INTRODUCTION TOALZHEIMER'S DISEASE PAPERS
Alzheimer's disease is the most common cause of irreversible dementia. Currently, Alzheimer'sdisease effects about two million Americans causing them and their families extensive anguish andsuffering. Caring for the Alzheimer patient has been described by Mace and Robins as a "Thirty-six hour day." In the course of the disease, the patient is initially cared for at home, may requirehome health care and eventually requires institutionalization. This issue is presented as a seriesof papers entitled "Caring for the person with Alzheimer's disease." The purpose of these papersis to provide information on the care and management of the Alzheimer's patient with specificdetail to dental treatment. By understanding the complexities of Alzheimer's disease, the dentalprofessional will be more knowledgeable and more comfortable in caring for these patients.
The first two papers provide an overview of the medical and social concerns occurring in thecare of patients with Alzheimer's disease. Dr. Seltzer's paper focuses on the medical aspects of thedisease. He addresses the diagnosis, etiology and medical management of the patient with seniledementia of the Alzheimer's type (SDAT). Ms. Fabiszewski's paper discusses the various types ofcare received by patients with SDAT. A model of the continuum of care from home to long termcare facility is described.
Dr. Somerman's paper discusses the dental implications of the medical management. Dr. Somer-man pays particular attention to the pharmacology of the medications prescribed by physiciansfor individuals with dementia, and the impact it exerts on dental treatment of these patients.
Drs. Niessen and Jones address oral health care issues for Alzheimer's patients as provided bydental professionals. Specifically, they propose a dental treatment guide and discuss clinical challengesthese patients may present. These two papers by Drs. Somerman, Niessen and Jones provide anoverview of the specific concerns in the provision of professional dental care to patients withAlzheimer's disease.
Dr. Terrie Wetle, in the last of the series, discusses the ethical dilemmas encountered in geriatricdentistry. Dr. Wetle presents a taxonomy of ethical issues occurring in geriatric medicine and den-tistry, with specific examples of some ethical issues arising in the provision of dental care to theperson with Alzheimer's disease.
With increased education about Alzheimer's disease, dental professionals can more adequatelydiagnose, prevent and treat the oral diseases of these individuals. Oral health function does nothave to decline simultaneously with cognitive function. Preservation of oral health may also preservethe person's dignity and subsequently improve the quality of life for those with this tragic disease.
M.J. SomermanL.C. Niessen