Sample Nursing Paper on Alzheimer’s Disease

How can the biopsychosocial medical interview model address the unique needs of older adults with Alzheimer’s?

Abstract

Over the years, researchers have proposed various non-medical and psychosocial models for the treatment of Alzheimer’s. Nonetheless, addressing Alzheimer’s patients’ unique needs using a model that integrates biological, social, and psychosocial processes in its management. Present models provide an increased understanding of factors that improve or worsen instead of illustrating the impact psychological factors have on the disease’s contextual biological processes. Accordingly, this paper explores the impact of the application of biopsychosocial medical interviews. With dementia being a multifactorial condition, only a few researchers address the differences between the biomedical and psychosocial interview models in its management. For this reason, a rationale exists for analyzing these differences to provide caregivers with a practical guide for implementing effective interventions in older adults living with dementia.

How Biomedical Approach Can Overlooks Alzheimer’s

Modern medicine has mostly centered its development on biological sciences to enhance the diagnosis and treatment of various physical and mental conditions. The emerging biomedical model for illnesses primarily focuses on a condition’s pathophysiology by analyzing the anatomical, neurophysiological, or biochemical components (Salinas et al., 2017. For the past century, healthcare providers have considered Alzheimer’s disease as pre-senile dementia associated with aging. The conceptualization of Alzheimer’s condition as a brain disease rather than a product of aging has become a subject of discussion with overarching global outcomes for science and society, significantly affecting research, awareness, and public perceptions.

How the Psychosocial Model can be Used to Address the Special Needs for Alzheimer’s

Several approaches are available for delivering effective psychosocial based interventions to older adults. Through the psychosocial model, caregivers can leverage assistive technologies to address accessibility, sustainability, and personalization challenges in patients with Alzheimer’s. The psychosocial-based dementia intervention’s cost-effectiveness recommends for application in the prevention delivery of palliative care at home or in health care institutions. As such, the psychosocial interview model can lower the costs associated with the provision of Alzheimer’s care in self-care settings or care homes. Moreover, its reliance on a specialist, personalized multicomponent treatment approach to provide psychological support to families living with an older adult reduces care home admission for the target population (Marseglia et al., 2020). Psychosocial based interventions support family carers. Given the multicomponent nature of this model, it is a useful tool for reducing depression, caregivers’ burden, behavioral and psychological symptoms of Alzheimer’s, and improving caregivers’ quality of life.

Application of the Biomedical Model

While aging calls for supportive care and acceptance, the classification as a disease introduces aspects of active interventions that can be potentially curative. The consideration of Alzheimer’s as a condition increased the expectation that neurobiological research will result in rational interventions, further propagating the conception as a new branch of science that applies to neurodegeneration (Salinas et al., 2017).. This approach’s novelty is that it increases advancements in biomedical research, leading to a comprehensive understanding of brain aging and theories about aging and dementia. Nonetheless, the impacts of the neurobiological model’s dominance are the emerging disconnect from the lived experience of the illness. In this line, the National Institute on Aging and Alzheimer’s Association (NIA-AA) stipulates an alternative diagnosis for the condition. The agency advises that diagnosis be informed by evidence of neuronal atrophy, biomarkers, or injury even among those who present no symptoms of cognitive deteriorations (Jack et al., 2018). This approach introduces the concept of asymptomatic Alzheimer’s disease. Unfortunately, the diagnostic biomarker criteria are only recommended for research reasons and are yet to be approved for clinical diagnostics.

However, great attention is drawn by the biomedical model’s deficits, especially in public campaigns, which has increased the level of hopelessness related to Alzheimer’s. According to Selkoe (2019), dementia has overtaken cancer as the most dreaded condition for persons above 50-years. Worse, there is no effective treating regimen for the disease. This has caused the need to redefine Alzheimer’s and new strategies for dealing with dementia syndrome. The significant challenges of the biomedical model is that it overlooks the resilience  capacity of the brain. In addition, it does consider the two major problems of the classical disease model. The first challenge is that there lacks adequate evidence linking the clinical features of the illness with the hallmarks of the condition’s neurobiology. Besides, the plaques and tangles do not bear any pathognomonic form. A substantial part of persons with dementia does not suffer sufficient neuropathology to explain the presenting cognitive behavior. Further, scientific research shows that portions of significantly older adults without dementia also indicate high AD pathology levels. Secondly, among older adults, the pathology is largely heterogeneous than previously envisaged, with a range of plaques and tangles alongside cerebrovascular disease, even among patients with the clinical diagnosis of Alzheimer’s illness.

