Disease Description
Nature
Alzheimer’s disease is a neurodegenerative disease that is diagnosed in old age. It is most often diagnosed after the age of 65, and cases of detection of senile dementia of the Alzheimer’s type at an earlier age are pretty rare (Alonso et al., 2018). The disease occurs due to abnormal accumulation of specific proteins in brain cells and the intercellular space. Settling in the gaps between nerve cells, amyloid plaques, and neurofibrillary tangles block the connection between them. It is impossible to slow down the death of cells, even if you consult a doctor at the first manifestations of the disease.
Signs
The signs of Alzheimer’s disease in women and men are generally similar, but they occur individually. The first manifestation of a disorder of brain activity in the elderly is a violation of short—term memory. This is followed by long-term memory loss, the ability to work, and speech disorders. Over time, speech becomes inhibited, and people cease to navigate in space and are unable to care for themselves.
Alzheimer’s disease is recognized by the World Health Organization as a global public health priority (Brandão et al., 2019). Despite significant progress in understanding the pathogenesis of AD and its conceptualization, it has not yet been possible to find adequate therapy for this form of pathology. The population of the WHO European region is aging at the fastest pace (Brandão et al., 2019). Therefore, age-related medicine here is the highest quality worldwide, including Alzheimer’s treatment.
Prevention
Since this is a progressive and incurable disease, prevention is ineffective and focuses on enhancing immunity and mitigating the symptoms of the disease. Therefore, the prevention of Alzheimer’s disease in the elderly is included in the traditional list of actions included in global policies regarding older people’s health. Among them are the formation and control of eating habits, such as following a diet, getting enough vitamins, and fighting obesity. Also, global policies aimed at combating the development of Alzheimer’s in the elderly include the prevention of cardiovascular diseases, intellectual and physical activity, and the fight against bad habits.
National Policies
National policies relevant to Alzheimer’s disease and older adults align with global health policy. Prevention of Alzheimer’s disease in old age and youth plays a vital role in maintaining health and sanity. Therefore, national policies are aimed at eliminating and minimizing risk factors in older people that contribute to the destruction of mental health.
As such, national policies consider all factors that impair the functioning of the circulatory system and the delivery of oxygen to the brain (Chang et al., 2020). Since Alzheimer’s is a degenerative disease of the brain, it is necessary to deal with prevention throughout life. However, national policies are also aimed at timely diagnosis of the disease, which is a highly effective method, as it allows for slowing down the progression of the disease.
Aging Nursing Theories
Today, several alternative theories partly contradict and partly complement each other. Modern biology devotes considerable attention to the problem of aging, and each year, new findings emerge that facilitate a deeper understanding of the mechanisms underlying this process.
Free Radical Theory
One of the aging nursing theories is the theory of free radicals (Gaugler et al., 2019). Its strong point is that the free radical theory explains the mechanism of aging and a wide range of associated pathological processes. For example, it explains cardiovascular diseases, weakened immunity, impaired brain function, cataracts, cancer, and even Alzheimer’s. According to this theory, the cause of cell dysfunction is the presence of free radicals, which are necessary for many biochemical processes. These are reactive oxygen species synthesized primarily in mitochondria, the cellular powerhouses.
The weaknesses of this theory are that, according to the theory of free radicals, older people need not only regular consumption of vegetables and fruits. Many substances that enter the body with food have an antioxidant effect, including vitamins A, C, and E. Therefore, older adults should include several cups of tea or coffee in their daily diet.
According to the theory, this will provide them with a sufficient dose of polyphenols, which are also good antioxidants (Gaugler et al., 2019). However, an excess of antioxidants – for example, in the case of an overdose of biologically active additives – is not only ineffective but can also enhance oxidative processes in cells. Nutrition, according to this nursing theory, may incorrectly interpret nutritional prevention of Alzheimer’s in older people.
Theory of Apoptosis
Another aging nursing theory is the theory of apoptosis. The strengths of this theory lie in its reliance on the latest genetic advances and its association with well-studied processes occurring in plants, which enables us to study it in greater detail. Apoptosis is the process of programmed cell death (Vichitvanichphong et al., 2019). As trees get rid of parts to preserve the whole, each cell, having passed its life cycle, must die, and a new one must take its place. Suppose a cell becomes infected with a virus, a mutation occurs, leading to malignancy, or its existence expires. In that case, the notit must die so as not to endanger the entire organism.
