Han’s is a 66 year old retired government worker that has been dealing with issues related to his memory. Han’s retired at the age of 60 because he could no longer perform his duties at work properly. The problems with his work performance had been an issue for five years before his retirement. At the age of 62, he could not remember the way home while leading a hike in an area he was familiar with and knew well. Over time his memory problems have become more noticeable and he even has failed to recognize good friends.
He has become more and more quiet, given up his hobbies and lost interest in the newspaper and television. His wife is not comfortable leaving him alone because of his memory issues (Butcher, Mineka, & Hooley, 2010). Confirm Diagnosis Dementia of the Alzheimer Type is a diagnosis of exclusion, other causes for the cognitive deficits must be ruled out first (American Psychiatric Association, 2000). This diagnosis is normally given after all other potential causes are ruled out by medical and family history, along with a physical examination including laboratory test in some cases (Butcher, Mineka, & Hooley).
Han’s has no sign of a medical condition that would be a factor in his memory failure. Han’s symptoms do not fit diagnostic criteria (C) for vascular dementia or other dementias due to other general medical conditions (APA). After the other possible diagnoses are ruled out then I must insure that Han meets the criteria for dementia of the Alzheimer type. Hans’ memory failures meet the criteria for A1. His inability to find his way home in an area that he has lived for 40 years meets the criteria for 2(d).
The next criteria for this diagnoses requires that the cognitive deficits in A1 and A2 cause significant impairment in social or occupational functioning and represents a significant decline for a previous level functioning (APA, 2000). The fact that his memory failure required him to retire early shows a significant impairment in occupational functioning. Han not recognizing his close friends and giving up hobbies shows a significant impairment in social function. There are standardized published rating scales that can be used to measure the severity of impairment (APA, 2000).
Criteria D requires cognitive deficits in A1 and A2 are not caused by other central nervous system conditions (1), systemic conditions that are known to cause dementia (2) or substance induced conditions (3). The information that I have would lead me to believe that this clients condition is not related one, two or three of criteria D. Criteria E requires that the deficits do not occur exclusively during the course of delirium, which they do not (APA). Criteria F requires the disturbance not to better accounted for by another disorder (APA).
This is an area that I felt another disorder might need to be considered. The fact that Han has begun to speak less and less, given up his hobbies, has not interest in the newspaper or televisions could be cause to diagnosis him with Major Depressive Disorder due to Alzheimer’s with depressive features, 293. 83 (APA). This could be listed along with 294. 10 Dementia of the Alzheimer’s type with early onset. The early onset needs to be the specify subtype because is memory failure began before the age of 65.
Counseling There is no treatment or cure for Alzheimer’s disease that will reverse the loss that this disease causes. The treatment that is used is to work the clients and their families to diminish agitiation and aggression in the patients. Also to help the family deal with the stress of caring for a family member who is suffering from this disease. As a counselor I would help this client reduce frustration and embarrassment that they might feel because of this disease.
In this type of situation I would see my professional services helping the family of the client. Taking care of a loved one that is suffering from Alzheimer’s can be stressful and demanding. Helping caregives learn how to distress and cope the stress will benefit them along with the person they was caring for.
References American Psychiatric Association. (2000). DSM-IV-TR. Arlington, VA: Author. Butcher, J. N. , Mineka, S. , & Hooley, J. M. (2010). Abnormal psychology (14th ed. ). Boston, MA: Allyn & Bacon.