Pathophysiology - Alzheimer’s Disease

Alzheimer’s Disease

• More commonly seen in elderly geriatric clients
• Irreversible
• Recent memory loss
• client can recall events and activities of 10 years ago, but not 10 minutes ago
• Sundowner’s syndrome
• confused, disoriented behaviour that become noticeable after the sun goes down and during the night
• Wandering behaviour
• restlessness and activity-seeking behaviour; “the stalking of old haunts”
• Disorientation and inability to sustain intentions
• the person forgets what she or he set out to do
• Catastrophic reactions
• heightened anxiety occurring during interviewing or questioning, when a person cannot answer or perform
• Combative behavior

Geriatric Consideration

• The cardinal rule is: do not push too fast in getting information, assisting with activities of daily living, or insisting that the person socialize. Continued pressure and insistence on a task may result in combative behaviour
• Potential situations that can lead to combative behaviour are threats to self-image, new things or people in environment, illusions, pressure to remember, and direct confrontation

Group Modalities for Elderly Clients

1. Remotivation therapy – resocialize regressed and apathetic elderly clients
2. Reminiscing therapy – share memories, increase socialization, enhance self-esteem
3. Psychotherapy – alleviation of presenting psychiatric problems, promote ability to interact with others in a group, increase ability to make decisions and function more independently

Goals of Nursing Care

1. To provide a quiet, structured environment to increase consistency and promote feelings of security
2. To promote contact with reality
3. To promote diversion activities that enhance self-esteem

Nursing Interventions

• Aviod dependency,
• Establish routine for activities of daily living,
• Meet client’s physical needs
• Do not isolate client from others in the unit
• Provide handrails, walkers, and wheelchairs
• Do not change schedules suddenly
• Make brief and frequent contact
• Use concrete ideas in communication
• Maintain reality orientation by encouraging reminiscing
• Provide occupational therapy
• Maintains flexible schedule
• Recognize specific accomplishments
• Encourage family involvement and provide emotional support
• Devise methods for assisting client with memory deficits
• Provide large clock with oversized numbers and hands
• Large calendar, indicating one day at a time with month, day, year identified in bold print