Core Concepts for Nursing Management of Alzheimer’s Disease

nurse with elderly patient

Neurodegenerative processes like Alzheimer’s disease touch almost all adult specialties within the nursing profession. With a spectrum of degenerative symptoms that progress over time, Alzheimer’s creates a mixture of physical, psychological, and psychosocial challenges that demand a unique set of skills and knowledge from healthcare professionals.

Although there is no cure for Alzheimer’s disease, a variety of treatments and lifestyle changes can support these patients in maintaining safe levels of autonomy in the face of a frustrating loss of control. Nurses need to have a strong understanding of how Alzheimer’s can affect people they come into contact with in a range of situations, and be prepared to identify and adapt to the needs of their patients.

Courses like Fundamentals of Alzheimer’s Disease for Healthcare Providers can provide key insights that help them manage these challenging situations, but ongoing education is necessary to stay on top of developing trends. Here are some of the basics every nurse needs to know when managing patients with Alzheimer’s disease.

Alzheimer’s vs. Dementia

The terms Alzheimer’s disease and dementia are often used interchangeably, and while they are certainly related, they’re not the same.

Dementia is a general term that refers to an overall cognitive decline severe enough to impact a person’s ability to independently manage their daily activities. It can stem from a wide range of causes and produce substantially different outcomes.

Alzheimer’s disease is the most common type of dementia, accounting for about two-thirds of all cases of dementia in persons aged 65 and older. It is identified by a progressive impairment of cognitive functions like memory, language, comprehension, reasoning, and judgment, and is the sixth leading cause of death in the U.S.

Alzheimer’s Disease Symptoms

Nursing management of Alzheimer’s disease is largely dependent on an up-to-date working knowledge of symptoms. While there is no cure, the disease process is well understood, and the symptoms a patient expresses help classify them as having preclinical, mild (cognitive impairment) mild (dementia), moderate, or late-stage Alzheimer’s.

Preclinical and Mild

The preclinical and mild symptoms usually include loss of recent memories and an inability to form them. This is often followed by trouble with problem-solving, judgment, and executive functioning. Some patients exhibit a lack of motivation and disorganization, which can develop into problems with multitasking and abstract thinking.

Nurses may encounter these patients in any healthcare setting, and often for injuries or illnesses not related to Alzheimer’s. These patients may need extra support for managing medications, treatment, and navigating care facilities.

Moderate

As Alzheimer’s disease progresses, the patient will experience language disorder and impairment of visuospatial skills. Additional symptoms like withdrawal, apathy, agitation, wandering, and even psychosis, are common. More severe symptoms include difficulty performing learned motor tasks, sensory issues, sleep changes, and the loss of fine and gross motor skills.

Patients with moderate Alzheimer’s are often easily identified by hospital staff or previously diagnosed. Ideally, they will be accompanied by a family member, friend, or caregiver, and will require substantial assistance throughout the healthcare process.

Late

In the late stage, patients typically require 24-hour care and may be completely unresponsive. This usually requires admission to a hospice or assisted living facility, and nurses working with these patients are often specialists or professional care providers.

Managing Alzheimer’s Care

Nursing management of Alzheimer’s disease is going to be dependent on the stage of the disease as well as any other chronic medical conditions a patient may be experiencing. Many patients with Alzheimer’s will be largely or partially independent, and supporting their autonomy while delivering effective care is often the route to the best possible outcome.

Because of this, one of the major steps in the nursing management of Alzheimer’s disease is the identification of deficits in self-care and gaps and the patient’s ability to maintain their safety. These opportunities can manifest through observed or reported problems in areas like hygiene, toileting, or eating, and finding a balance of independent and assisted care.

A well-rounded approach to nursing management of Alzheimer’s patients should also reinforce wellness across various areas of health. Attention to the person as a whole can set the foundation for a healthy approach to Alzheimer’s management and include interventions like:

  • Discouraging the use of drugs or alcohol that can further injure the brain.
  • Encouraging regular exercise in line with the person’s physical limitations.
  • Using communication that is clear and direct, and allowing for time to respond to limit frustration.
  • Discussing beneficial communication strategies with the patient’s family to enhance their involvement in the patient's care.
  • Establishing a routine around healthy sleep patterns and medication to support the management of any comorbidities.

 

All of these general points can be nuanced and require training to manage effectively. Courses like Alzheimer’s Disease, Dementia, and Cognitive Decline, an Introduction provide context and in-depth guidance for healthcare professionals when working with these patients.

Medications for Alzheimer's

Successful nursing management of Alzheimer’s disease sometimes includes the use of medications. Administering or supporting the patient in taking their medications as prescribed by the healthcare provider can be assisted by creating routines, as many of them are administered on a regular schedule to reach and sustain therapeutic dosing.

There are also specific medications that treat symptoms at different stages of Alzheimer's disease. While every patient’s pharmaceutical regime will be unique, common drugs nurses will encounter are things like cholinesterase inhibitors, medication for agitation, and even some antipsychotics to preserve brain function and modify behaviors.

Alzheimer’s Management Mistakes

In addition to providing quality nursing management of Alzheimer’s disease, it’s important to avoid certain pitfalls. Cognitive decline can often lead to frustration and depression in these patients, and avoiding the following can help achieve the best possible outcomes:

  • Arguing—the patient may have a limited ability to understand and it will lead to frustration.
  • Expecting all patients with Azlhiemer’s to act the same.
  • Shaming or blaming the patient for not remembering something.
  • Talking to them like they’re a child.
  • Doing everything for them, and promoting independence where appropriate.
  • Expecting medication to solve all the problems.

Enhance Your Nursing Management of Alzheimer’s Disease

Without clear causation and no cure, Alzheimer’s disease represents a complex disease process with best practices that will continue to evolve. The nursing management of Alzheimer’s disease demands the attention and support of patients and their families across a spectrum of symptoms that can progress for many years.

Nurses familiar with evidence-based management can support their patient’s health and happiness along the way, and Premiere is committed to providing the best evidence-based CE content to support them. Alzheimer’s Disease, Dementia, and Cognitive Decline, an Introduction and Fundamentals of Alzheimer’s Disease for Healthcare Providers created by Megan Arbour PhD, RN, CNM, CNE, and Trisha Mareno both offer essential information every healthcare professional can use to improve outcomes in every stage of the disease.

All of Premiere’s content is developed by industry experts and empowers nurses and healthcare workers to develop their careers and maintain professional certifications with high-quality online content.

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