Contemporary Health Issues and Policies: Alzheimer’s Disease and Palliative Care

This paper discusses the Canadian Palliative Care Association (CHPCA) and its advocacy for end-of-life patients with Alzheimer’s disease (AD). It also highlights the extent and urgency of AD among elderly persons in Canada, its impacts on the elderly at the end-of-life, and recommendations for the government to support caregivers and families.

Running head: CONTEMPORARY HEALTH ISSUES AND POLICIES 1
Contemporary Health Issues and Policies
Student’s Name
Institutional Affiliation

CONTEMPORARY HEALTH ISSUES AND POLICIES 2
Background of the Organization
The selected organization in this paper is the Canadian Palliative Care Association
(CHPCA) that echoes the voice about palliative care in Canada, This association mainly focuses
on advocating and advancing for the eminence of end-of-life within the Canadian society. Its
main goal is to engage in public education, public policy, and increase awareness about palliative
care. This organization was founded in 1991 whereby it had a Board of Directors who were
volunteers and also, professionals of palliative care from the Canadian territories and provinces.
Palliative care focuses on relieving suffering as well as improving the quality of people who are
at the end-of-life (Slocum-Gori et al., 2013). In this case, Hospice palliative care mainly strives
to support the patients and families in many ways. For instance, Hospice palliative care seeks to
eliminate psychological, physical, spiritual, social, and practical problems faced by patients that
are connected to their needs, expectations, fear, and hope (Shadd et al., 2013). Additionally,
hospice palliative care also prepares and manages the dying process and self-determined closure
of life. Lastly, it helps families to cope with grief and loss during the patient’s illness and at
death. In simpler words, the organization was founded to treat the existing health problems,
prevent newer issues, and also, promote the chances for necessary or valuable experiences and
self-actualization.
Health Issue
The health issue selected is Alzheimer’s disease (AD) which is seen as a chronic
neurodegenerative illness that begins slowly and worsens with time. AD is recognized as the
main cause of 60%-70% dementia cases (Wong, Gilmour & Ramage-Morin, 2016). The most
significant symptom of AD is the inability to recall events. As the illness advances, symptoms
also include disorientation, language issues, loss of motivation, mood swings, behavioral

CONTEMPORARY HEALTH ISSUES AND POLICIES 3
problems, and the inability to manage self-care. An individual condition leads them towards
withdrawing from society and family. Eventually, the body functions might be lost and later, AD
leads to death. The speed of AD progression may change, but a typical life expectancy of a
patient with the illness is 3-9 years. Notably, the main cause of AD is not well understood.
However, it is perceived that 70% of AD’s risks are perceived to be inherited from the parents
whereby many genes are involved (Roberts et al., 2015). Other risk factors include hypertension,
depression, or head injuries. The illness is also connected to neurofibrillary tangles and plaques
that may develop in an individual’s brain. Potential diagnosis of the illness concerns the history
of the disease and a cognitive examination along with blood tests and medical imaging that help
in identifying the potential causes. However, the actual symptoms of AD may be mistaken with
ageing. Notably, the majority of individuals with AD more than 65 years but this does not
guarantee it as a disease caused by age. It is said that physical and mental exercise has a
likelihood of decreasing AD however, there lacks strong evidence to support the arguments. It is
important to understand that there lack medications that have been discovered to minimize the
risks for AD. However, some medications may help in improving the disease-illness temporarily.
Furthermore, the ill individuals require help from other people and precisely the caregivers are
burdened. Pressures experienced by can be economic, physical, psychological, physical, or social
(Tschirhart, Du & Kelley, 2014).
Population Group Advocated for
The population group advocated for AD is those at the end of life. It is important to
comprehend that death is a sudden thing and it occurs in different ways. However, for some
elderly persons, their bodies tend to weaken whereby their mind is also impacted. Other elderly
people maintain a strong physical outlook but with time they are affected by cognitive losses

CONTEMPORARY HEALTH ISSUES AND POLICIES 4
(Livingston et al., 2017). Therefore, the end-of-life care targets the elderly people who are
provided with help in palliative care. Such kind of care is not offered when elderly people begin
experiencing breathing problems or when their heartbeat stop. It is important to realize that
elderly people require medical care for so many days or even months before they encounter
death (Hahn et al., 2013). In this case, CHPCA is the selected organization that is selected to
advocate for AD among the individuals at the end-of-life. Precisely, the palliative care will be
directed towards treating some signs and symptoms of AD such as difficulty in sleeping, anxiety,
and depression among the elderly people (Quill & Abernethy, 2013). As the illness continues,
the palliative care offers guidance to the family as they plan for the aged person to receive care
either in a nursing home, living facility or at home.
Evidence for the Extent and Urgency of the Issue
Notably, there is evidence that demonstrates the extent and urgency of AD among elderly
persons, particularly in Canada. To start with, the prevalence of AD in Canada is 7.1%. Most
evidently, about two-thirds of elderly persons living in Canada suffer from AD and they should
be provided with palliative care (Manuel et al., 2016). Yearly, there are about 76, 000 new cases
for patients with AD that are diagnosed in Canada. This approximation presents an incidence of
14.3 new case per1, 000 among elderly population above 65 years. The extent and urgency of
AD can also be illustrated using various stages of AD. To begin with, mild AD shows that
individuals experience memory loss. Further, they experience other issues such as trouble in
handling money, getting lost, delaying in completing usual house tasks, as well as behavioral and
personality changes. On the other hand, moderate AD damages the brain, sensory processing,
conscious thoughts, and sensory processing. At this point, individuals may not be in a position to
learn or execute multiple tasks. The elderly people also experience delusions, hallucinations, and

