Questions:
10.1 What are the later stages of Alzheimer’s characterized by?
10.2 How can counselors contribute to Alzheimer’s prevention efforts?
10.3 What do neuroscientists speculate about building complex verbal skills early in life counteracting the effects of Alzheimer’s?
11.1 What are some issues that counselors are faced with when treating patients with Alzheimer’s?
11.2 Counselors are guided by what principles when they are conducting studies that potentially involve clients with cognitive impairments?
11.3 What might prevent a client’s consistent ability to give informed consent or make sound decisions?
12.1 What did Webber et al’s study find about dementia and living at home?
12.2 What was one purpose of Study 2?
12.3 What are the differences between the samples of the three different studies that might have caused variations in results?
13.1 What are two examples of how interventions have moderate benefits for people such as caregivers?
13.2 Early in the disease process, what are the goals for interventions with the person with dementia?
13.3 For the goals of the care recipient, what are some problems or conditions that are shown to be sensitive to specialized dementia care?
13.4 What is one unique feature in the treatment of dementia?
14.1 What are six roles that a qualified mental health professional can play?
14.2 Although physical problems are important and should often take first priority, what should be assessed and addressed first in comprehensive end-of-life care?
14.3 Why do anxiety disorders commonly accompany terminal illness?
14.4 What are some end-of-life issues that counselors are faced with?
15.1 Why does Alzheimer’s pose a major clinical challenge?
15.2 What are some significant advances in our understanding of Alzheimer’s disease?
15.3 What are some issues that must be resolved with your participation continuing the follow-up of AD patients?
16.1 What are some existential and spiritual concerns that many dying people have?
16.2 What are existential and spiritual attitudes and values shaped by?
16.3 Regarding psychodynamic issues and counter-transference, what should a counselor take into consideration of a dying person?
17.1 What does the prevention orientation that counselors advocate emphasize?
17.2 What are some community-based interventions that Israel (1988) described that has received some empirical support?
18.1 What are the four things that counselors are advised to do in light of maltreatment to an elder?
18.2 What happens to counselors who fail to report maltreatment of an elder?
18.3 What are some risk factors for abuse according to Kapp?
18.4 What must a counselor do if they have sound reasons to suspect that an older person is being maltreated?
19.1 What are four basic questions that can help rule out the presence of an underlying physical condition?
19.2 What are primary features of delirium?
19.3 Why are older adults particularly prone to developing delirium as the result of either using or withdrawing from a drug?
19.4 What are two common factors that contribute to the low detection rate of depression?
21.1 According to Black, Rabins, German, McGuire, and Roca, why might older adults underutilize psychological services?
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Answers:
A. Mental conditions that may cause intermitted periods of confusion and disorientation
AA. “Are the psychological symptoms accompanied by any unexplained symptoms?”, “Could the psychological symptoms be due to an identified chronic disorder that is worsening?”, “Could prescription drugs, over the counter medications, or other substances be causing the problems?”, “Are there any cognitive impairments?”
B. Determining when an individual can no longer truly give informed consent to remain in therapy, the client’s inability to remain in a safe and independent living environment due to his or her condition, and determining if the client is safe around others
BB. They might not recognize or under acknowledge mental health problems or because of their lack of Medicare/Medicaid
C. Participants in Webber et al’s cases were attending an Alzheimer’s Disease Diagnostic and Treatment Center in California. Participants in Study 1 were drawn from a nationwide epidemiologic study of demotion in Canada, and participants in Study 2 were all persons with dementia referred to a community–based mental health team.
CC. Reduced consciousness, and reduced ability to maintain, focus, and shift attention to outside stimuli
D. Elderly persons with dementia living alone in the community were mostly women live
DD. Carefully read the statute in their jurisdiction and seek legal consultation for any aspects of it that seem unclear; develop skills to competently assess for elder abuse but recognize that the purpose of that assessment is to determine whether there is a basis for reporting, not to conduct the investigation itself; initiate an informed consent process with all clients that explains elder abuse as another limit to confidentiality; and to the potential damage mandated reporting of elder abuse can inflict on the counseling relationship and develop strategies to minimize the damage and repair the relationship
E. Dementia that carries the potential to destroy memory, cognitive capacity, and elements of basic temperament
EE. They must share that client disclosure with the appropriate authorities, even if the conversation is otherwise considered confidential or legally privileged
F. The powerful brain pathways are created that are able to compensate for faculties lost through the pathological processes of Alzheimer’s disease
FF. Common symptoms of depression becomes less prominent with age, and somatic symptoms become more apparent
G. Advocating for preschool reading programs and other initiatives that foster verbal development
GG. Risk criminal penalties for their failure
H. Client dignity and doing no harm to the client
HH. This is due to age related changes in the body’s ability to metabolize and distribute a drug
I. To explore more fully informal services that were used by those living alone, in terms of family and neighbor involvement providing care
J. For the goals of the care recipient, what are some problems or conditions that are shown to be sensitive to specialized dementia care?
K. Respite can reduce a caregivers’ feelings of distress when provided with sufficient amounts and individual and family counseling programs can relieve the strain of caregivers and may even delay institutional placement
L. Involve people actively in addressing current problems such as depression or in planning for their future
M. Because of its high prevalence in the aging population, its prolonged course, and the absence of curative treatment
N. How one should go through the dying process, beliefs about reward and punishment in the afterlife, surrender to or anger at a Higher Power, and what happens after death
O. The person with dementia cannot participate actively in treatment
P. Psychosocial matters that include emotional, intellectual, spiritual, interpersonal, social, cultural, and economic dimensions of the human experience
Q. Psychosocial issues, diagnosable mental disorders, anxiety disorders, clinical and other mood disorders, delirium, dementia, personality disorders, and substance abuse
R. Driving ability, legal competency, nursing home placement, and termination of care
S. Programs aimed at strengthening existing social ties by education and consultation to family members of the elderly, various kinds of support groups and support services for older adults that facilitate independent living, training older adults in the role of natural helps, and participation in self-help and advocacy organization run by and for older adults
T. Attempts to allay hopelessness and improve motivation and problem solving, an examining the ecological niche within which older adults live
U. Cultural background, personal experience, and/or individual beliefs
V. Advocate, counselor, educator, evaluator, multidisciplary team member, and researcher
W. Because of their apprehension to symptoms, including pain, and about treatment, care-taking arrangements, and fears about the dying process
X. Diagnosis has improved considerably by careful attention to clinical features of the disease, thus facilitating appropriate decision-making and clinical research. Much progress has been made toward understanding the cause of AD, without which definitive treatment will remain elusive. Finally, the drug tacrine HC1 (Cognex) has provided the first therapeutic approach that may alter the course of the disease in some patients.
Y. Treatment team should be aware of their own, the dying person’s, and the significant others’ beliefs and unresolved issues or conflicts including, but not limited to, feelings about death that may affect treatment decisions
Z. Medical and cognitive condition of the older adult, older person’s tendency to act disruptively, the emotional stability of the people caring for the older person, social isolation of the family, and the history of using violence to resolve conflict
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