Nursing Care for Alzheimer’s Disease and Dementias: Early Detection & Planning
By Jessica Holbrook, MSN, RN
Alzheimer's disease is a degenerative disease that impacts a person's thinking, memory, and reasoning. This cognitive decline is largely caused by small abnormalities, so-called amyloid plaques, and tau tangles. It is thought that these plaques and tangles are a result of mutations in the tau gene or repeated damage in the brain. For nurses, understanding the nursing diagnosis for Alzheimer's disease is essential in supporting patients who are newly diagnosed.
Did you know that Alzheimer's disease is the most common cause of dementia in adults and is the seventh most common cause of death in the United States? Because it is so common, it is important to recognize the early signs of dementia and seek supportive care right away. To strengthen your nursing care for Alzheimer's Disease, consider our course Alzheimer Disease and Dementias: Early Detection and Care Planning.
Early signs of Alzheimer's Disease
Almost all cases of Alzheimer’s disease develop after a person turns 60 years old. Therefore, there are a few signs of aging to be aware of as your patients, or even loved ones, age. AARP provides helpful information about what to look for if you suspect your loved one is experiencing some form of dementia. Our course, Frontotemporal Dementia, also provides insight into the disease.
Memory loss
Memory loss is often one of the first signs that family and friends notice about a person who is developing Alzheimer’s disease. As dementia develops, a person may lose more and more memories and even begin to forget details of important events such as marriages or the births of children.
Personality changes or apathy
In many forms of dementia, sufferers develop personality changes and may become apathetic or depressed. Unfortunately, most personality changes associated with dementia make a person more impulsive, angry, or apathetic. If you notice that your patient is losing interest in things that they once loved, starts having angry outbursts, or becomes withdrawn, you might consider early dementia as a cause.
Misplacing important items
Almost everyone misplaces items occasionally. While being stressed or busy can make people more likely to lose their keys, dementia can exacerbate this problem. If you have a loved one with Alzheimer’s disease, you may notice that they are constantly misplacing important items, and you may need to come up with a system such as AirTags to help them keep track of things.
Communication problems
As Alzheimer’s develops, it can cause communication problems such as difficulty following a conversation, being unable to find the right words or items or how to describe things or misunderstanding intentions.
Repetition
You may notice that people with Alzheimer’s may ask the same question over and over or repeatedly tell the same story, forgetting that they had already asked or told the story.
Getting lost
While occasionally getting lost is a normal part of life for everyone, people with dementia often get lost in familiar areas such as their own neighborhood or even inside their own homes.
Difficulties with simple or everyday tasks
For those with dementia, simple tasks become complex, and everyday tasks can become difficult or even dangerous. Forgetting about a hot stove, failing to lock doors, losing important items, or experiencing difficulties operating a vehicle all present huge challenges to people with Alzheimer’s and other forms of dementia.
Risk factors
According to the Dementia Society, advanced age and family history are major contributors to the development of dementia and Alzheimer’s disease.
Other factors that may contribute to the development of Alzheimer’s disease are modifiable, meaning they can be managed by lifestyle modifications.
Modifiable risk factors for dementia include cardiovascular disease, stroke, diabetes, depression, head injury, and hypothyroidism.
Nursing Diagnosis for Alzheimer's Disease
Early detection and diagnosis can make a big difference in the way that dementia and Alzheimer’s disease are managed and treated. IT is important to be equipped with the knowledge of diagnosis and treatment options before coming up with a nursing care plan for Alzheimer's disease.
PET scans
A PET scan is one of the best ways to get an accurate diagnosis of Alzheimer’s disease. Experts at the Alzheimer’s Society explain that during a PET scan, the practitioner injects a special compound into the blood that attaches to amyloid proteins in the brain. When this compound lights up under imaging, practitioners can see exactly what is happening in the brain.
MRI
An MRI is another imaging technique that shows changes in the brain associated with Alzheimer’s disease. While it cannot detect amyloid proteins or tau tangles, radiologists using MRI technology are able to detect areas of the brain that are shrinking due to dementia or Alzheimer's.
DNA test
While a DNA test cannot confirm or predict an Alzheimer’s diagnosis, it can tell a person about their risk and may help medical providers piece together a diagnosis along with other information. It is important to note that while DNA testing can be informative, you can develop Alzheimer's without carrying the gene, and carrying the gene does not mean you will develop Alzheimer’s.
Spinal fluid analysis
Researchers at Colombia University have shown that the amyloid proteins found in the brains of people suffering from Alzheimer’s disease can also be found in spinal fluid. While this test is not definitive, it does give clinicians useful information.
Treatment options
Researchers and healthcare providers have yet to find a cure for Alzheimer’s disease. However, there are some treatment options available that can mitigate symptoms and improve functioning for people with this type of dementia.
The first line of treatment for Alzheimer’s disease is called cholinesterase inhibitors. These medications include:
- Donepezil (Aricept, Adlarity)
- Galantamine (Razadyne)
- Rivastigmine transdermal patch (Exelon)
These medications often provide the most benefit of any treatment option for those suffering from dementia and Alzheimer’s disease.
When cholinesterase inhibitors are not enough, another medication is called NMDA antagonists. These drugs work by blocking the toxic effects related to excess glutamate and preventing the breakdown of acetylcholine in the brain.
Supportive Nursing Care for Alzheimer's Disease
The best thing to do for people struggling with Alzheimer’s disease is to provide them with supportive nursing care for Alzheimer's Disease.
Supportive care for those with dementia and Alzheimer's focuses primarily on keeping them safe and helping them attain the highest quality of life possible. Reorienting people to time, place, and situation as frequently as possible helps them avoid feelings of confusion or being lost.
Patience also goes a long way in supporting those with dementia and Alzheimer's. Even as their memory fades, people with these disorders still need love, kindness, and human interaction. Helping them participate in the activities they enjoy also helps.
In the later stages of the disease, live-in care or an assisted living facility may be necessary. Families searching for an assisted living center should spend time interviewing the staff, looking at facility reviews, and talking to other patients to find out what kind of care is provided in the facility.
Interested in strengthening your expertise? See our entire Alzheimer's Disease and dementia course list below:
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