Language Discourse with dementia in mind

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Language Discourse with dementia in mind

• Presented By
• Joshua DeAngelo Avery
• Dr. Boyd Davis
• Gerontology 5050
• Language, Aging and Health
• University of North Carolina at Charlotte
• Spring 2006

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Topics of Discussion

• Aging
• Dementia
• Chemotherapy
• Factors
• Issues
• Interventions

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Introduction

• With life, comes aging a natural process which
  should not be deemed as a negative to society.
  Unfortunately, many societies pessimistically
  identify individuals as they age and as research
  has shown, this can be detrimental to an
  individuals well being.
• For example, in attempt to reject the aging
  process as much as possible, many Americans seek
  plastic surgery to counterbalance the effects of
  aging. Yet, as this project will show, aging
  should not be rejected, nor should people feel
  pressure from society to reject the natural aging
  process.

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Aging

• As aging occurs in each of us, we must all be
  prepared to handle what I will call the side
  effects of this process. Here, side effect can
  mean any perimeters that the individual or the
  society create as a constraining mechanism. In
  other words, when a person believes that they are
  too old to participate/do something, then they
  are suffering from the side effects of aging.
  Some research would point the finger at societal
  attributes and social ideologies, while it is
  also important to understand that this idea of
  too old can be based on an individuals cultural
  and ethnic background as well.
• In many cases, the side effects of aging are not
  as detrimental to either the individual or the
  society, yet some minimize their place in the
  overall scheme of society based on their age.
  This is sad in a lot of cases because it is not
  an absolute. Age should not act as a barrier or
  necessarily a bridge, but ability rather than
  age should be identified as a more accurate
  factor in ones place in society.

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Aging

• In America, production is a general key to
  success, thus the American society often gauges
  an individuals value based on their ability.
  Success and productivity are frequently
  understood to be the markers of importance and
  therefore as people age, an inaccurate
  correlation can be disproportionately made.
• To some, elderly people loose their productive
  value as they age and though this may be true to
  some extent, it is also not an absolute. Some
  sociologists would even note that an elderly
  individuals labor productivity should not be the
  sole qualifier of their social worth. For there
  are many parts to a successful society, and
  ironically elderly individuals metaphorically
  become the pistons that drive the social engine.

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Dementia

• Since health issues are often associated with
  aging, it is not unusual for negative health
  issues to be viewed as a natural side effect of
  the aging process. Though this is not always
  true for each individual across the board, it can
  be the case for the larger percentage of aging
  adults.
• Along with those who face the ordinary obstacles
  of aging, when other severe ailments, such as
  dementia are also present in the body, the
  challenges in communication and autonomy both
  increase.

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Dementia

• Individuals with dementia face several factors
  when considering treatment options that are not
  as common to individuals who do not suffer from
  the disorder. This becomes particularly
  important when identifying the use,
  effectiveness, and accuracy of communication
  through language discourse.
• In many instances, language discourse can be the
  cornerstone of correct and accurate treatment,
  therefore patients with dementia are at high
  risks when language becomes a barrier of
  communication rather than a bridge.

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Dementia

• To this end, it is important that when studying
  individuals with dementia, factors that encourage
  correct treatment are embraced. Though Dementia
  is seen as a scary disease with no present cure,
  that doesnt mean patients with dementia deserve
  to be treated inhumanely.
• Unfortunately, along with cognitive skills,
  language and communication functions are also
  affected when dementia intrudes the human mind.
  For physicians and medical professionals, it
  becomes even that much more important to
  accurately assess an individual with dementias
  needs, particularly when they struggle with an
  underlying communication barrier within
  themselves.

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Chemotherapy

• This treatment uses powerful drugs to kill cancer
  cells. In cases of small cell lung cancer,
  chemotherapy may be used to slow the cancer's
  growth, to prevent it from spreading further, or
  to relieve symptoms and make you more comfortable
  (palliative care).
• A combination of drugs usually is given in a
  series of treatments over a period of weeks or
  months, with breaks in between so your body can
  recover. Even so, because the drugs damage
  healthy cells along with malignant ones, they can
  cause serious side effects. In fact, for many
  people, side effects from chemotherapy are the
  most disturbing aspect of cancer treatment.

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Factors

• Fast-growing cells such as those in your
  digestive tract, bone marrow and hair are
  especially likely to be affected. But although
  side effects are common, their severity depends
  on the drugs used and your response to them.
• To elderly patients who also suffer from
  dementia, the question becomes, do the benefits
  outweigh the costs?
• This becomes an extended issue when communication
  may be compromised. Since elderly adults with
  dementia often lack recall and recognition, the
  use of several drugs, particularly in
  chemotherapy can offer additional decision-making
  challenges that arent as prevalent with those
  who do not suffer from dementia.

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Issues

• Studies have shown that when communication
  between patient and physician is compromised,
  treatment practices can also be questioned.
  Particularly, in the sensitive area of
  chemotherapy treatments for patients with
  dementia, there are several factors that can
  influence the ethical dilemma of this issue.
• Mental Issues
• Understanding what the treatments are for
• Understanding what the treatments are doing
• Understanding the side effects of the treatments
• Physical Issues
• Inability to sit still for long periods of time
  during treatment

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Intervention

• Ultimately, many studies have developed similar
  conclusions. In the area of aging, research has
  often shown that individuals who share similar
  backgrounds or ethnic identities may find it
  easier to accurately converse with each other,
  rather than with a person from another cultural
  background.
• As we saw in the metaphor analysis completed
  earlier this semester, even the same phrase can
  be interpreted a variety of ways by several
  different individuals. In medical practices,
  this should also be considered even in everyday
  communication between patient and physician.

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Intervention

• In accessing language with aging it is also
  imperative to acknowledge the loss of memory
  found with aging adults. It is no secret that
  diagnosing treatment options for cancer patients
  altogether can be challenging in several ways.
  However, specifically when these individuals
  happen to be riddled by dementia, considering the
  mere use of chemotherapy as a treatment option
  can become a tricky and potentially problematic
  decision all to itself.
• When faced with these obstacles, people with
  dementia need the contributions and support of
  their family and those who care about their
  overall well being. The importance of proactive
  care through advanced directives such as advanced
  care planning becomes all the more vital when
  dealing with people who suffer from the ailments
  caused by dementia.

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Intervention

• Even when both autonomy and competency become
  questioned, legal procedures such as substituted
  judgment and Power of Attorney allow method for
  the best interest of the individual to be
  implemented.
• Furthermore, with any aging individual and
  especially those with dementia, along with the
  family and an active support network, they should
  all work as a team in taking proactive steps
  towards accommodating the specific needs of the
  person. I believe if the physicians and medical
  staff are able to fulfill their roles as the
  information providers and caretakers, families
  should also be able to act as positive
  contributors in assisting the person to gain the
  best care available. As stated earlier, family
  involvement and accurate assessments are the key.
  When a persons autonomy and competency are both
  in question, it is the family or guardians
  responsibility to be involved in making sure that
  the individuals well being is satisfied to their
  own personal standards.

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Conclusion

• All in all, I believe the question of should
  chemotherapy be used for people with dementia
  needs to be re-examined. Instead, I would
  suggest that chemotherapy can be used as means to
  assist cancer patients including those with
  dementia only if certain strategies are
  implemented to affectively contribute an
  individuals well being.
• Inclusive measures should be taken so that the
  individual still feels like a part of the society
  and the society still acknowledges that the
  individual is a key component that keeps the
  societies engine revved up.