医学英语 老年痴呆.doc

Unit 2Human Growth and DevelopmentHuman growth and development is a process that begins at birth and doesnt end until death. During all stages of growth and development, individuals have different needs that must be met. And as aging occurs, certain physical, psychological, and even social changes also occur in all individuals. Some individuals can learn to adapt to and cope with the changes, but others experiences extreme frustration and mental distress. It is important for the health care workers to be aware of the various life stages in order to provide quality health care. Text A Confusion and Disorientation in the ElderlyAlthough most elderly individuals remain mentally alert until death, some experience of confusion and disorientation. Signs of confusion or disorientation include talking incoherently, not knowing their own names, not recognizing others, wandering aimlessly, lacking awareness of time or place, displaying hostile and combative behavior, hallucinating, regressing in behavior, pay less intention to personal hygiene, and being unable to respond to simple commands or follow instructions.Confusion and disorientation is sometimes a temporary condition. Stress and/or depression due to physical and psychological changes is one possible cause. Use of alcohol or chemicals is another. Kidney disease, which interferes with1 electrolyte balance; respiratory disease, which decreases oxygen; or liver disease, which interferes with metabolism, are other causes. Elderly individuals are also more sensitive to medications, and drugs can sometimes accumulate in the body and cause confusion and disorientation. Even poor nutrition or lack of fluid intake can interfere with mental ability. Frequently, identification and treatment of any of these conditions decreases and even eliminates the confusion and disorientation. Foe example, changing a medication or giving it in smaller does may restore normal function.Disease and/or damage to the brain can sometimes result in chronic confusion or disorientation. A cerebrovascular accident, or stroke, which damages brain cells, is one possible cause. A blood clot can obstruct blood flow to the brain, or a vessel can rupture and cause hemorrhaging in the brain. Arteriosclerosis, a condition in which the walls of blood vessels become thick and lose their elasticity, is common in the elderly individuals. If the vessels become narrow due to deposits of fat and minerals, such as calcium, the condition is called atherosclerosis. These conditions can cause transient ischemic attacks (TIAs), or ministrokes, which result in temporary periods of diminished blood flow to the brain. Each time an attack occurs, more damage to brain cells results.Dementia, also called brain syndrome, is a loss of mental ability characterized by a decrease in intellectual ability, loss of memory, impaired judgment, personality change, and disorientation. When the symptoms are caused by high fever, kidney infection, dehydration, hypoxia (lack of oxygen), drug toxicity, or other treatable conditions, the condition is called acute. When the symptoms are caused permanent, irreversible damage to brain cells, the condition is called chronic. Cerebral vascular accidents, arteriosclerosis, and TIAs can be contributing causes to chronic dementia. One modern theory suggests that chronic dementia is caused by either a complete lack or an inadequate amount of an enzyme. Whatever the cause, chronic dementia is usually regarded as a progressive, irreversible disease.Alzheimers disease2 is a form of dementia that causes progressive changes in brain cells. It can occur in individuals as young as 40 years of age, but frequently occurs in those in their sixties. The cause is unknown, but there are many theories currently being researched. A genetic defect, a missing enzyme, toxic effects of aluminum, a virus, and the faulty metabolism of glucose have all been implicated as possible causes. Whatever the causes, Alzheimers disease is viewed as a terminal, incurable brain disease usually lasting from 3 to 10 years. In the early stages, the individual exhibits memory loss, mood and personality changes, depression, poor judgment, confusion regarding time and place, and an ability to plan and follow through with many activities of daily living. As the disease progresses, nighttime restlessness occurs, mood swings becomes frequent, personal hygiene is ignored, weight fluctuates, paranoia and hallucinations increase, and full-time supervision becomes necessary. In the terminal stage, the individual experiences total disorientation regarding person, time and place; becomes incoherent and is unable to communicate with words; loses control of bladder and bowel functions; develops seizures; loses weight despite eating a balanced diet; becomes totally dependent; and finally, lapses into a coma and dies. Death is often caused by pneumonia, infections, and kidney failure. Progress through the various stages of this disease varies among individuals.Whatever the cause of confusion or disorientation, certain courses of care should be followed. A primary concern is to provide a safe and secure environment. Dangerous objects such as drugs, poisons, scissors, knives, and cleaning solutions should be kept out of reach and in a locked area. If the individual tends to wander, doors and windows should be secure. Following the same routine is also important. Meals, baths, dressing, walks, and bedtime each occur at approximately the same time each day. Any change in routine can cause stress and confusion. Even though the individual should be encouraged to be as active as possible, activities should be kept simple and last for short periods of time. A calm, quiet environment is also important. Loud noises, crowded rooms, and excessive commotion can cause the individual to become agitated and more disoriented.Reality orientation (OR) consists of activities that help promote awareness of person, time and place. The activities should be followed by anyone caring for the confused individual, whether the care is in the home or in a long-term care facility. Some aspects of reality orientation are the following:1. Address the person by the name they prefer, for example, “Mr. Smith” or “Mike.”2. Avoid terms such as “sweetie,” “baby,” and “honey.” 