Recently Aruba Alzheimer Foundation gave a presentation regarding topics of importance for the group in our community who needs more attention and support, our older persons. Together with Drs. Melva Croes Yanez, who aside from her work at the foundation is a neuropsychologist, we want to help bring awareness to the community regarding what our older persons are experiencing and what we can do to help, ensuring them the quality of life they deserve.
In order to create awareness and education, it is important to understand certain aspects and put the focus on these. This is not only important for Alzheimer’s patients but for any aspect relating to health.
Diagnosis: what is it?
This is the process carried out by an authorized and competent professional with the goal of determining the origin and nature of a condition/illness, through an extensive evaluation of the signs, symptoms and tests (laboratory and clinical, for example, MRI, physiological, neuropsychological, etc.)
For this process to be reliable, we must always take into consideration and adapt based on cultural differences in emotional and physical expressions of the client or patient. This means that it is not enough to just bring a translator to ensure good communication at the doctor’s office!
This is mentioned because it is customary for a family member of the client, or the doctor’s secretary, to assume the role of translator or interpreter during the medical intake interview with the client or patient. This interpreter, who is not an adequate professional, has a tendency to make mistakes in the translation which can potentially be dangerous for the diagnosis, and in turn the life, treatment and guidance that the patient will receive after diagnosis, for example because of misunderstandings.
When all the necessary tests have been completed, the professional or doctor will analyze the results in order to determine the possible cause of the symptoms that were observed. This results in a diagnosis.
The professional gives the diagnosis to the client or patient.
The medical professional has an obligation to explain the result in an honest way that the client or patient as well as their representative can understand; and to give this diagnosis to the patient in writing. This is to fulfill the civic rights of the patient or client.
It is extremely important to understand this part, according to Croes Yanez.
With this knowledge, when we are receiving a service from a medical professional we can be sure that this fulfills our rights, and that they are fulfilling their tasks and obligations correctly.
It is important that we always make sure that we are receiving a reliable diagnosis that complies with this process.
Importance of a reliable process and diagnosis
The importance of a reliable process and diagnosis for the client or patient is for example to bring clarity for the patient who has uncertainty regarding their condition; can guarantee adequate treatment; can reduce or possibly prevent complications and/or progression of the condition.
A correct diagnosis according to protocol can prevent damage caused by an unnecessary diagnosis and/or incorrect treatment.
Aside from eliminating uncertainty with the client, their family and representatives, the diagnosis can also open the door for the opportunity to come into contact with other people with the same condition in order to receive support, better self-management of the condition and prognosis on how to deal with the condition, and can also contribute to a better quality of life after diagnosis.
It can happen that a diagnosis is not correct. This can have different reasons. For example, the diagnosis was not made according to protocol, the information that was provided was not correctly interpreted, the material used lacks credibility and did not take the cultural norms of the client into consideration, or it was interpreted according to the cultural framework of reference of the professional, etc.
Neurocognitive disorder instead of dementia
DSM-5 was introduced in 2013. In general, DSM stands for Diagnostic Statistical Manual and its roots go back to the 19th century. This 5th manual, same as those before it, is directed among others to scientists and advisors who determine the standard and protocols of classification of mental disorders and illnesses. All those working on the field of diagnosis of mental disorders and illnesses need to have knowledge of DSM-5 in order to provide the most reliable diagnosis possible.
Since 2013, the terminology ‘neurocognitive disorder’ is used replacing the term ‘dementia’, which is considered a rude word. In fact, this term does not fit with the description of the symptoms observed in the patient. Until now, there are still professionals refusing to use the new introduced term of ‘neurocognitive disorders’ and choose to continue using the word dementia – which means, ‘without mind’. Use of this term can have consequences on the diagnosis, because if the diagnosis itself speaks of a person without a mind, it can be expected that those who receive this diagnosis will begin acting according to this expression.
This can have as a consequence that the client or patient will not be given the usual respect and care, and might even be stigmatized because of the diagnosis. This without a doubt will lead to stigmatization, discrimination, depersonification and even abuse or negligence of those suffering one of these progressive conditions after diagnosis.
FAA continues fighting for the dignity of all those suffering from neurocognitive disorders, so they can be sure that for FAA, every human being is someone has a mind.