“STANDING IN THE GAP”. An education and outreach program on memory loss, dementia and Alzheimer’s disease for African Americans. “STANDING IN THE GAP”. Standing in the Gap is a reference to each individual’s moral responsibility to be of service to others in need.
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An education and outreach program on memory loss, dementia and
Alzheimer’s disease for African Americans
Standing in the Gap is a reference to each individual’s moral responsibility to be of service to others in need.
The term “African American” refers to people having origins in any of the Black race groups of Africa, as well as people of African descent from Caribbean Islands and parts of South America.
Each of these groups has distinct cultural and social identities.
Many African Americans perceive their success on the individual, familial and cultural levels in terms of enduring a lifetime of oppressive and discriminatory actions. In spite of these actions, African American elders passed on values, beliefs and wisdom to their families.
Lives can be seen as successful, but it is believed that the price of enduring such pressure is experiencing mental and/or physical health problems.
Combination of worry and stress thought by many to cause damage to the brain. It is believed that one can actually overuse one’s mind to the detriment of the brain. That is, “thinking too much” or “too much head work.”
Presents as a loss of consciousness and a physical collapse.
Is a condition in which the blood is not flowing normally through the body.
It is thicker or sweeter and therefore, believed to be stagnating in the higher area (head, chest) of the body.
When the pressure of “too much blood” occurs you develop memory problems.
Dementia is an umbrella term that refers to a general loss of abilities involving memory and judgment, language and abstract thinking as well as changes in personality.
Causes a steady decline in the ability to:
Alzheimer’s disease is more prevalent among African Americans than among whites – with estimates ranging from 14 – 100 percent higher.
A person with a history of either high blood pressure or high cholesterol is twice as likely to develop Alzheimer’s disease.
High blood pressure and high cholesterol occur more frequently in African Americans.
African Americans have a 60 percent higher risk of type 2 diabetes – a condition that contributes to vascular disease.
African Americans have a higher rate of vascular dementia than whiteAmericans.
Can still take care of their personal needs and may still be in the workforce
Has trouble with finding names for common items
Loses things more often
May begin to ask the same question over and over
Gets lost easily in places well known
Personality changes may occur
Loses interest in things once enjoyed
Displays anxiety or depression
Experiences difficulty with simple activities
May hallucinate or become paranoid
Requires close supervision
Becomes more confused about recent events
Argues more than usual
No longer able to communicate
Unable to recognize themselves when they look into the mirror
Can not care for themselves
Unable to recognize family members
May be bed-bound and become totally debilitated
Memory and thinking tests
Patient history should include the following:
Medical History –
Physicians should ask about relevant diseases: mental disorders, history of head trauma, review information about infections or illnesses such as pneumonia, diabetes, urinary tract infections or chronic renal failure.
Medical History -
The review of all medications is a critical component of the assessment because drug toxicity is the most common cause of dementia-like symptoms that can be resolved.
A wide range of drugs have been associated with cognitive changes. Patients should bring all medications to the appointment including, over the counter pills.
Focused History –
It must identify signs and symptoms such as difficulty learning and retaining new information, handling complex tasks, reasoning ability, spatial ability and orientation, language and exhibits behavior problems.
Family History –
Physician should inquire about a family history of Alzheimer’s disease especially early onset or other rare genetic conditions that might lead to dementia.
Social and Cultural History
Social and Cultural History –
Include information about recent life events and social support networks, literacy, socioeconomic, ethnic and cultural background. These factors may affect performance on mental status examinations.
Physical Examination –
Standard medical principles should be used to guide a physical examination as a part of the assessment process.
Mental Status Examination -
Used to develop a picture along with functional performance; provides baseline data for monitoring over time; and can document multiple cognitive impairments.
Mental Status Examination -
Factors such as age, primary language, educational level and cultural influences should be taken into consideration in the interpretation of mental status scores.
Laboratory Tests –
Complete Blood Count (CBC),
electrolyte panel, screening for metabolic panel,
thyroid gland function, B-12 and folate levels,
tests for syphilis and depending on history for HIV antibodies, urinalysis, ECG, chest X-ray, CT and an EEG.
African Americans tend to be diagnosed at a later stage of Alzheimer’s disease – limiting the effectiveness of treatments that depend upon early action.
Early diagnosis may help the person with dementia:
Currently, there is no cure for the disease, but there are 5 drugs on the market that may help reduce some of the symptoms associated with the disease. They are:
African Americans are seriously underrepresented in current clinical trials of potential treatments for Alzheimer’s disease.
This has occurred even though evidence of genetic differences and response to drugs varies significantly by race and ethnicity.
The person with dementia is not:
“There is no time like the present”
“What you don’t know can hurt you”
“This is the first day of the rest of your life”
“It is always darkest before the dawn”
The Alzheimer’s Association is the largest national voluntary organization dedicated to conquering Alzheimer’s disease through research and to providing information and support to people with Alzheimer’s disease, their families and caregivers.
Information and Referral
Alzheimer’s Association Safe Return™
Information and Referral services provide information about Alzheimer’s disease, services provided by the chapter and community resources. Service delivery may include Helplines, the Contact Center, information packets, Web sites or resource libraries.
Assists the person with the disease and/or their families by providing information and making appropriate referrals, supportive listening, assessment of needs, developing an action plan or problem solving. This can be done by telephone, e-mail or in person.
Provide individuals with knowledge and skills necessary to enhance the quality of care for a person with dementia. May be carried out through caregiver conferences, community programs, in-service trainings for professionals, newsletters or using videos.
Learning that you are not in this alone can be beneficial. Supports groups are regularly scheduled in-person or virtual gatherings of persons with Alzheimer’s disease, family, friends or caregivers who interact around issues relating to Alzheimer’s disease. Groups have social, educational and/or support components and are lead by a trained individual.
Is an identification program that assists in the safe and timely return of individuals with Alzheimer’s disease who wander or become lost.
Safe Return provides family support, wandering awareness and ongoing education and training opportunities to emergency personnel as well as to the lay community.