This paper compares collaborative care for a patient with bipolar disorder versus a patient with Alzheimer’s disease. Bipolar disorder, with respect to the findings of Morrison (2012), is a mental disorder usually characterized by incidents of mania. It has various symptoms that include grandiosity, irritability, distractibility, and euphoria. Whenever there is a manic incident, patients (people suffering from bipolar disorder) gain remarkable energy, which causes them to talk, think and move rapidly. However, the same patients can also, experience moments of depression as well as periods of partial or full recovery. On the other hand, research has indicated that the most prevalent type of dementia is Alzheimer’s disease. Dementia is a general terminology for all sorts of conditions that influence an individual to experience decline.
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Although Alzheimer’s diseases was discovered more than a century ago, research regarding its causes, symptoms and treatment began happening only thirty years ago (Morrison,2012). Research; however, is still in progress to uncover the exact biological changes that lead to Alzheimer’s, its prevention and stoppage. Decline in cognitive abilities in patients suffering from bipolar disorder is a consequence of both psychological and social factors that relate to chronic diseases. However, it is significant to note that cognitive impairment outcomes in patients with bipolar disorder are still in uncertain due to development of Alzheimer’s disease syndrome in due course. This has raised a lot questions regarding the connection between Alzheimer’s and bipolar disorder.
As mentioned earlier, bipolar disorder is a brain (mental) disorder that influences an individual to experience abnormal changes in activity levels, energy, moods, and the capacity to perform daily duties. This condition has severe symptoms, which vary from the usual ups and downs that all people undergo all the time. In most cases, symptoms of bipolar disorder result into suicide cases, poor performance at school or job and even spoilt relationships. In regard to causes, scientific research is still in progress; however, with respect to the findings of Fast and Preston (2012), most scientists point out that bipolar disorder does not have a single cause claiming that various factors such as genes, brain structuring have to work together in order to initiate the condition. In regard to Alzheimer’s disease, it is worth noting that scientists have working to establish the exact cause of the condition, but the success has not yet been realized. Just like bipolar disorder several factors have to work together in order to initiate the condition. Despite the fact that bipolar disorder and Alzheimer’s disease are both diseases of the brain, a group of factors that influence their occurrence are different. Factors such as; past serious head injuries, family history, increasing age, and lifestyle factors are likely to lead to the occurrence of Alzheimer’s disease. On the other hand, bipolar disorder is caused by genetic factors and brain structuring.
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These two disorders, also, differ in the sense that both of them affect at different ages. Bipolar disorder begins developing in people who are in their early adulthood; in fact, with respect to the findings of Fast and Preston (2012), more than half of the cases are usually diagnosed before the age of twenty five years. In some extreme cases, some individuals portray initial symptoms in the course of their childhood as others develop them later as they grow. Alzheimer’s disease, on the other hand, commonly affects people who are beyond the age of 65 years. Besides, it is more prevalent in women than men. In regard to diagnosis, the similarity between these two conditions is that early diagnosis is essential because it can provide an opportunity for the affected and infected persons to develop proper plans for the future. Besides, it helps patients in both cases to access treatment, support and advice that can enable them to manage the problem. Guidelines from the Diagnostic and Statistical Manual of Mental Disorders (DSM) are significant resources that doctors rely upon while diagnosing bipolar disorder (Alzheimer’s Society, 2012). However, in order for diagnosis to occur, an individual should exhibit a significant change from his/her usual behavior or mood. In the case of Alzheimer’s disease, tests for the disorder are still under development process. The doctor, however, requires providing the patient with information regarding his/her medical history as well as the symptoms that have been observed. In terms of symptoms, different patients suffering from both disorders exhibit different symptoms. For instance; bipolar patients will show the following symptoms: disorientation, difficulty in performing usual duties, loss of judgment, personality changes, difficulty in communicating, and continuous forgetfulness. In the case of Alzheimer’s disease, the patient will exhibit the following symptoms: confusion with place and/or time, poor judgment, difficulty in completing usual tasks, memory loss, withdrawal from social activities, and challenges in solving problems and/or planning (Morrison, 2012). The two disorders, however, are similar in symptoms such as memory loss, poor judgment, and difficulty in completing usual tasks.
