Thursday, May 7, 2009

Nursing Care Plans for Alzheimer's Disease

Alzheimer's disease is a progressive degenerative disorder of the cerebral cortex that accounts for more than half of all cases of dementia. An estimated 5% of people older than age 65 have a severe form of this disease, and 12% suffer from mild to moderate dementia. Alzheimer's disease is a slowly progressive disease of the brain that is characterized by impairment of memory and eventually by disturbances in reasoning, planning, language, and perception. Many scientists believe that Alzheimer's disease results from an increase in the production or accumulation of a specific protein (beta-amyloid protein) in the brain that leads to nerve cell death.

Causes For Alzheimer's Disease
The cause of Alzheimer's disease is unknown, The amyloid cascade hypothesis is the most widely discussed and researched hypothesis about the cause of Alzheimer's disease. The strongest data supporting the amyloid cascade hypothesis comes from the study of early-onset inherited (genetic) Alzheimer's disease. Mutations associated with Alzheimer's disease have been found in about half of the patients with early-onset disease. In all of these patients, the mutation leads to excess production in the brain of a specific form of a small protein fragment called ABeta (Aβ).
The cause of Alzheimer's disease is unknown, risk factors for alzheimer's disease:
  • Neurochemical risk factors for Alzheimer’s disease, such as deficiencies of the neurotransmitters acetylcholine, somatostatin, substance P, and norepinephrine
  • Environmental risk factors for Alzheimer’s disease, such as aluminum and manganese; trauma;
  • Genetic immunologic factors, autosomal dominant form of Alzheimer's disease associated with early onset and early death; this form accounts for about 100,000 deaths per year. A family history of Alzheimer's disease and the presence of Down syndrome are two established
  • Viral risk factors for Alzheimer’s disease such as slow-growing central nervous system viruses.
Complications For Alzheimer's Disease
  • Complications of Alzheimer's disease include injury from own violent behavior or wandering or unsupervised activity;
  • Pneumonia and other infections
  • Some time patient with Alzheimer's Disease refuses or forgets to eat; malnutrition and dehydration
  • Aspiration.
Nursing Assessment Nursing Care Plans  for Alzheimer's Disease
The onset of this disorder is insidious the initial changes are almost imperceptible but gradually progress:
  • Patient history shows very small changes, such as forgetfulness and subtle memory loss without loss of social skills and behavior patterns.
  • Over time the patient began experiencing recent memory loss and had difficulty learning and remembering..
  • General deterioration in personal hygiene and appearance and an inability to concentrate.
  • Difficulty with abstract thinking and activities that require judgment;
  • Progressive difficulty in communicating; and a severe deterioration of memory, language, and motor function that in the more severe cases finally results in coordination loss and an inability to speak or write.
  • Repetitive actions and experience restlessness;
  • Negative personality changes e.g. Irritability, depression, paranoia, hostility, and combativeness, nocturnal awakening, disorientation.
  • Suspicious and fearful of imaginary people and situations
  • Misperceives his environment
  • Misidentifies objects and people
  • Difficulty using correct words, possibly even substituting meaningless words. He may report that conversations with the patient drift off into nonsensical phrases. The patient's
  • Labile Emotions
Neurologic examination
  • Impaired sense of smell
  • Impaired stereo gnosis
  • Gait disorders,
  • Tremors
  • Loss of recent memory.
  • Positive snout reflex.
10 classic  signs of Alzheimer's disease:
  1. Memory loss
  2. Disorientation to time and place
  3. Difficulty performing familiar tasks
  4. Problems with language
  5. Poor or decreased judgment,
  6. Problems with abstract thinking
  7. Misplacing things
  8. Changes in mood or behavior
  9. Changes in personality
  10. Loss of initiative.

Alzheimer's disease test Diagnostic

  • Position emission tomography
  • Computed tomography scanning
  • EEG
  • Cerebrospinal fluid analysis
  • Cerebral blood flow studies may detect abnormalities in blood flow to the brain.
  • Neuropsychologic

Alzheimer’s disease therapy and Treatment
No definitive cure or treatment for Alzheimer's disease. Only focuses on attempting to slow progression of the Alzheimer’s disease, managing behavioral problems, implementing modifications of the home environment, and family support.

Nursing diagnoses Nursing Care Plans for Alzheimer's Disease
  • Bathing or hygiene self-care deficit
  • Constipation
  • Disturbed thought processes
  • Dressing or grooming self-care deficit
  • Feeding self-care deficit
  • Imbalanced nutrition: Less than body requirements
  • Impaired verbal communication
  • Ineffective coping
  • Risk for infection
  • Toileting self-care deficit
  • Disabled family coping
  • Interrupted family processes
  • Risk for injury

Nursing outcomes, Nursing interventions and Patient teaching Nursing Care Plans for Alzheimer's Disease HERE 

Other resource for Alzheimers Disease nursing care:

Alzheimer's Disease, An Issue of Nursing Clinics!

Cognitive Neuropsychology of Alzheimer's Disease!

Pharmacological Treatment of Alzheimers Disease!
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