3. State your name and correct the person if he or she calls you a wrong name. For example, if a patient thinks you are his or her daughter, say “I am not your daughter Lisa. Im Mrs. Simmers, your nurse for today.”4. Make constant references to day, time, and place. “It is 8:00 Tuesday morning and time for breakfast.”5. Use clocks, calendars, and information boards to point out time, day, and activities.6. Keep the individual oriented to day-night circles. During the day, encourage the person to wear regular clothes. Also, open the curtains and point out the sunshine. At night, close the curtains, use the night light if necessary, and promote quiet and rest.7. Speak slowly and clearly and ask clear and simple questions.8. Never rush or hurry the individual.9. Repeat instructions patiently. Allow time for the individual to respond.10. Encourage conversations about familiar things or current events.11. Encourage the use of a television or a radio, but avoid over stimulating the individual. 12. Keep familiar objects and pictures within view. Avoid moving the persons furniture or belongings.13. Dont agree with incorrect statements. Gently provide correct information. For example, when a person states it is time to dress for work, say, “You dont have to go to work today. You retired 7 years ago.”14. Dont hesitant to use touch to communicate with the person.15. Encourage independence and self help whenever possible.Caring for a confused or disoriented individual can be frustrating and even frightening at times. Continual assessment of the individuals abilities and problems is needed to design a health care program that will allow the individual to function within the level of his or her ability. Patience, consistency, and sincere caring are essential on the part of the health care provider. n.坐立不安；不安定instability, imbalanceNotes：1. Text A and Text B are adapted from Diversified Health Occupations Essentials 4th edition by Louise Simmers.2. interferes with：干扰，干涉；妨碍They say it interferes with activities outside schools including summer employment.并且他们说这还会干扰校外活动，包括夏季雇佣。3. Alzheimers disease 阿兹海默症；老年痴呆症First described in 1906 by the German physician Dr.Alois Alzheimer, is a disease that progressively destroys brain cells, affecting memory, language behavior and ultimately, character. In the United States about 10% of the population over 65 suffers from Alzheimers disease and up to 45% of those over 85 may have the disease. Alzheimers patient may live seven to ten years with the disease.The symptoms of the disease can be having problems learning new information and remembering to perform routine tasks, such as locking the door or turning off the gas; having problems finding the right words to express oneself; and having difficulties finding ones way.Up to now many things about this disease still remain a mystery. But research continues to bring us a better understanding of the disease, more accurate diagnoses and more effective treatments.Exercises: Word-buildingMedical Terminology is a special vocabulary used by health care professionals for effective and accurate communication. Study the Prefixes and Suffixes Related to the Systems and Organs of the Body in the following box.Prefixes and Suffixes for the Systems and Organs of the Body名称通用名前 (后) 缀示例血blood hemo-/hemato- hemorrhage / hematology血管vessel vaso-vasoactive / vasography静脉 vein veno-venography / venous动脉artery arterio-arteriography / arteriosclerosis神经 nerveneur-/neuro-neural / neuralgia髓 marrow myel-/myelo-myeloid / myelitis神经 nerveneur-/neuro-neural / neuralgia细胞 cell cyto-/cyte-cytology/cytobiology尿 urine uro-/ur-urology/urosurgery体 body somato-/-somesomatology / somatopsychic肌muscle Myo-mycology / myositis1.The project is a partnership between Bayer Schering and the Chinese Society of Hematology. 2.To investigate roles of vasoactive substances in cerebral vascular diseases. 3. In any case, they note that a venous ultrasound or magnetic resonance venography is optional. 4. Arteriosclerosis affects an increasingly broad segment of the older population. 5. The doctor diagnosed my illness as neuralgia.6. Methods Apply conventional and enhanced MRI scan to 10 patients clinically diagnosed with acute myelitis. 7. Diagnosis is made through cytology of the mass. 8. This article commented the advancement of tissue engineering technology in urology. 9. Normal Somatology includes NormalAnatomy,Histology&Embriology, Physiology, Biochemistry. 10. Heart myositis and lobar anxiety patient are sensitive to strong heart glucoside, should notice dosage. Study carefully all the new words and phrases in the box. Fill in the gaps with words or phrases chosen from the box. Change the form where necessary.alert regress obstruct disorientation impaired acute. implicate incoherent fluctuate rupture hallucinate diminish lapse elasticity eliminate intake irreversible restless agitated combative1. Some commentators abroad say that Chinas current policy is . 