In managing bipolar disorder, the right treatment that includes therapy and medication is the most essential beginning point. Efforts are supposed to be made to ensure that such patients access the right advice that can help them maintain a healthy lifestyle. Some of the resources required for managing bipolar disorder include medications and mood stabilizers, and efforts include embracing a regular schedule of sleep, eating the right diet, and embracing healthy habits. In regard to medication, patients suffering from bipolar disorder should stick to the doctor’s prescription during medication. Such medication may include mood-stabilizers like lithium or carbamazepine (Fast & Preston, 2012). Also, taking time to exercise on a daily basis is a productive approach for managing the condition. Just like for bipolar disorder, exercise is a crucial reliever of stress in the case of Alzheimer’s disease. Both the patient and the caregiver require consulting with the physician in order to engage in simple exercises whenever it is safe for the patient. Also, drugs can be used as alternative treatments in form of supplements and vitamins for boosting memory. Examples of drugs for treating Alzheimer’s disease are rivastigmine, galantamine, donepezil, and memantine (Alzheimer’s Society, 2012). Caregivers managing patients in both conditions require creating a calm environment that can enable patients to relieve stress. The similarity in both cases is that the primary caregiver should be the patient’s close family member whose responsibility is to ensure that the patient receives the most appropriate care. The burden endured by a patient suffering from Alzheimer’s is greater that endured by a patient suffering from bipolar disorder. This is because severe cases of Alzheimer’s can lead to frequent hallucinations and sometimes permanent loss of memory.
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While taking care of a patient with bipolar disorder, family members may encounter a number of issues. The first issue is the change in personality of the patient. In most cases, such patients become abusive and violent to the extent that police and social workers become involved (Fast & Preston, 2012). In this case, the relationship between the patient and the family becomes strained. Family members also experience the feeling of despair especially when the patient does not indicate positive response to treatment. The second issue is self-harm by the patient. During episodic illness, a patient can use an object in the environment to inflict harm upon him/herself or other people. In the case of Alzheimer’s disease, two issues that can arise are sleep problems and aggression (Alzheimer’s Society, 2012). There are a lot of changes that people suffering from Alzheimer’s disease undergo with the main one being sleeplessness. In regard to aggression, the patients may at times lush out or become violent for no apparent reason. In such a case; however, it is the responsibility of the caregiver to know exactly what to do in order in order to prevent the outburst before it happens.
In caring for a patient with a mental disorder such as bipolar disorder and a medical disorder such as Alzheimer’s, there are various legal and ethical issues that a registered nurse requires considering. In the case of mental disorder (bipolar disorder), the fundamental legal issue is that the federal/state laws guarantees patients same civil rights just like any other citizens. Following due process with respect to civil commitment, involuntary commitment of psychiatric patients to any mental facility equals massive denial of freedom that needs due process protection. Therefore, for a registered nurse to ensure that there is process protection, he/she should apply for a writ of habeas corpus, which is a procedural tool that is essential for challenging any detention that is unlawful (Dossey, 2015). In a situation where a patient suffering from bipolar disorder is admitted in hospital, the RN should seek to establish if the admission is voluntary. In this case, the patient or the guardian will have the right to demand for release after the admission period. Involuntary admission should only be undertaken when the patient can no longer meet essential needs or poses danger to self and other people. With respect to ethical considerations, the RN requires observing confidentiality at all times, and should only disclose patient’s medical information to authorized people. In the event that there is no confidentiality, most patients will become afraid of seeking for the required mental medical attention from the facility. Besides, the RN should have respect for human dignity and life (Alzheimer’s Society, 2012). In this case the RN should desist from discrimination, harassment, or abuse.
