderly people and erodes their ability to function interdependently and independently (Miller, 2008). marginalization hinders elderly people from living a quality life this is because the health benefits, disability insurance, pensions  and savings of people in these areas are rendered worthless due to hyperinflation. Women especially face it rough because they have lower degrees of formal education as compared to men. The older adults development policies encourage labor market reforms that introduce pension-equivalent systems that would ensure the older people have enough economic and social security to see them through old age.

Advancing Health and Well-Being into Old Age
The policies adapted by WHO, IFSW and MIPAA define health as not only absence of infirmity and disease but as complete mental, physical and social well-being (United Nations, 2008). The three organizations promoted the ageing perspective through promotion of health and disease, preventing injury and disability factors that encourage old age health in women (United Nations, 2008). The organizations recognize that older adults health should be taken in lifespan context. The organizations policies of well-being incorporate not only individuals efforts but also the governments and private organizations such as nongovernmental organizations. The policies encourage support to the social workers who ensure the needs, goals and strengths of the elderly people with diseases such as Alzheimer nave favorable societal conditions that lead to their physical and mental well-being.

The organizations have set up policies that would ensure that the aged are equipped with the proper knowledge on how to take care of their health. These initiatives encourage people suffering from Alzheimer and other diseases to eat a balanced diet, moderate on alcohol use, quit smoking, do regular exercises as well as integrate socially with other people. These factors would ensure that they age healthily and reduce the risk of contracting old age ailments. The policy elaborate that primary care, preventive care as well as mental health are essential for health ageing. Preventive health care services should be encouraged to solve mental and emotional health problems. Non-adherence to medical cure procedures and risky behavior are attributed to the cause of unhealthy ageing. The policy encourages specialized care to elderly people suffering from Alzheimers and dementias of other kinds.

Incontinence affects 30 of elderly population, an embarrassing situation where involuntary leakage of urine (Cooper, 1997). The condition is usually normal and can be easily treated and cured. The situation occurs mostly in women because of menopause and multiple births among other causes such as Alzheimers and drinking less water. Incase the elderly is suffering from incontinence heshe should visit a doctor. The elderly should cut on taking diuretics such as caffeine and alcohol because they drain the body water. In order to keep the bladder healthy, they should drink a lot of water but avoid taking 3 hours before bedtime. Exercise that control pelvic muscles such as pelvic muscles should be undertaken and the elderly should avoid aspartame products because they irritate the bladder. The bathroom floor should be slip resistant to avoid slip and falls because incontinence causes many visits to the toilet. Incase the condition is not permanently treated caregivers should provide the elderly with adult diapers and protective underwear. They should apply them soothing creams and lotion incase there is skin irritation or rash.

As people age their skin becomes thin and dry. Therefore, an elderly skin is always dry and should be taken care of regularly. The skin should be cleaned regularly especially the groin, armpits, under areas and feet. If the aged sweats regularly, absorbent clothing should be provided to avoid rashes, fungal infection and extreme dryness. To avoid extreme dryness frequent hot baths should be avoided. The skin should be kept hydrated with a hydrating cream to preserve natural moisture and avoid cracking, itchiness and pain. The skin should be prevented from itching by using bathing oil. Routine checkups on the elderly skin for skin disorders, dryness, change in color, blisters, swelling should be undertaken (Maas, 2001).

Ensuring and Enabling Supportive Environments
The MIPAA policies advocate for safer environment for elderly people either with Alzheimer, disabilities or healthy. The organization encourages accessible, safe ands affordable housing that the elderly has relief or support from family or caregivers. They also prohibit and prevent mistreatment of the elderly. They encourage environments where the elderly is empowered and encouraged to participate socially. The home where the elderly is staying should be designed in such as way that it does not threaten herhis health. The home should be well maintained and repaired. Sometimes when it is hard to provide a safe and accessible home for elderly, most people take them institutional care or community based care (Clark, 2002). The elderly should be provided with home care services such as meals, personal care, housekeeping and home health care (Miller, 2008)

The Nursing practice and continual professional development should help in creating the skills necessary in coping with Alzheimer in elderly. The profession insists that for safety reasons some basic home adaptations like well-lit rooms, handrails on the stairs, low profile carpeting among others should be established. The elderly should visit a neurologist for proper diagnosis incase of a mild dementia. The caregiver should ensure that the medication given is taken as specified. The caregiver should keep a pill organizer to ensure that the medications are dispensed daily. The elderly nutrition should be improved by making sure at least one hot meal is provided each day. There should be one person left to take care of the elderly, help her with daily chores and keep them company. Incase the elderly is incontinent, disposable briefs that are snug fitting with elastic leg bands should be provided and a toilet schedules kept to change.

Conclusion
Dealing with an elderly who is suffering from Alzheimer and other dementias is a hard experience. The family of Annette found it hard to take care of her and employed a home based worker to take care of her during the day. MIPAA, WHO and IFSW set policies that would ensure that the elderly people live a fulfilling life. The policy included approaches that ensure their development, health and well-being as well as providing supporting environments to them.

Elderly adults suffering from Alzheimers should be allowed to in designing and implementing policies, programs and research that ensure their well-being during ageing. The policies ensure that the quality of life of elder adults is respected their rights are supported, strengthened and protected. The policies ensure that older people are not neglected, financially exploited or mistreated. The policies requires every social worker and caregiver to have demonstrated skills, values, knowledge and attitude that is positive and necessary for safe and effective care of elderly persons. Elderly people love feeling appreciated and important it is therefore necessary to do some simple things for them such as massaging their aching parts, giving them medicine etc. They also fear getting hurt and may usually hide their problems. It is therefore important to understand them and constantly ask if they are all right. Their views need to be taken in consideration even if they are not correct as it makes them feel important.