Alzheimer’s Disease Nursing Care Plan &
Management
Description
● Alzheimer’s disease is an irreversible, progressive brain disease that slowly
destroys memory and thinking skills, and eventually even the ability to carry out the
simplest tasks. In most people with Alzheimer’s, symptoms first appear after age
60.
● Alzheimer’s disease is the most common cause of dementia among older people.
Dementia is the loss of cognitive functioning—thinking, remembering, and
reasoning—to such an extent that it interferes with a person’s daily life and
activities. Estimates vary, but experts suggest that as many as 5.1 million
Americans may have Alzheimer’s.
● Dementia involves progressive decline in two or more of the following areas of
cognition: memory, language, calculation, visual-spatial perception, judgment,
abstraction, and behavior.
,Causes
The cause of AD is unknown but knowledge about the hereditary links is growing. Patients
with Down syndrome eventually develop DAT if they live long enough. There is a
higher-than-normal concentration of aluminum in the brain of a person with DAT, but the
effect is unknown. A distinct protein, AZ 50, has been identified at autopsy in the brains of
DAT patients. This protein has been isolated from neurons that were not yet damaged,
suggesting that its presence early in the degenerative process might cause the neuronal
damage. The life expectancy of a DAT patient is reduced 30% to 60%.
Characteristics/ Signs and Symptoms
The disease course is divided into four stages, with progressive patterns of cognitive and
functional impairments.
Pre-dementia
Stage 1 is characterized by recent memory loss, increased irritability, impaired judgment, loss
of interest in life, decline of problem-solving ability, and reduction in abstract thinking. Remote
memory and neurological exams remain unchanged from baseline.
Early
Stage 2 lasts 2 to 4 years and reveals a decline in the patient’s ability to manage personal and
business affairs, an inability to remember shapes of objects, continued repetition of a
meaningless word or phrase (perseveration), wandering or circular speech patterns
(circumlocution dysphasia), wandering at night, restlessness, depression, anxiety, and
intensification of cognitive and emotional changes of stage 1.
, Moderate
Stage 3 is characterized by impaired ability to speak (aphasia), inability to recognize familiar
objects (agnosia), inability to use objects properly (apraxia), inattention, distractibility,
involuntary emotional outbursts, urinary or fecal incontinence, lint-picking motion, and
chewing movements. Progression through stages 2 and 3 varies from 2 to 12 years.
Advanced
Stage 4, which lasts approximately 1 year, reveals a patient with a masklike facial expression,
no communication, apathy, withdrawal, eventual immobility, assumed fetal position, no
appetite, and emaciation.
Diagnostic Examination
● Alzheimer’s disease is usually diagnosed clinically from the patient history,
collateral history from relatives, and clinical observations, based on the presence
of characteristic neurological and neuropsychological features and the absence of
alternative conditions.
● Advanced medical imaging with computed tomography (CT) or magnetic
resonance imaging (MRI), and with single photon emission computed tomography
(SPECT) or positron emission tomography (PET) can be used to help exclude other
cerebral pathology or subtypes of dementia.Moreover, it may predict conversion
from prodromal stages (mild cognitive impairment) to Alzheimer’s disease.
● Assessment of intellectual functioning including memory testing can further
characterize the state of the disease.Medical organisations have created
diagnostic criteria to ease and standardize the diagnostic process for practicing
physicians. The diagnosis can be confirmed with very high accuracy post-mortem
when brain material is available and can be examined histologically.
Primary Nursing Diagnosis
Self-care deficit related to impaired cognitive and motor function
● Outcomes. Self-care: Activities of daily living—Bathing, Hygiene, Eating, Toileting;
Cognitive ability; Comfort level; Role performance; Social interaction skills; Hope
Management
Description
● Alzheimer’s disease is an irreversible, progressive brain disease that slowly
destroys memory and thinking skills, and eventually even the ability to carry out the
simplest tasks. In most people with Alzheimer’s, symptoms first appear after age
60.
● Alzheimer’s disease is the most common cause of dementia among older people.
Dementia is the loss of cognitive functioning—thinking, remembering, and
reasoning—to such an extent that it interferes with a person’s daily life and
activities. Estimates vary, but experts suggest that as many as 5.1 million
Americans may have Alzheimer’s.
● Dementia involves progressive decline in two or more of the following areas of
cognition: memory, language, calculation, visual-spatial perception, judgment,
abstraction, and behavior.
,Causes
The cause of AD is unknown but knowledge about the hereditary links is growing. Patients
with Down syndrome eventually develop DAT if they live long enough. There is a
higher-than-normal concentration of aluminum in the brain of a person with DAT, but the
effect is unknown. A distinct protein, AZ 50, has been identified at autopsy in the brains of
DAT patients. This protein has been isolated from neurons that were not yet damaged,
suggesting that its presence early in the degenerative process might cause the neuronal
damage. The life expectancy of a DAT patient is reduced 30% to 60%.
Characteristics/ Signs and Symptoms
The disease course is divided into four stages, with progressive patterns of cognitive and
functional impairments.
Pre-dementia
Stage 1 is characterized by recent memory loss, increased irritability, impaired judgment, loss
of interest in life, decline of problem-solving ability, and reduction in abstract thinking. Remote
memory and neurological exams remain unchanged from baseline.
Early
Stage 2 lasts 2 to 4 years and reveals a decline in the patient’s ability to manage personal and
business affairs, an inability to remember shapes of objects, continued repetition of a
meaningless word or phrase (perseveration), wandering or circular speech patterns
(circumlocution dysphasia), wandering at night, restlessness, depression, anxiety, and
intensification of cognitive and emotional changes of stage 1.
, Moderate
Stage 3 is characterized by impaired ability to speak (aphasia), inability to recognize familiar
objects (agnosia), inability to use objects properly (apraxia), inattention, distractibility,
involuntary emotional outbursts, urinary or fecal incontinence, lint-picking motion, and
chewing movements. Progression through stages 2 and 3 varies from 2 to 12 years.
Advanced
Stage 4, which lasts approximately 1 year, reveals a patient with a masklike facial expression,
no communication, apathy, withdrawal, eventual immobility, assumed fetal position, no
appetite, and emaciation.
Diagnostic Examination
● Alzheimer’s disease is usually diagnosed clinically from the patient history,
collateral history from relatives, and clinical observations, based on the presence
of characteristic neurological and neuropsychological features and the absence of
alternative conditions.
● Advanced medical imaging with computed tomography (CT) or magnetic
resonance imaging (MRI), and with single photon emission computed tomography
(SPECT) or positron emission tomography (PET) can be used to help exclude other
cerebral pathology or subtypes of dementia.Moreover, it may predict conversion
from prodromal stages (mild cognitive impairment) to Alzheimer’s disease.
● Assessment of intellectual functioning including memory testing can further
characterize the state of the disease.Medical organisations have created
diagnostic criteria to ease and standardize the diagnostic process for practicing
physicians. The diagnosis can be confirmed with very high accuracy post-mortem
when brain material is available and can be examined histologically.
Primary Nursing Diagnosis
Self-care deficit related to impaired cognitive and motor function
● Outcomes. Self-care: Activities of daily living—Bathing, Hygiene, Eating, Toileting;
Cognitive ability; Comfort level; Role performance; Social interaction skills; Hope
