Contemporary Cases Handout

Contemporary Cases Handout - Contemporary Cases for...

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Contemporary Cases for Consideration Simulated Presence Therapy As many as five million people in the United States today are suffering from Alzheimer's disease. That number is expected to increase dramatically as the baby boomer population continues to age – reaching over 14 million by the middle of the 21 st century, according to the Alzheimer's Association. Although 70 percent of Alzheimer's patients in the U.S. – particularly those in the early stages of the disease – are cared for in a home setting, the need for institutional services increases as symptoms worsen. Approximately half of the current residents of nursing homes and assisted living facilities have been diagnosed with Alzheimer's disease, as well as 25% of all elderly hospital patients. A defining feature of Alzheimer's disease is progressive dementia: the loss of memory and other cognitive functions. Withdrawal, confusion, anxiety, and agitation are common problems associated with Alzheimer's dementia. Often, these problems can be eased by interaction with trusted family members, caregivers, and other close associates. However, it is not always possible – especially in institutional settings – to have a soothing presence available whenever an Alzheimer's patient becomes distressed. In an attempt to address the needs of patients suffering from dementia-related agitation, researchers in the 1990s investigated the possibilities of a "simulated presence therapy" (SPT) that would mimic the experience of speaking to a loved one on the telephone. The Boston firm SimPres, Inc. has developed a patented technology for SPT interventions that is now used in institutional Alzheimer's care. Here is how SPT usually works: A patient's caregiver or family member creates a list of special memories, pleasant reminiscences, favorite anecdotes, and other recollections. The caregiver or relative then has an extended telephone conversation with the patient in which the items from the list are discussed. This phone conversation is recorded, and then edited to focus the discussion on a few key themes. Care is taken to include phrases and expressions that connote affection and other positive emotions. The voice of the patient is deleted, so that only half of the conversation remains, with gaps of silence where the patient may interject responses. This recording can then be played subsequently for the patient; sometimes it is played through a device that resembles a telephone, and sometimes it is played through a personal stereo with headphones. According to nurses who have used the SPT system with elderly residents in extended-care facilities, "when the tape is played, the resident experiences the effect of 'conversing' with the caregiver." Numerous scientific studies have documented significant improvements in patients' moods and behavior with the use of SPT. Some researchers have claimed that SPT ameliorates "problem behavior" in over 80% of Alzheimer's patients. Others describe major declines in
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Contemporary Cases Handout - Contemporary Cases for...

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