医学英语 老年痴呆

Unit2HumanGrowthandDevelopmentHumangrowthanddevelopmentisaprocessthatbeginsatbirthanddoesn’tenduntildeath.Duringallstagesofgrowthanddevelopment,individualshavedifferentneedsthatmustbemet.Andasagingoccurs,certainphysical,psychological,andevensocialchangesalsooccurinallindividuals.Someindividualscanlearntoadapttoandcopewiththechanges,butothersexperiencesextremefrustrationandmentaldistress.Itisimportantforthehealthcareworkerstobeawareofthevariouslifestagesinordertoprovidequalityhealthcare.TextAConfusionandDisorientationintheElderlyAlthoughmostelderlyindividualsremainmentally alertuntildeath,someexperienceofconfusionanddisorientation.Signsofconfusionordisorientationincludetalkingincoherently,notknowingtheirownnames,notrecognizingothers,wanderingaimlessly,lackingawarenessoftimeorplace,displayinghostileandcombativehallucinating,regressinginpaylessintentiontopersonalhygiene,andbeingunabletorespondtosimplecommandsorfollowinstructions.Confusion and disorientation is sometimes a temporarycondition. Stress and/or depression due to physical andpsychologicalchangesisonepossiblecause.UseofalcoholorchemicalsisKidneydisease,whichinterfereswith1electrolyte balance; disease, which decreasesoxygen;orliverdisease,whichinterfereswithmetabolism,areothercauses.Elderlyindividualsarealsomoresensitivetomedications,anddrugscansometimesaccumulateinthebodyandcauseconfusionanddisorientation.Evenpoornutritionorlackoffluid intake can interfere with mental ability. Frequently,identificationandtreatmentofanyoftheseconditionsdecreasesandeveneliminatestheconfusionanddisorientation.Foeexample,changingamedicationorgivingitinsmallerdoesmayrestorenormalfunction.Diseaseand/ordamagetothebraincansometimesresultinchronicconfusionordisorientation.Acerebrovascularaccident,orstroke,whichdamagesbraincells,isonepossiblecause.Abloodclotcanobstructbloodflowtothebrain,oravesselcanruptureandcausehemorrhaginginthebrain.Arteriosclerosis,aconditioninwhichthewallsofbloodvesselsbecomethickandlosetheirelasticity,iscommonintheelderlyindividuals.Ifthevesselsbecomenarrowduetodepositsoffatandminerals,suchascalcium,theconditioniscalledatherosclerosis.Theseconditionscancausetransientischemicattacks(TIAs),orministrokes,whichresultintemporaryperiodsofdiminishedbloodflowtothebrain.Eachtimeanattackoccurs,moredamagetobraincellsresults.Dementia,alsocalledbrainsyndrome,isalossofmentalabilitycharacterizedbyadecreaseinintellectualability,lossof memory,impairedjudgment,personalitychange,anddisorientation.Whenthe symptoms are caused by high kidney infection,dehydration,hypoxia(lackofoxygen),drugtoxicity,orothertreatableconditions, theconditioniscalled acute.Whenthesymptomsarecausedpermanent,irreversibledamagetobraincells,the condition is called chronic. Cerebral vascular accidents,arteriosclerosis,andTIAscanbecontributingcausestochronicdementia.Onemoderntheorysuggeststhatchronicdementiaiscausedbyeitheracompletelackoraninadequateamountofanenzyme.Whateverthecause,chronicdementiaisusuallyregardedasaprogressive,irreversibledisease.Alzheimer’sdisease2 isaformofdementiathatcausesprogressivechangesinbraincells.Itcanoccurinindividualsasyoungas40yearsofage,butfrequentlyoccursinthoseintheirsixties.Thecauseisunknown,buttherearemanytheoriescurrentlybeingresearched.Ageneticdefect,amissingenzyme,toxiceffectsofaluminum,avirus,andthefaultymetabolismofglucosehaveallbeenimplicatedaspossiblecauses.Whateverthecauses,Alzheimer’sdiseaseisviewedasaterminal,incurablebraindiseaseusuallylastingfrom3to10years.Intheearlystages,theindividualexhibitsmemoryloss,moodandpersonalitychanges,depression,poorjudgment,confusionregardingtimeandplace,andanabilitytoplanandfollowthroughwithmanyactivitiesofdailyliving.Asthediseaseprogresses,nighttimerestlessnessoccurs,moodswingsbecomesfrequent,personalhygieneisignored,weightfluctuates,paranoiaandhallucinationsincrease,andfull-timesupervisionbecomesnecessary.Intheterminalstage,theindividualexperiencestotaldisorientationregardingperson,timeandplace;becomesincoherentandisunabletocommunicatewithwords;losescontrolofbladderandbowelfunctions;developsseizures;losesweightdespiteeatingabalanceddiet;becomestotallydependent;andintoacomaanddies.Deathisoftencausedbypneumonia,infections,andkidneyfailure.Progressthroughthevariousstagesofthisdiseasevariesamongindividuals.Whateverthecauseofconfusionordisorientation,certaincoursesofcareshouldbefollowed.Aprimaryconcernistoprovideasafeandsecureenvironment.Dangerousobjectssuchasdrugs,poisons,scissors,knives,andcleaningsolutionsshouldbekeptoutofreachandinalockedarea.Iftheindividualtendstodoorsandwindowsshouldbesecure.Followingthesameroutineisalsoimportant.Meals,baths,dressing,walks,andbedtimeeachoccuratapproximatelythesametimeeachday.Anychangeinroutinecancausestressandconfusion.Eventhoughtheindividualshouldbeencouragedtobeasactiveaspossible,activitiesshouldbekeptsimpleandlastforshortperiodsoftime.Acalm,quietenvironmentisalsoimportant.Loudnoises,crowdedrooms,andexcessivecommotioncancausetheindividualtobecomeagitatedandmoredisoriented.Realityorientation(OR)consistsofactivitiesthathelppromoteawarenessofperson,timeandplace.Theactivitiesshouldbefollowedbyanyonecaringfortheconfusedindividual,whetherthecareisinthehomeorinalong-termcarefacility.Someaspectsofrealityorientationarethefollowing:Addressthepersonbythenametheyprefer,forexample,“Mr.Smith”or“Mike.”Avoidtermssuchas“sweetie,”“baby,”and“honey.”Stateyournameandcorrectthepersonifheorshecallsyouawrongname.Forexample,ifapatientthinksyouarehisorhersay“IamnotyourdaughterLisa.I’mMrs.Simmers,yournursefortoday.”Makeconstantreferencestoday,time,andplace.“Itis8:00Tuesdaymorningandtimeforbreakfast.”Useclocks,calendars,andinformationboardstopointouttime,day,andactivities.Keeptheindividualorientedtoday-nightcircles.Duringtheday,encouragethepersontowearregularclothes.Also,openthecurtainsandpointoutthesunshine.Atnight,closethecurtains,usethenightlightifnecessary,andpromotequietandrest.Speakslowlyandclearlyandaskclearandsimplequestions.Neverrushorhurrytheindividual.Repeatinstructionspatiently.Allowtimefortheindividualtorespond.Encourageconversationsaboutfamiliarthingsorcurrentevents.Encouragetheuseofatelevisionoraradio,butavoidoverstimulatingtheindividual.Keepfamiliarobjectsandpictureswithinview.Avoidmovingtheperson’sfurnitureorbelongings.Don’tagreewithincorrectstatements.Gentlyprovidecorrectinformation.Forexample,whenapersonstatesitistimetodressforwork,say,“Youdon’thavetogotoworktoday.Youretired7yearsago.”Don’thesitanttousetouchtocommunicatewiththeperson.Encourageindependenceandselfhelpwheneverpossible.Caringforaconfusedordisorientedindividualcanbefrustratingand even frightening at times. Continual assessment of theindividual’sabilitiesandproblemsisneededtodesignahealthcareprogramthatwillallowtheindividualtofunctionwithinthelevelofhisorherability.Patience,consistency,andsincerecaringareessentialonthepartofthehealthcareNotes：TextAandTextBareadaptedHealthOccupationsEssentials4theditionbyLouiseSerfereswith：干扰，干涉；妨碍Theysayitinterfereswithactivitiesoutsideschoolsincludingsummeremployment.并且他们说这还会干扰校外活动，包括夏季雇佣。