With respect to caring for a patient suffering from Alzheimer’s, different legal tests, or standards are practiced in different states. As opposed to the case in bipolar disorder, the legal implication requires that the RN considers a patient in the early stages of Alzheimer’s as mentally competent individual. The RN is then supposed to involve the patient in a durable power of the attorney that permits a trusted person to make health care, legal and financial related decisions by signing legal documents on behalf of the patient (Dossey, 2015). Ethical implications for the RN to consider while dealing with a patient suffering Alzheimer’s are similar to those involved in bipolar disorder. During diagnosis; for instance, the RN should tell the truth depending on the situation, and should help the patient and family access essential resources like support group interventions and counseling. Besides, in both cases, the RN should ensure that the basic human right to essential resources such as food and water is guaranteed irrespective of religion, race, nativity, ethnicity, state of health, age, disability and any other considerable characteristic (Morrison, 2012). In advanced stages of inter-professional collaboration, both the family and the patient become included as significant team members.
It is significant to note that inter-professional team members can provide collaborative and continuous care in the acute care setting. In this case, specialists in different disciplines in healthcare work together in order to provide care to a patient in an acute care setting. Members of the inter-professional team have to divide their work depending on their areas of specialization. During collaboration, they share relevant information in order to support the work of one another. They also coordinate interventions and processes in order to provide various programs and services. In advanced stages of inter-professional collaboration, both the family and the patient become included as significant team members (Dossey, 2015). An appropriate example is where integrated health teams, community health teams, and family health teams work together to provide the necessary care to a patient with mental health complications such as Alzheimer’s disease.
The role of professional nurses within the team is to influence the manner in which care is delivered in an acute setting in order to minimize errors, enhance quality, and lead to improved patient outcomes. The first example is effective management of pain. The inability by the interprofessional team to manage pain influences the patient to experience an undesirable quality of life. Professional nurses play a great role by managing the pain that patients report. This is significant for improving patient outcome. The second example is coordinating patient care. The desire of any patient in an acute setting is that treatment should run successfully. Professional nurses play a great a role in ensuring that the patient receives the right care at the right time (Dossey, 2015). The third example is curbing and eliminating infections with acute care settings. Professional nurses play a significant role in ensuring that infections such as bloodstream infections do not occur.
In order to experience positive outcomes, patients require adhering to medication regimen and follow-up visits. The first example is simplifying the regimen whereby the provider makes deliberate efforts to adjust dosage, amount, frequency and timing. The provider should also ensure that the medication regimen matches the daily activities of the patient. The second example is imparting knowledge. In most cases, adherence is most likely to be enhanced whenever a patient appreciates the significance of treatment (Morrison, 2012). The third example is provision of trust through communication. The physician should communicate with the patient to ensure that he/she has a significant level of trust in the instructions in order to enhance adherence to medication regimen.
There are a number of measures that should be considered while evaluating the effectiveness of the interprofessional plan of care. The overarching objective is a significant measure that should encompass three perspectives, which are the patient, the family and the team (Dossey, 2015). Medical, environmental, social and emotional problems of the patient are also significant measures for evaluating effectiveness. The resources and strengths possessed by the patient comprise a significant measure to consider especially where their mobilization will be necessary for addressing the each problem. The RN can evaluate the interprofessional team efforts and identify necessary modifications by utilizing various tools such as zaption video assessment, knowledge test, E-walk, and implicit evaluation test (Morrison, 2012).
In conclusion, this paper compared collaborative care for a patient with bipolar disorder versus a patient with Alzheimer’s disease. Bipolar disorder is a brain (mental) disorder that influences an individual to experience abnormal changes in activity levels, energy, moods, and the capacity to perform daily duties. Despite the fact that bipolar disorder and Alzheimer’s disease are both diseases of the brain, a group of factors that influence their occurrence are slightly different. While taking care of a patient with bipolar disorder, family members may encounter a number of issues such as personality change. With respect to caring for a patient suffering from Alzheimer’s, different legal tests, or standards are practiced in different states. As opposed to the case in bipolar disorder, the legal implication requires that the RN considers a patient in the early stages of Alzheimer’s as mentally competent individual.