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Alzheimer’s Disease Nursing Guide

This clinical guide provides a quick reference for understanding Alzheimer’s disease, emphasizing nursing considerations using the nursing process. 

Content reviewed by Ann Dietrich, MD, FAAP, FACEP

Alzheimer’s Disease Overview

ICD-10 Code 

  • G30 - Alzheimer's disease

Alzheimer’s Disease Etiology and Epidemiology 

Alzheimer’s disease is a progressive neurological disorder and the most common cause of dementia. It is characterized by a continuous decline in cognitive, behavioral, and social skills, which affects a person's ability to function independently (Honig et al., 2018). The disease causes brain shrinkage and neuronal cell death. 

Alzheimer’s Disease Prevalence: 

  • Approximately 7 million people in the U.S. have Alzheimer’s disease, with 73% being 75 years or older. 
  • Of the 55 million people living with dementia globally, over 60% are estimated to have Alzheimer’s disease. 

Alzheimer’s Disease Symptoms: 

  • The primary sign is memory impairment, particularly the inability to recall conversations or recent events.  
  • As the disease progresses, individuals experience debilitating memory loss and a reduced ability to perform daily tasks (Aisen et al., 2017). 

Diagnosis 

Diagnosis involves gathering information from family members and performing various tests (Canter, 2016): 

History: 

  • Medical history 
  • Use of over-the-counter medications (including vitamins, herbs, etc.) 
  • Diet 
  • Ability to perform activities of daily living (ADLs) 
  • Changes in personality or behaviors 

Memory Tests: 

  • Assess attention, counting, language, and problem-solving skills

Diagnostic Tests: 

  • Blood and urine tests to rule out other medical problems 
  • CT scan 
  • MRI and PET scans to rule out other medical issues 

Definitive Diagnosis: 

  • Alzheimer's can only be definitively diagnosed post-mortem through brain tissue examination during an autopsy. 

Management 

There is no cure for Alzheimer’s disease. Therefore, management focuses on: 

Goals: 

  • Improving or maintaining quality of life 
  • Enhancing cognition, mood, and behavior 
  • Promoting a safe environment 
  • Encouraging social engagement 
  • Maintaining daily functioning 

Treatment: 

  • Medications can temporarily slow disease progression and alleviate symptoms, helping to improve or maintain independence for a time.  
  • Support programs are available for patients and their families. 

 

Alzheimer’s Disease Nursing Care Plan

Assessment 

  • Altered mental status 
  • Irritability 
  • Social withdrawal 
  • Decreased ability to perform ADLs 
  • Difficulty with numbers 
  • Misplacing items 
  • Behavioral changes and impaired decision-making 
  • Repetitive questioning 
  • Forgetting conversations 
  • Inability to multitask 
  • Difficulty identifying people, places, or things 
  • Criteria outlined by the National Institute on Aging and the Alzheimer’s Association  

Nursing Diagnoses/Risk For 

  • Dehydration 
  • Falls 
  • Infections 
  • Wandering 
  • Social Isolation 
  • Self-care Deficit 
  • Impaired Communication 
  • Disturbed Thought Process 

Interventions 

  • Collect baseline cognitive level. 
  • Assess the ability to read, write, and comprehend. 
  • Develop a daily routine. 
  • Allow rest time. 
  • Avoid reality checks. 
  • Provide time to respond to stimuli. 
  • Allow time for activities. 
  • Monitor weight. 
  • Assist with ADLs. 

Expected Outcomes 

  • Remain safe and free from injury 
  • Comfortably express needs 
  • Maintain weight 
  • Remain free from irritability 
  • Maintain or improve function 

Individual/Caregiver Education 

  • Regular checkups 
  • Healthy diet 
  • Sufficient rest 
  • Report behavioral changes 
  • Keep a daily schedule 
  • Avoid activities causing behavioral changes 
  • Speak slowly and allow time to respond 
  • Assist with ADLs 
  • Find local support groups 
  • Consider respite care when needed 

Alzheimer's Disease and Related Disorders: Approaches to Treatment

The goal of this course is to teach the healthcare team in acute care about treatment approaches to Alzheimer’s disease and other related disorders.

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Additional Information

Content Release Date 

3/31/2022

Content Expiration

12/31/2028

Course Contributor

Ann M. Dietrich, MD, FAAP, FACEP, Professor of Pediatrics and Emergency Medicine for the University of South Carolina School of Medicine Greenville, has over 30 years of experience in pediatric emergency medicine. Throughout her career, Dietrich has helped educate medical students, residents, fellows, and junior attendings, including as an educator at Ohio State University and the American College of Emergency Physicians. She also collaborated on several research projects, including one on concussions and one on improving mental healthcare for children. Dietrich helped develop guidelines on the impact of concussions on children and worked with trauma surgeons to enhance care for pediatric trauma patients.

References