Alzheimer’sdisease 阿兹海默症；老年痴呆症Firstdescribedin1906bytheGermanphysicianDr.AloisAlzheimer,isadiseasethatprogressivelydestroysbraincells,affectingmemory,languagebehaviorandultimately,character.IntheUnitedStatesabout10%ofthepopulationover65suffersfromAlzheimer’sdiseaseandupto45%ofthoseover85mayhavethedisease.Alzheimer’spatientmayliveseventotenyearswiththedisease.Thesymptomsofthediseasecanbehavingproblemslearningnewinformationandrememberingtoperformroutinetasks,suchaslockingthedoororturningoffthegas;havingproblemsfindingtherightwordstoexpressoneself;andhavingdifficultiesfindingone’sway.Uptonowmanythingsaboutthisdiseasestillremainamystery.Butresearchcontinuestobringusabetterunderstandingofthedisease,moreaccuratediagnosesandmoreeffectivetreatments.Exercises:ⅠWord-buildingMedicalTerminologyisaspecialvocabularyusedbyhealthcareprofessionalsforeffectiveandaccuratecommunication.StudythePrefixesandSuffixesRelatedtotheSystemsandOrgansoftheBodyinthefollowingbox.PrefixesandSuffixesfortheSystemsandOrgansoftheBody名称通用名前(后)缀示例血bloodhemo-/hemato-hemorrhage/hematology血管vesselvaso-vasoactive/vasography静脉veinveno-venography/venous动脉arteryarterio-arteriography/arteriosclerosis神经nerveneur-/neuro-neural/neuralgia髓marrowmyel-/myelo-myeloid/myelitis神经nerveneur-/neuro-neural/neuralgia细胞cellcyto-/cyte-cytology/cytobiology尿urineuro-/ur-urology/urosurgery体bodysomato-/-somesomatology/somatopsychic肌muscleMyo-mycology/myositisTheprojectisapartnershipbetweenBayerScheringandtheChineseSocietyofHematology.Toinvestigaterolesofvasoactivesubstancesincerebralvasculardiseases.Inanycase,theynotethat"avenousultrasoundormagneticresonancevenographyisoptional.Arteriosclerosisaffectsanincreasinglybroadsegmentoftheolderpopulation.Thedoctordiagnosedmyillnessasneuralgia.MethodsApplyconventionalandenhancedMRIscanto10patientsclinicallydiagnosedwithacutemyelitis.Diagnosisismadethroughcytologyofthemass.Thisarticlecommentedtheadvancementoftissueengineeringtechnologyinurology.NormalSomatologyincludesNormalAnatomy,Histology&Embriology,Physiology,Biochemistry.Heartmyositisandlobaranxietypatientaresensitivetostrongheartglucoside,shouldnoticedosage.ⅡStudycarefullyallthenewwordsandphrasesinthebox.Fillinthegapswithwordsorphraseschosenfromthebox.Changetheformwherenecessary.alert regressalert regressobstructdisorientationimplicateincoherentfluctuateruptureimpairedlapseelasticityeliminateintakecombativeirreversiblerestlessacute.SomecommentatorsabroadsaythatChina'scurrentpolicy.Nodifficultycanever theadvanceoftheChinesepeople.Thegraverthreatthistimeisthatcountriesaretemptedtotheirdebtsthroughhigherinflation. ofbridgepavementwithcementconcreteisaverycommonproblem.ForsomefragilestatesinWestAfrica,theseproblemsmaybe ,anddangerous.Manycharacteristicsofinternetlanguage valuesandculturalconnotations.Somepeople, andenthusiastic,seizeeveryopportunitywithbothhandsandturnittogoodadvantageEnhancethepatient'sorientationforce,ifsevere ,avoidgoingoutalone.Thepricesofvegetablesandfruits withtheseasons.Aftera ofseveralyearshecamebacktoseeus.IfIcan adefect,Iimprovemyproductivity.Sheis byhissuddenappearanceattheparty.Manyprisoners,onbeingfreed, toalifeofcrime. Trynottobecome anddefensivewhenyouarebeingcriticized.FlowerGardenersbegintoget whenFebruaryarrives. Iknow.Butwhyyoursuddeninterestinlesseningyoursalt ?Shebecamequite asthediseasegotworse.The ofhishearthadbeencrushedoutofhimbyearlysorrows.Afterbeinglostinthedesertforfivedays,Billbeganto .Whenpeopledonotgetenoughsleep,theirjudgmentandabilitiesmaybe .