2. No difficulty can ever the advance of the Chinese people.3. The graver threat this time is that countries are tempted to their debts through higher inflation.4. of bridge pavement with cement concrete is a very common problem.5. For some fragile states in West Africa, these problems may be , and dangerous.6. Many characteristics of internet language post-modern values and cultural connotations.7. Some people, and enthusiastic, seize every opportunity with both hands and turn it to good advantage8. Enhance the patients orientation force, if severe , should avoid going out alone.9. The prices of vegetables and fruits with the seasons.10. After a of several years he came back to see us.11. If I can a defect, I improve my productivity.12. She is by his sudden appearance at the party.13. Many prisoners, on being freed, to a life of crime.14. Try not to become and defensive when you are being criticized.15. Flower Gardeners begin to get when February arrives.16. I know. But why your sudden interest in lessening your salt ?17. She became quite as the disease got worse. 18. The of his heart had been crushed out of him by early sorrows. 19. After being lost in the desert for five days, Bill began to . 20. When people do not get enough sleep, their judgment and abilities may be . . TranslationSection A: Translate the following passage into Chinese.With the increase in life expectancy, a number of aging-related diseases such as osteoporosis and Alzheimers disease have become important research targets of contemporary medicine. While Alzheimers disease is not a normal part of the aging process, the risk of developing the disease will increase as people grow older.The exact cause of Alzheimers disease is not entirely clear, but researchers have found that some risks factors for it include heredity, hypertension, high cholesterol levels, atherosclerosis, cardiovascular problems and brain damage. osteoporosis ,stiuprusis n. 外科 骨质疏松症)cholesterol klestrl n. 生化 胆固醇cardiovascular ,k:diuvskjul adj. 解剖 心血管的Section B: Translate the following passage into English.照料老年痴呆症犯者的责任通常落在他们配偶和子女身上。照料者必须始终警惕老年痴呆症犯者有可能离走迷失。当目睹老年痴呆症慢慢地把他们所爱的人从他们那里多走，他们遭受着巨大的痛苦和压力。毫不奇怪，照料者常常由于这一压力产生自身的健康和心理问题。所以，如何去关怀面临巨大痛苦和负担的老年痴呆症犯者的照料者，也是值得关注的问题。Text BDeath and DyingDeath is often referred to as “the final stage of growth.” It is experienced by everyone and cannot be avoided. In our society, the young tend to ignore its existence. It is usually the elderly, having lost spouses and/or friends, who begin to think of their own deaths. When a patient is told that he or she has a terminal illness, a disease that cannot be cured and will result in death, the patient may react in different ways. Some patients react with fear and anxiety. They fear pain, abandonment, and loneliness. They fear the unknown. They become anxious about their loved ones and about unfinished work or dreams. Anxiety diminishes in patients who feel they have had full lives and who have strong religious beliefs regarding life after death. Some patients view death as a final peace. They know it will bring an end to loneliness, pain, and suffering. Dr. Elizabeth Kbler -Ross1 has done extensive research on the process of death and dying and is known as a leading expert on this topic. Because of her research, most medical personnel now feel patients should be told of their approaching deaths. However, patients should be left with “some hope” and the knowledge that they will “not be left alone.” It is important that all staff members who provide care to the dying patient know both the extent of information given to the patient and how the patient reacted.Dr. Kbler-Ross has identified five stages of grieving that the dying patients and their families/friends may experience in preparation for death. The stages may not occur in order, and they may overlap or be repeated several times. Some patients may not progress through all of the stages before death occurs. Other patients may be in several stages at the same time. The stages are denial, anger, bargaining, depression, and acceptance. Denial is the “No, not me!” stage, which usually occurs when a person is first told of a terminal illness. It occurs when the person cannot accept the reality of death or when the person feels the loved ones cannot accept the truth. The person may make statements such as “The doctor does not know what he is talking about” or “The tests have to be wrong.” Some patients seek second medical opinions or request additional tests. Others refuse to discuss their situations and avoid any references to their illnesses. It is important for patients to discuss these feelings. The health care worker should listen to a patient and try to provide support without confirming or denying. Statements such as “It must be hard for you” or “You feel additional tests will help?” will allow the patient to express feelings and move on to the next stage.Anger occurs when the patient is no longer able to deny death. Statements such as “Why me?” or “Its your fault” are common. Patients may strike out at2 anyone who comes in contact with them and become very hostile and bitter. They may blame themselves, their loved ones, or health care personnel for their illnesses. It is important for the health care worker to understand that this anger is not a personal attack; the anger is due to the situation the patient is experiencing. Providing understanding and support, listening, and making every attempt to respond to the patients demands quickly and with kindness is essential during this stage. This stage continues until the anger is exhausted or the patient must attend to3 other concerns.Bargaining occurs when patients accept death but want more time to live. Frequently, this is a period when patients turn to religion and spiritual beliefs. At this point, the will to live is strong, and patients fight hard to achieve goals set. They want to see their children graduate or get married; they want time to arrange care for their families; they want to hold new grandchildren; or other similar desires. Patients make promises to God to obtain more time. Health care workers m