Nurses working with, and caring for patients suffering from dementia will oftentimes realize the difficulty of the task. It can be an exhausting and frustrating work. One of the reasons why it is extremely challenging to work with patients suffering from Alzheimer is that they do not retain explanations or instructions.
Thus, it is important for the nurses and the caregivers to learn patience, especially when it comes to giving instructions. Nurses have to deal with the impact of frustration, especially in the absence of positive response or feedback from the patients. Nurses can minimize the effects of caring for patients with dementia by conveying negative feelings with other health workers or caregivers. However, the best way to prepare for encounters with Alzheimer’s patients is to learn more about the nature of the disease.
What is Alzheimer’s?
Dr. Alois Alzheimer from Frankfurt, Germany was one of the first physicians to figure out the scientific framework that helps people identify the onset of the said disease. Thus, this mental health problem was named in his honor. Dr. Alzheimer was one of the first physicians to discover that this particular medical condition is progressive. He also discovered that Alzheimer’s is a fatal disease of the brain.
In fact, it is a degenerative disease of the brain that leads to a condition called dementia (Lu & Bludau, 2011). The term dementia was coined to describe the significant loss of memory and mental abilities of the patient (Lu & Bludau, 2011). In most cases, the problems relating to memory loss and impaired mental capabilities are severe enough to affect daily life.
There are other diseases that can cause dementia. However, Alzheimer’s disease is the most common type of dementia, and it accounts for at least 60 percent of all cases regarding dementia. As a result the word dementia is oftentimes used interchangeably with the said mental ailment.
It is important to highlight the significance of dementia. In order to experience the fullness of life, an individual needs to perform basic activities such as eating, changing clothes, and going to the bathroom. People suffering from Alzheimer’s disease lose the capability to perform these basic skills.
The problem is exacerbated by significant memory loss. It is not just an ordinary memory loss, like the inability to remember the name of America’s first president or the name of a distant relative. In many cases, patients are unable to remember the name of their spouses and children. They cannot remember how to go home to their own place of residence.
Important Information About Alzheimer’s Disease
Alzheimer’s disease occurs more frequently in older adults. In other words, it is highly unlikely for children and teenagers to be diagnosed with this mental health problem. It is important to point out that it is very expensive to take care of patients with Alzheimer’s disease. The cost of nursing home care is also escalating.
In order to minimize problems related to Alzheimer’s disease, it is imperative to have an early diagnosis. However, occasional bouts of forgetfulness are not enough to diagnose the problem with certainty.
Look for telltale signs such as cognitive problems, language problems, mood changes, personality changes, and physical symptoms (Smith & Kenan, 2004). Cognitive symptoms include any significant changes that lead to the impairment of the patient’s capability to “think, speak, reason, remember, plan and exercise reasonable judgment” (Smith & Kenan, 2004, p.28).
It is also important to remember the risk factors associated with Alzheimer’s disease. The number one risk factor is age. As a person gets older, he or she increase the probability of developing Alzheimer’s disease. In fact, 1 out of 10 individuals over the age of 65 and half of those over the age of 85 have greater chances of developing the said mental ailment (Gogia & Rastogi, 2011).
It is also interesting to point out that head injury or brain trauma increases the likelihood of developing this medical problem. The list also includes genetics, Down syndrome, environmental toxins, and Parkinson’s disease (Gogia & Rastogi, 2011). Early diagnosis is possible. However, the patients’ relatives, family members and health workers must be familiar with at least ten warning signs of Alzheimer’s disease.
These warning signs are listed as follows: 1) problems with abstract thinking or reasoning; 2) frequently misplaced things; 3) changes in person’s mood or behavior; 4) changes in personality; 5) loss of initiative; 6) memory loss problems; 7) difficulty performing familiar tasks; 8) language problems; 9) disoriented about the current time and place; 10) poor or decreased judgment (Smith & Kenan, 2004).
When it comes to diagnostic criteria or nursing assessments, it is important to point out that depression in older adults is the disorder frequently confused with dementia (Halter, 2014). At the same time, dementia, depression, and delirium can coexist. Therefore, nurses should know how to assess the important differences in order to ascertain that the patient is suffering from Alzheimer’s disease. They need to have this capability in order to rule out other pathological conditions (Halter, 2014).
Nurses can utilize technology, such as, brain imaging with CT scan, position emission tomography, and other scanning technologies that can help them rule out other conditions. A misdiagnosis can lead to the formulation of an inappropriate treatment strategy. In most cases, misdiagnosis can lead to detrimental results (Lu & Bludau, 2011). It is critical to perform a thorough evaluation before making any conclusions regarding the medical condition of the patient.
Once diagnosis has been made, it is time to look into pharmacological and non-pharmacological interventions. Unfortunately, there is no cure for this dreaded disease. The focus of treatment is to delay the progression of the disease. In terms of using medication, drugs like rivastigmine, galantamine, and donepezil have the capability to slow the progression of the said disease (Videbeck, 2011).
These drugs can slow the progression of dementia for about six months. Drugs like antipsychotics, antidepressants, and benzodiazepines can help manage the symptoms. However, these drugs have no effect on the progression of dementia.
With regards to non-pharmacological interventions, there is a need to take care of the person as a whole. Caregivers must learn how to keep the patient physically well, socially engaged, and mentally stimulated (Lu & Bludau, 2011). Therefore, aside from giving medication, the caregiver must look after all the aspects of the individual.
Aside from pharmacological and non-pharmacological interventions, it is important to consider the psychosocial aspect of providing care. It is imperative to address issues regarding safety, interpersonal involvement, and social interaction (Videbeck, 2011). One has to keep this in mind, most clients receive care at home.
A spouse or adult child often assumes the caregiver’s role. Due to the challenges that they face on a daily basis, they need ongoing education and support from health care professionals such as a nurse. Nurses must teach them to address other issues, such as, nutrition, as well as different methods on how to handle symptoms as they arise. The main goal is to maintain overall health of the patient suffering from the said disease.
Gogia, P. & Rastogi, N. (2009). Clinical Alzheimer rehabilitation. New York: Springer.
Halter, M. (2014). Varcaroli’s foundations of psychiatric mental health nursing. CA: Elsevier.
Lu, L. & Bludau, J. (2011). Alzheimer’s disease. CA: ABC-CLIO.
Smith, M. & Kenan, M. (2004). Alzheimer’s for dummies. New Jersey: Wiley Publishing.
Videbeck, S. (2011). Psychiatric-mental health nursing. New York: Kluwer.