Ⅲ.TranslationSectionA:TranslatethefollowingpassageintoChinese.Withtheincreaseinlifeexpectancy,anumberofaging-relateddiseasessuchasosteoporosisandAlzheimer’sdiseasehavebecomeimportant research targets of contemporary medicine. WhileAlzheimer’sdiseaseisnotanormalpartoftheagingprocess,theriskofdevelopingthediseasewillincreaseaspeoplegrowTheexactcauseofAlzheimer’sdiseaseisnotentirelyclear,butresearchershavefoundthatsomerisksfactorsforitincludeheredity,hypertension,highcholesterollevels,atherosclerosis,cardiovascularproblemsandbraindamage.osteoporosis[,ɔstiup'rusisncholesterolk'lestrɔln生化]胆固醇cardiovascular[,kɑ:diu'væskjul]adj.SectionB:TranslatethefollowingpassageintoEnglish.年痴呆症犯者的照料者，也是值得关注的问题。TextBDeathandDyingDeathisoftenreferredtoas“thefinalstageofgrowth.”Itisexperiencedbyeveryoneandcannotbeavoided.Inoursociety,theyoungtendtoignoreitsexistence.Itisusuallytheelderly,havinglostspousesand/orfriends,whobegintothinkoftheirowndeaths.Whenapatientistoldthatheorshehasa terminalillness,adiseasethatcannotbecuredandwillresultindeath,thepatientmayreactindifferentways.Somepatientsreactwithfearandanxiety.Theyfearpain,abandonment,andloneliness.Theyfeartheunknown.Theybecomeanxiousabouttheirlovedonesandaboutunfinishedworkordreams.Anxietydiminishesinpatientswhofeeltheyhavehadfulllivesandwhohavestrongreligiousbeliefsregardinglifeafterdeath.Somepatientsviewdeathasafinalpeace.Theyknowitwillbringanendtoloneliness,pain,andsuffering.Dr.Elizabethhasdoneextensiveresearchontheprocessofdeathanddyingandisknownasaleadingexpertonthistopic.Becauseofherresearch,mostmedicalpersonnelnowfeelsdedfrg.,shouldbeleftwith“somehope”andtheknowledgethattheywill“notbeleftalone.”Itisimportantthatallstaffmemberswhoprovidecaretothedyingpatientknowboththeextentofinformationgiventothepatientandhowthepatientreacted.Kǜbler-Rosshasidentifiedfivestagesofgrievingthatthedying patients and their families/friends may experience inpreparationfordeath.Thestagesmaynotoccurinorder,andtheymayoverlaporberepeatedseveraltimes.Somepatientsmaynotprogressthroughallofthestagesbeforedeathoccurs.Otherpatientsmaybeinseveralstagesatthesametime.Thestagesaredenial,bargaining,depression,andacceptance.Denialisthe“No,notme!”stage,whichusuallyoccurswhenapersonisfirsttoldofaterminalillness.Itoccurswhenthepersoncannotaccepttherealityofdeathorwhenthepersonfeelsthelovedonescannotacceptthetruth.Thepersonmaymakestatementssuchas“Thedoctordoesnotknowwhatheistalkingabout”or“Thetestshavetobewrong.”Somepatientsseeksecondmedicalopinionsorrequestadditionaltests.Othersrefusetodiscusstheirsituationsandavoidanyreferencestotheirillnesses.Itisimportantforpatientstodiscussthesefeelings.Thehealthcareworkershouldlistentoapatientandtrytoprovidesupportwithoutconfirmingordenying.Statementssuchas“Itmustbehardforyou”or“Youfeeladditionaltestswillhelp?”willallowthepatienttoexpressfeelingsandmoveontothenextstage.Angeroccurswhenthepatientisnolongerabletodenydeath.Statementssuchas“Whyme?”or“It’syourfault”arecommon.PatientsmaystrikeoutanyonewhocomesincontactwiththemandbecomeveryhostileandTheymayblamethemselves,theirlovedones,orhealthcarepersonnelfortheirillnesses.Itisimportantforthehealthcareworkertounderstandthatthisangerisnotapersonalattack;theangerisduetothesituationthepatientisexperiencing.Providingunderstandingandsupport,listening,andmakingeveryattempttorespondtothepatient’sdemandsquicklyandwithkindnessisessentialduringthisstage.Thisstagecontinuesuntiltheangerisexhaustedorthepatientmustattendto3otherconcerns.Bargainingoccurswhenpatientsacceptdeathbutwantmoretimetolive.Frequently,thisisaperiodwhenpatientsturntoreligionandspiritualbeliefs.Atthispoint,thewilltoliveisstrong,andpatientsfighthardtoachievegoalsset.Theywanttoseetheirchildrengraduateorgetmarried;theywanttimetoarrangecarefortheirfamilies;theywanttoholdnewgrandchildren;orothersimilardesires.PatientsmakepromisestoGodtoobtainmoretime.Healthcareworkersmustagainbesupportiveandbegoodlisteners.Wheneverpossible,theyshouldhelppatientsmeettheirgoals.Depressionoccurswhenpatientsrealizethatdeathwillcomesoonandtheywillnolongerbewiththeirfamiliesorbeabletocompletetheirgoals.Theymayexpresstheseregrets,ortheymaywithdrawandbecomequiet.Theyexperiencegreatsadness,and,attimes,overwhelmingItisimportantforhealthcareworkerstoletpatientsknowthatitis“OK”tobedepressed.Providingquietunderstanding,support,and/orasimpletouch,andallowingpatientstocryorexpressgriefareimportantduringthisperiod.Acceptanceisthefinalstage.Patientsunderstandandacceptthefactthattheyaregoingtodie.Patientsmaycompleteunfinishedbusinessandtrytohelpthosearoundthemdealwiththeoncomingdeath.Gradually,patientsseparatethemselvesfromtheworldandotherpeople.Attheend,theyareatpeace4anddiewithdignity.Duringthisfinalstage,patientsstillneedemotionalsupportandthepresenceofothers,evenifitisjustthetouchofahand.Providingcaretodyingpatientscanbeverydifficult,butveryrewarding.Providingsupportivecarewhenfamiliesandpatientsrequireitmostcanbeoneofthegreatestsatisfactionsahealthcareworkercanexperience.Inordertobeabletoprovidethiscare,healthcareworkersmustfirstunderstandtheirownpersonalfeelingsaboutdeathandcometotermswith5thesefeelings.Feelingsoffrustration,anduncertaintyaboutdeathcancauseworkerstoavoiddyingpatientsorprovidesuperficial,mechanicalcare.Withexperience,healthcareworkerscanfindwaystodealwiththeirfeelingsandlearntoprovidethesupportivecareneededbythedying.Hospicecarecanplayanimportantroleinmeetingtheneedsofthedyingpatient.Hospicecarecanbeofferedinhospitals,medicalcenters,andspecialfacilities,butmostfrequentlyitisofferedinthepatient’shome.Thephilosophybehindthiscareistoallowthepatienttodiewithdignityandcomfort.Painiscontrolledsothatthepatientcanremainactiveaslongaspossible.Psychological,spiritual,social,andfinancialcounselingareprovidedforboththepatientandfamily.Inmedicalfacilities,personalcareofthepatientisprovidedbythestaff;inthehomesituation,thiscareisprovidedbyhomehealthaidesandotherhealthcareprofessionals.Therighttodieisanotherissuethathealthcareworkersmustunderstand.Becausehealthcareworkersareethicallyconcernedwithpromotinglife,allowingpatientstodiecancauseconflict.alargenumberofsurveyshaveshownthatmostpeoplefeelthatanindividualwhohasaterminalillness,withnohopeofbeingcured,shouldbeallowedtorefusemeasuresthatlife.Thisiscalledrighttodie.Moststateshavepassed,orarenowcreating,lawsthatallowadultswhohaveterminalillnessestoinstructtheirdoctors,towithholdtreatmentsthatmightprolonglife.Undertheselaws,specificactionstoendlifecannotbetaken.theuseofrespirators,pacemakers,andothermedicaldevicescanbewithheld,andthepersoncanbeallowedtodiewithdignity.Healthcareworkersdealwithdeathandwithdyingpatientsbecausedeathisapartoflife.Byunderstandingtheprocessofdeathandbythinkingabouttheneedsofdyingpatients,thehealthcareworkerwillbeabletoprovidethespecialcareneededbytheseindividuals.Notes:Dr.ElizabethKǜblerstrikeout（atattack猛烈攻击：Helosthistemperandstrokeoutwildly.Inarecentarticleshestrikesoutathercritics.attendtosb/sth1.givecarefulthoughttoyourworkandstoptalking.2.givepracticalconsiderationtosb/sth照顾，关照某人/某事物：Anurseattendstohisneeds.atpeace(withoneself/sb/sth)让（自己）平静，与(某人/某事物)和睦：She’sneveratpiecewithherself,ieisalwaysetotermswith(withsb)reachanagreement达成协议cometotermswith(with)learntoacceptsth顺从/设法忍受某事物：cometotermswithherdifficulty安于她自己的困难处境Exercises:Ⅰ.CompleteeachofthefollowingsentencesbytranslatingtheChineseintoEnglish,usingthephrasesinthebox.attendattendto atpeace dealwith strikeoutattendto refermoveont