CONTEMPORARY HEALTH ISSUES AND POLICIES 5
paranoia that cause them to behave in an impulsive way (Goodman et al., 2013). Lastly, the
tangles and plaques spread in the brain and as a result, people cannot communicate effectively.
At the end-of-life, the elderly people stay in bed as the body tends to shut down. Therefore,
CHPCA should advocate for palliative care for elderly people who are at the end of life to
prolong their life span. Immediate actions need to be undertaken to overcome and minimize the
prevalence of the illness in Canada and worldwide.
Impacts of the Health Issue on the Elderly at the End-Of-Life
AD is perceived as a continuous degenerative disorder that causes dementia. In this case,
AD indicates a higher prevalence among elderly people and therefore, it has significant impacts
on this population. In most cases, AD increases with age. Notably, the prevalence of individuals
between 65-74 years is 3%, while for those above 84 years it is 47.2% (Jacklin, Walker &
Shawande, 2013). The main impacts of AD on elderly people are that it causes memory loss
along with personality disintegration and also, physical control that calls for palliative care in
end-of-life. Moreover, elderly people experience the problem of brain shrinking in size. The
brain shrinkage can only be detected using computerized tomography. Despite the fact that the
brain of elderly people shrinks, they also function appropriately. Despite the health impacts of
AD, it also has social impacts among the elderly population as it is associated with distress that
impacts the patient and the caregiver. On the other hand, AD causes economic impacts as it
increases the costs of health care progressively that also influence the quality of individual life at
a late stage.
Aims and Objectives of the Policy for Advocacy
CHPCA needs to consider various aims and objectives of the policy to advocate for AD
for elderly individuals at the end-of-life. To begin with, the main aim of advocating for AD is to

CONTEMPORARY HEALTH ISSUES AND POLICIES 6
ensure that the general public realizes the signs and symptoms of AD to take earlier interventions
to overcome it. Therefore, CHPCA needs to engage in aggressive efforts to ensure that the
condition is addressed without delay. The most significant objective of the policy is to advance
earlier detection, awareness, and discovery of the illness. Notably, most people who live with
AD should be covered by funding and the improvements made by CHPCA programs. CHPCA
needs to strive to ensure that incentives are established for clinicians requiring them to discover
AD at early stages. Moreover, the aims and objectives must also be connected with health
professionals as they play a significant role into ensuring that they educate the patients in
palliative care about the risks for AD (Robert et al., 2014). Additionally, CHPCA needs to take
significant steps towards closing the prevailing gaps to ensure there is a progressive diagnosis of
AD and also, that the health professionals must be educated to get ready to contain the illness.
Other goals and objectives to the policy are to ensure that also there is awareness of AD in the
nonclinical settings as palliative care is also offered to the elderly people at home. In this case, it
is evident that AD lacks effective treatments and therefore patients diagnosed with the illness
should be put through care planning to minimize stress and confusion that may arise among
friends and family. Lastly, the policy should also address the stigma among patients with AD and
also, their families.
Recommendations or Actions for Government
The government should support in providing the medications to maintain the individual
mental functions for patients with AD. Some of the medications include galantamine,
rivastigmine, and Donepezil that help in overcoming mild AD while donepezil can also contain
severe AD. Moreover, Memantine also minimizes the prevalence of severe AD. In this case, the
government should support the campaigns to overcome AD by ensuring that all facilities

CONTEMPORARY HEALTH ISSUES AND POLICIES 7
especially those that provide palliative care have adequate medications to serve the population
suffering from AD (Bartfay & Bartfay, 2013). Notably, the medications do not cure AD
completely as they just minimize the symptoms and some behavioral issues. Therefore, the
government has a huge role to play to ensure that newer innovations to cure AD are discovered.
In this case, the government needs to engage in the process of looking for newer treatments by
liaising with scientists in the ongoing clinical tests, drug therapies, and cognitive training.
A second recommendation is that the government has a huge role to play in supporting
caregivers and families. This means that the government should offer financial support and also,
the emotional and physical costs for individuals with AD (Geldmacher & Kerwin, 2013). The
families are faced with high demands of costs and also, making important decisions about the
kind of care that needs to be provided to the patients. Therefore, the government needs to
develop evidence-based programs and approaches that can support the families and caregivers to
contain the illness while the researchers proceed to look for newer interventions.
The third recommendation is the government should ensure that the health professionals
are adequately equipped with knowledge about AD. For instance, health professionals need to be
well informed about the illness. Moreover, programs may be designed to teach patients about
various stages of AD for them to stay alert (Feldman et al., 2013). Therefore, health
professionals should be in a position to offer good coping skills to patients.
Conclusions
To summarize, the health policy plays a significant role in determining the way to
incorporate the health concerns for elderly people at their end-of-life especially those with AD.
In this case, CHPCA has a significant role to advocate for end-of-life patients with AD to contain
the problem. Notably, health services can act as preventive measures for AD even though there is

CONTEMPORARY HEALTH ISSUES AND POLICIES 8
no cure that has been discovered. For this reason, the government has a big role to play in
advocating for AD as scientists continue to look for a possible cure of the disease. Among the
recommendations, the government should ensure that the health professionals are educated and
well equipped with adequate knowledge about AD. Additionally, the government also has an
obligation to ensure that the health facilities have adequate medications to contain the prevalence
of AD for patients in palliative care.

CONTEMPORARY HEALTH ISSUES AND POLICIES 9
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