How can the biopsychosocial medical interview model address the unique needs of older
adults with Alzheimer’s?
Abstract
Over the years, researchers have proposed various non-medical and psychosocial models
for the treatment of Alzheimer's. Nonetheless, addressing Alzheimer's patients' unique needs
using a model that integrates biological, social, and psychosocial processes in its management.
Present models provide an increased understanding of factors that improve or worsen instead of
illustrating the impact psychological factors have on the disease's contextual biological
processes. Accordingly, this paper explores the impact of the application of biopsychosocial
medical interviews. With dementia being a multifactorial condition, only a few researchers
address the differences between the biomedical and psychosocial interview models in its
management. For this reason, a rationale exists for analyzing these differences to provide
caregivers with a practical guide for implementing effective interventions in older adults living
with dementia.
How Biomedical Approach Can Overlooks Alzheimer’s
Modern medicine has mostly centered its development on biological sciences to enhance
the diagnosis and treatment of various physical and mental conditions. The emerging biomedical
model for illnesses primarily focuses on a condition's pathophysiology by analyzing the
anatomical, neurophysiological, or biochemical components (Salinas et al., 2017. For the past
century, healthcare providers have considered Alzheimer's disease as pre-senile dementia
associated with aging. The conceptualization of Alzheimer's condition as a brain disease rather
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than a product of aging has become a subject of discussion with overarching global outcomes for
science and society, significantly affecting research, awareness, and public perceptions.
How the Psychosocial Model can be Used to Address the Special Needs for Alzheimer’s
Several approaches are available for delivering effective psychosocial based interventions
to older adults. Through the psychosocial model, caregivers can leverage assistive technologies
to address accessibility, sustainability, and personalization challenges in patients with
Alzheimer's. The psychosocial-based dementia intervention's cost-effectiveness recommends for
application in the prevention delivery of palliative care at home or in health care institutions. As
such, the psychosocial interview model can lower the costs associated with the provision of
Alzheimer's care in self-care settings or care homes. Moreover, its reliance on a specialist,
personalized multicomponent treatment approach to provide psychological support to families
living with an older adult reduces care home admission for the target population (Marseglia et
al., 2020). Psychosocial based interventions support family carers. Given the multicomponent
nature of this model, it is a useful tool for reducing depression, caregivers' burden, behavioral
and psychological symptoms of Alzheimer's, and improving caregivers' quality of life.
Application of the Biomedical Model
While aging calls for supportive care and acceptance, the classification as a disease
introduces aspects of active interventions that can be potentially curative. The consideration of
Alzheimer's as a condition increased the expectation that neurobiological research will result in
rational interventions, further propagating the conception as a new branch of science that applies
to neurodegeneration (Salinas et al., 2017).. This approach's novelty is that it increases
advancements in biomedical research, leading to a comprehensive understanding of brain aging
and theories about aging and dementia. Nonetheless, the impacts of the neurobiological model's
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dominance are the emerging disconnect from the lived experience of the illness. In this line, the
National Institute on Aging and Alzheimer’s Association (NIA-AA) stipulates an alternative
diagnosis for the condition. The agency advises that diagnosis be informed by evidence of
neuronal atrophy, biomarkers, or injury even among those who present no symptoms of
cognitive deteriorations (Jack et al., 2018). This approach introduces the concept of
asymptomatic Alzheimer’s disease. Unfortunately, the diagnostic biomarker criteria are only
recommended for research reasons and are yet to be approved for clinical diagnostics.
However, great attention is drawn by the biomedical model's deficits, especially in public
campaigns, which has increased the level of hopelessness related to Alzheimer's. According to
Selkoe (2019), dementia has overtaken cancer as the most dreaded condition for persons above
50-years. Worse, there is no effective treating regimen for the disease. This has caused the need
to redefine Alzheimer’s and new strategies for dealing with dementia syndrome. The significant
challenges of the biomedical model is that it overlooks the resilience capacity of the brain. In
addition, it does consider the two major problems of the classical disease model. The first
challenge is that there lacks adequate evidence linking the clinical features of the illness with the
hallmarks of the condition’s neurobiology. Besides, the plaques and tangles do not bear any
pathognomonic form. A substantial part of persons with dementia does not suffer sufficient
neuropathology to explain the presenting cognitive behavior. Further, scientific research shows
that portions of significantly older adults without dementia also indicate high AD pathology
levels. Secondly, among older adults, the pathology is largely heterogeneous than previously
envisaged, with a range of plaques and tangles alongside cerebrovascular disease, even among
patients with the clinical diagnosis of Alzheimer's illness.
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Application of the Psychosocial Model in Alhzeimer’s
In contrast to the traditional biomedical interview model, the biopsychosocial medical
interview model focuses on the micro-level interactions between individuals. Its effectiveness in
meeting the social needs of older adults with Alzheimer's depends on reducing disabilities,
promotion of cognitive functions, mood, and emotional regulation as the model has no adverse
health risk to older adults. It uses a multidisciplinary approach to develop practical-based
analysis interventions to address cognitive, behavioral, functional limitations, and improve
seniors' quality of life with Alzheimer's. Combining the psychosocial model with
pharmacological options provides health care providers with a potent tool for delivering effective
palliative care. According to Teachman et al. (2019), psychosocial model interventions focus on
providing patient-centric care to end-of-life and living Alzheimer's patients.
The suitability of the psychosocial model is promising as evaluations reveal its
applicability in delivering patient-centric and multicomponent-based dementia care to older
adults. However, several limitations affect its relevance in addressing the unique needs of older
adults—concerns about the suitability, effectiveness, and acceptability of assistive technologies
by patients and caregivers. As a result, there is a need for new paradigms to evaluate the
effectiveness of rapidly evolving technologies. While some psychosocial based interventions can
effectively address the unique needs of seniors with dementia, they might have minimal health
outcomes in patients with dementia compared to the scope of change required. Fossey et al.
(2019) contend that only the development of evidence-based psychosocial interventions can
contribute to delivering effective care to older adults living with dementia. Nonetheless, the
application of this model requires a shift in the methodologies used to collect data for evaluation
of the sensitivity of the model to contextual, biomedical, and patient data. For this reason, the
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development of new initiatives for addressing the health and safety needs of seniors living with
dementia entails engaging families, caregivers, and the public in the management of the
condition. The success of dementia intervention depends on the ability of caregivers to select the
right model and integrate its principles to address the special needs of older adults. Because of
the extensibility of the psychosocial interview model, this review recommends its adoption by
caregivers.
Conclusion
There is an emerging epidemiological agreement that lifestyle factors provide crucial
avenues of prevention, consequently affecting the treatment course. Reseracrhers are utilizing an
integrative model comprising biomedical and psychosocial approaches to address significant
health challenges. An integrative model provides for greater justice to phenomenology and
pathology for Alzheimer’s patients. Both techniques' novelty provides insights into the
integrative approach by identifying a range of preventive compensatory factors. Integrating
compensatory factors such as social engagement, high education, mentally stimulating activities,
and maintaining cardiovascular health increases brain and cognitive reserves. Researchers and
developers agree that due to the complexity of the human condition, it is challenging to explain
Alzheimer from a biomedical perspective alone; thus, the adoption of a biopsychosocial model
will be more suitable to explain why the symptoms and course of the illness may vary among
individuals by exploring the interdependence of the biological, psychological, and social traits.
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