Alzheimer's Disease

 

Alzheimer's disease, named for the doctor who first described the condition, Dr. Aloios Alzheimer in 1906, has an incidence rate that increases with age and affects thirty-two percent of people ages eighty-five years and older, two-thirds of those being women (Jett, 2020). The higher incidence rate in women of older ages is only because more women survive to eighty-five than men. Alzheimer's disease is a brain disease that affects a person's mental abilities and progresses in stages. According to Jett (2020), there have been advances in genetic science that have provided us with the knowledge that specific genes are related to the development of Alzheimer's disease. Symptoms start with memory loss as the stages advance. Diagnosis is often based on the decline of functioning, slow onset of symptoms, and a slow decline of mental abilities (Jett, 2020). The use of magnetic resonance imaging (MRI) can be used in combination with the changes taking place to diagnose this disease.

Alzheimer's disease is a progressive disease meaning it will continue to get worse over time. There are three phases or stages of the disease, each having various symptoms and therapies as the disease progresses. The first stage of Alzheimer's disease is considered early stage and is mild. During the early stage, the person will still function independently, maintaining the ability to live independently and continue to drive a vehicle (Alzheimer's Association, n.d.). During this early stage, the person will usually notice their memory is not the way it used to be. They may have difficulty remembering names or forgetting material they just read. It becomes more difficult for them to stay organized, and they will often misplace valuable items they usually would not lose.  Family might start noticing something is wrong. It is crucial to start financial and medical planning during this stage while the person can still help in decision-making (Alzheimer's Association, n.d.). The second stage is usually the longest stage and can last for several years. This stage is the middle stage or moderate stage. It is marked by increased confusion, the inability to tell one's history, the inability to dress according to the weather, displays of frustration and anger, loss of bladder control, loss of ability to remember the what day it is, and wandering or becoming lost in familiar places (Alzheimer's Association, n.d.). During the moderate stage, it is crucial to help the person maintain as much independence as possible (U.S. Department of Health and Human Services, n.d.).  Allowing the person simple choices to maintain at least some control in their lives is essential. Offering options like, "Do you want to wear the green shirt or the blue shirt today?" allows the person to make choices without feeling overwhelmed with too many options.  Mental cognition and being able to perform daily living activities are positively correlated (Clemmensen et al., 2020). As the disease advances, the person will start to lose the ability to dress, toilet, and groom themselves. It is important to allow the person to perform as many activities of daily living tasks as possible to help maintain the abilities. During this stage, safety can become a concern if the person wanders and gets lost. They might turn on the stove and forget to turn it off or attempt to drive a vehicle if they have access to one. Caregivers should try and seek respite when feeling fatigued. Caregiver burnout can lead to unintentional abuse or neglect of the person with Alzheimer's disease.  Reminiscence therapy has been shown to decrease the rates of depression during the moderate stage of Alzheimer's disease (Li et al., 2020). Talking about the past and remembering the positive parts of one's life can help reduce the chances of depression during the middle stage of Alzheimer's disease. The third and final stage is the late stage and is severe. During the final stage, the person will need total care for all activities of daily living. This person will need around-the-clock supervision as they will lose the ability to walk, dress, talk and even swallow. During the final stage, the family might want to seek support from hospice services and support groups. Therapeutic touch and relaxing music help the emotional wellbeing of the person with late-stage Alzheimer's disease (Alzheimer's Association, n.d.).

Local resources for families: https://www.alz.org/cnfl

24-hour helpline: 24/7 HELPLINE800.272.3900

References:

Clemmensen, F. K., Hoffmann, K., Siersma, V., Sobol, N., Beyer, N., Andersen, B. B., Vogel, A., Lolk, A., Gottrup, H., Høgh, P., Waldemar, G., Hasselbalch, S. G., & Frederiksen, K. S. (2020). The role of physical and cognitive function in daily living activities in patients with mild-to-moderate Alzheimer's disease - a cross-sectional study. BMC Geriatrics, 20(1), N.PAG. https://doi.org/10.1186/s12877-020-01926-9

Jett, K. F. (2020). Ebersole & Hess' toward healthy aging: human needs & nursing response (Tenth). Elsevier.

Li, M., Lyu, J., Zhang, Y., Gao, M., Li, R., Mao, P., Li, W., & Ma, X. (2020). Efficacy of Group Reminiscence Therapy on Cognition, Depression, Neuropsychiatric Symptoms, and Activities of Daily Living for Patients With Alzheimer Disease. Journal of Geriatric Psychiatry & Neurology, 33(5), 272–281. https://doi.org/10.1177/0891988719882099

U.S. Department of Health and Human Services. (n.d.). Alzheimer's Disease and Related Dementias. National Institute on Aging. https://www.nia.nih.gov/health/alzheimers.