 

 

Application of the Psychosocial Model in Alhzeimer’s

In contrast to the traditional biomedical interview model, the biopsychosocial medical interview model focuses on the micro-level interactions between individuals. Its effectiveness in meeting the social needs of older adults with Alzheimer’s depends on reducing disabilities, promotion of cognitive functions, mood, and emotional regulation as the model has no adverse health risk to older adults. It uses a multidisciplinary approach to develop practical-based analysis interventions to address cognitive, behavioral, functional limitations, and improve seniors’ quality of life with Alzheimer’s. Combining the psychosocial model with pharmacological options provides health care providers with a potent tool for delivering effective palliative care. According to Teachman et al. (2019), psychosocial model interventions focus on providing patient-centric care to end-of-life and living Alzheimer’s patients.

The suitability of the psychosocial model is promising as evaluations reveal its applicability in delivering patient-centric and multicomponent-based dementia care to older adults. However, several limitations affect its relevance in addressing the unique needs of older adults—concerns about the suitability, effectiveness, and acceptability of assistive technologies by patients and caregivers. As a result, there is a need for new paradigms to evaluate the effectiveness of rapidly evolving technologies. While some psychosocial based interventions can effectively address the unique needs of seniors with dementia, they might have minimal health outcomes in patients with dementia compared to the scope of change required.  Fossey et al. (2019) contend that only the development of evidence-based psychosocial interventions can contribute to delivering effective care to older adults living with dementia. Nonetheless, the application of this model requires a shift in the methodologies used to collect data for evaluation of the sensitivity of the model to contextual, biomedical, and patient data. For this reason, the development of new initiatives for addressing the health and safety needs of seniors living with dementia entails engaging families, caregivers, and the public in the management of the condition. The success of dementia intervention depends on the ability of caregivers to select the right model and integrate its principles to address the special needs of older adults. Because of the extensibility of the psychosocial interview model, this review recommends its adoption by caregivers.

Conclusion

There is an emerging epidemiological agreement that lifestyle factors provide crucial avenues of prevention, consequently affecting the treatment course. Reseracrhers are utilizing an integrative model comprising biomedical and psychosocial approaches to address significant health challenges. An integrative model provides for greater justice to phenomenology and pathology for Alzheimer’s patients. Both techniques’ novelty provides insights into the integrative approach by identifying a range of preventive compensatory factors. Integrating compensatory factors such as social engagement, high education, mentally stimulating activities, and maintaining cardiovascular health increases brain and cognitive reserves. Researchers and developers agree that due to the complexity of the human condition, it is challenging to explain Alzheimer from a biomedical perspective alone; thus, the adoption of a biopsychosocial model will be more suitable to explain why the symptoms and course of the illness may vary among individuals by exploring the interdependence of the biological, psychological, and social traits.

 

 

References

Fossey, J., Garrod, L., Tolbol Froiland, C., Ballard, C., Lawrence, V., & Testad, I. (2019). What influences the sustainability of an effective psychosocial intervention for people with dementia living in care homes? A 9 to 12‐month follow‐up of the perceptions of staff in care homes involved in the WORLD randomised controlled trial. International Journal of Geriatric Psychiatry, 34(5), 674-682. https://doi.org/10.1002/gps.5066

Jack, C. R., Bennett, D. A., Blennow, K., Carrillo, M. C., Dunn, B., Haeberlein, S. B., … Silverberg, N. (2018). NIA-AA Research Framework: Toward a biological definition of Alzheimer’s disease. Alzheimer’s & Dementia14(4), 535–562. doi:10.1016/j.jalz.2018.02.018

Marseglia, A., Darin‐Mattsson, A., Kalpouzos, G., Grande, G., Fratiglioni, L., Dekhtyar, S., & Xu, W. (2020). Can active life mitigate the impact of diabetes on dementia and brain aging? Alzheimer’s & Dementia. https://doi.org/10.1002/alz.12142

Salinas, J., Beiser, A., Himali, J. J., Satizabal, C. L., Aparicio, H. J., Weinstein, G., Mateen, F. J., Berkman, L. F., Rosand, J., & Seshadri, S. (2017). Associations between social relationship measures, serum brain-derived neurotrophic factor, and risk of stroke and dementia. Alzheimer’s & Dementia: Translational Research & Clinical Interventions3(2), 229-237. https://doi.org/10.1016/j.trci.2017.03.001

Selkoe, D. J. (2019). Alzheimer disease and aducanumab: Adjusting our approach. Nature Reviews Neurology15(7), 365-366. https://doi.org/10.1038/s41582-019-0205-1

Teachman, B. A., McKay, D., Barch, D. M., Prinstein, M. J., Hollon, S. D., & Chambless, D. L. (2019). How psychosocial research can help the National Institute of mental health achieve its grand challenge to reduce the burden of mental illnesses and psychological disorders. American Psychologist, 74(4), 415-431. https://doi.org/10.1037/amp0000361