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An Exploratory Study of Intellectual Disability Staff Nurse’s Experiences of Caring for People with Down Syndrome in the early stage of Alzheimer's Disease.

An Exploratory Study of Intellectual Disability Staff Nurse’s Experiences of Caring for People with Down Syndrome in the early stage of Alzheimer's Disease.

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An essay for the 2011 Undergraduate Awards (Ireland) Competition by michelle beaumont. Originally submitted for LM155 at University of Limerick, with lecturer eileen carey in the category of Nursing
An essay for the 2011 Undergraduate Awards (Ireland) Competition by michelle beaumont. Originally submitted for LM155 at University of Limerick, with lecturer eileen carey in the category of Nursing

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Published by: Undergraduate Awards on Aug 31, 2012
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05/13/2014

 
An Exploratory Study of Intellectual Disability Staff Nurse’sExperiences of Caring for People with Down Syndrome in theearly stage of Alzheimer's Disease
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1.0 Introduction
A significant proportion of people with Down Syndrome will develop Alzheimer'sDisease. However due to their impaired cognitive abilities and a lack of knowledge abouthow Alzheimer's Disease presents itself in people with Down Syndrome the conditionmay go undetected or misdiagnosed (Taggart and Slevin 2006; Holland 1998). Peoplewith Down Syndrome have a short time period between diagnosis of Alzheimer's Diseaseand death (Deb et al 2007). This may be as a result of diagnostic overshadowing or theinability to recognise the early signs of Alzheimer's Disease. To learn more about howAlzheimer's Disease develops in people with Down Syndrome the experiences of staff nurses caring for them need to be utilised. This literature review will define Downsyndrome, Alzheimer’s Disease and the correlation between the two. The assessmentmethods for Alzheimer's Disease will be discussed along with the many challengesassociated with assessing people with Down Syndrome. Finally the research that has beencarried out with regards to staff awareness will be presented. This will include how theservice user developing Alzheimer's Disease impacts on staff highlighting the importanceof being fully knowledgeable about the condition. This in turn emphasises how accessingstaff knowledge will improve the care for people with Down Syndrome and Alzheimer'sDisease.
1.1 Down Syndrome and Alzheimer's Disease
Dr. Langdon Down first described Down Syndrome in 1866, with Professor Lejeuneestablishing its chromosomal basis in 1959 (Watson 2002). People with Down Syndromehave 47 chromosomes, the extra chromosome residing with autosome 21 (Watson 2002)(Appendix 1). The link between Down Syndrome and Alzheimer’s Disease was firstrecorded by Jervis in 1948 (Prasher 2005), indicating that Alzheimer’s disease is more prevalent in people with Down Syndrome (Deb et al 2007; Ball et al 2004; Holland et al2000). Prasher (1995 cited by McCarron et al 2002b) identified the UK’s statistics for the prevalence of Alzheimer’s Disease in Down Syndrome compared to the general population as: 36% in people with Down Syndrome aged 50-59 years and 54% in peoplewith Down Syndrome aged 60-69 years as opposed to between 4.3% and 8.3% in thegeneral population 65 years and over. However, it has been acknowledged that these
 
 prevalence incidences may be hugely underestimated as older cohort representatives weredifficult to obtain (Nieuwhuis-Mark 2009). These dramatic statistics highlight the needfor knowledge about this condition. The Intellectual Disability nurses care for peoplewith Down Syndrome as they develop Alzheimer's Disease and are the means to gainingmore knowledge.Alzheimer’s Disease is a neurodegenerative condition accounting for 70% of all dementiacases (Ouldred and Bryant 2008). There is a build-up of abnormal proteins between thenerve cells and a reduction in the number of neurotransmitters (Ouldred and Bryant2008). It results in the cells of the brain being slowly destroyed. A sufferer of Alzheimer’s disease will eventually become completely dependent (McCarron 2004).The assumption is that the amyloid protein, associated with genetic susceptibility is alliedto chromosome 21. Therefore, the extra copy of chromosome 21 which people withDown Syndrome have, may increase their risk of developing Alzheimer's Disease(Ouldred and Bryant 2008). Plaques and tangles typical of Alzheimer’s Disease have beknown to develop by the time the person with Down Syndrome reaches their 20’s. Theywill generally develop Alzheimer’s Disease 20-30 years earlier than the general population, with approximately 10% showing signs of Alzheimer’s Disease in their 40’s(Jacobsen Bosch 2003).

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