Unlike necrosis, the violent death of cells due to injury, burns, poisoning, or lack of oxygen caused by clogged blood vessels, during apoptosis, the cell is carefully self-disassembled into its constituent parts. Neighboring cells use their fragments as a building material. When dead mitochondria are too large, their decay products poison the cell and lead to its apoptosis.
The weakness of this theory is the lack of research conducted within its framework. Aging, from the perspective of apoptosis, results from more cells dying in the body than are born, and the dying functional cells are replaced by connective tissue. Therefore, the research that needs to be carried out involves searching for methods to counteract the destruction of cellular structures by free radicals (Vichitvanichphong et al., 2019).
Apoptosis aging nursing claims that old age is a disease that can and should be treated; the aging program of the body can be disabled and thereby turn off the mechanism that shortens our lives. The main reactive oxygen species that leads to the death of mitochondria and cells is hydrogen peroxide. However, the proposed SKQ drug, designed to prevent signs of aging, has not been tested successfully.
Person-Centered Care Theories
Henderson’s Nursing Theory
There is no single nursing theory specifically related to the healthcare of older adults worldwide. The principles on which they are based are different. For example, the basis of Henderson’s nursing theory is the concept of the vital needs of an older adult (Tanioka et al., 2019). Awareness of these needs and assistance in meeting them are prerequisites for the nurse’s actions to ensure the patient’s health, recovery, or a dignified end of life.
Orem’s Self-Care Deficit Nursing Theory
The Orem theory is based on the principle of inadequate care, also known as the nursing theory of inadequate care (Mudd et al., 2020). According to this model, an elderly patient is a single functional system with motivation for self-withdrawal. A person performs self-care regardless of age, whether healthy or ill, and the possibilities and needs for self-care should be balanced. According to this theory, every older adult must care for themselves to maintain their vital functions.
In the Orem model, a nurse is assigned a specialist role, ensuring the independence of a patient with Alzheimer’s. Nursing care is considered adequate when it maintains or restores a balance between opportunities and needs for self-care (Couto et al., 2018). Thus, Alzheimer’s disease, within the framework of this theory, causes insufficiency in self-care or lack of self-care. The assessment of the quality of care should determine the ability of an elderly patient with Alzheimer’s and his family to carry out self-care in the future.
The goal of nursing intervention in this nursing theory is to restore the balance between opportunities and self—care needs. If a patient with Alzheimer’s and his relatives and friends cannot maintain a balance between their needs and possibilities for self-care, and the needs of self-care exceed the capabilities of the person themselves. There is a need for nursing intervention.
References
Alonso, R., Pisa, D., Fernández, A. M., & Carrasco, L. (2018). Infection of fungi and bacteria in brain tissue from elderly persons and patients with Alzheimer’s disease. Frontiers in Aging Neuroscience, 8(117), 2325– 2333.
Brandão, M. A., Barros, A. L., Primo, C. C., Bispo, G. S., & Lopes, R.O. (2019). Nursing theories in the conceptual expansion of good practices in nursing. Revista Brasileira de Enfermagem, 72(2), 132– 140.
Chang, E. S., Kannoth, S., Levy, S., Wang, S. Y., Lee, J. E., & Levy, B. R. (2020). Global reach of ageism on older persons’ health: A systematic review. Plos One, 10(6), 116– 128.
Couto, A. M., Caldas, C. P., & Castro, E. A. (2018). Family caregiver of older adults and cultural care in nursing care. Revista Brasileira de Enfermagem, 71(3), 165– 172.
Gaugler, J. E., Bain, L. G., Mitchell, L., Finlay, J., Fazio, S., & Jutkowitz, E. (2019). Reconsidering frameworks of Alzheimer’s dementia when assessing psychosocial outcomes. Alzheimer’s & Dementia: Translational Research & Clinical Interventions, 5(24), 388– 397.
Mudd, A., Conroy, T., Feo, R., & Kitson, A. (2020). Where and how does fundamental care fit within seminal nursing theories: A narrative review and synthesis of key nursing concepts. Journal of Clinical Nursing, 29(124), 3652– 3666.
Tanioka, T., Smith, M. C., & Zhao, Y. (2019). Framing the development of humanoid healthcare robots in caring science. International Journal for Human Caring, 23(2), 112– 120.
Vichitvanichphong, S., Talaei-Khoei, A., Kerr, D., & Ghapanchi, A. H. (2018). Assistive technologies for aged care: Comparative literature survey on the effectiveness of theories for supportive and empowering technologies. Information Technology & People, 16(21), 1– 25.