Alzheimer’s disease—or senile dementia of the Alzheimer’s type—is a chronic, progressive, irreversible, and degenerative brain/neurologic disorder that begins insidiously accompanied by profound effects on memory, cognition, ability for self-care and disturbances in behavior and affect (Smeltzer & Bare, 2004). Alzheimer’s disease (AD) is ubiquitous to the geriatric stage of the life of man. Patients with AD manifest not only progressive memory impairment, cognitive deficits and functional alterations but also a variety of neuropsychiatric disturbances such as agitation, aggression, hallucination and delusion. These symptoms ultimately affect up to 75% of individuals with dementia and, once present, tend to be sustained or recurrent (Street et al., 2000).

 Dr. Barnwell (Matt Barry) told Duke (James Garner) that “Senile dementia is irreversible. It’s degenerative. After a certain point, its victims don’t come back.” Duke believes, “She remembers doc. I read to her and she remembers. Not always, but she remembers.” After finding out about her illness, before the disease totally stole her memory, Allie (Gena Rowlands) wrote her love story in a notebook with an instruction “read this to me, and I’ll come back to you.”

–   The Notebook, 2004

Tomey & Alligood (2001), believed that a person strives to reach own goals—but not in the case of patients suffering from Alzheimer’s Disease with memory impairment, they may even forget what a goal is. It is the doctor and the nurse function to define what goal is appropriate for them. Patients as said to achieve their maximum potential through the learning process (Tomey & Alligood, 2001), but for AD, where learning is not only that easy but not possible as well; their actions are usually occur in concurrence with feelings—since feelings are not influenced by rationality (Tomey & Alligood, 2001).  It is thus the function of the nurse to utilize the therapeutic use of oneself and the knowledge about the concept of Alzheimer disease. Ability on education and communication skills is imperative to facilitate the teaching and learning process. Rehabilitation is a process of learning to live within limitations (Tomey & Alligood, 2001), but in the care of Alzheimer’s disease, rehabilitation can be achieved with the help and support of the care providers. The possibility is raised that a reconceptualization of the nurse can be a person whose effectiveness is enhanced through a sense of shared humanity with patients (Taylor, 1992).

Illness is directed by feelings-out-of-awareness—thus healing may be hastened by helping people move in the direction of self-awareness towards healing (Tomey & Alligood, 2001). The process of reflection, repetition, reminding and retelling the past will help the victims to have the chance of moving from the unlabeled threat of Alzheimer’s disease and geriatric conditions. Once people are brought to terms with their true feelings and motivations, they become free to release their own powers of healing and properly labeled threat with which helps people deal constructively (Tomey & Alligood, 2001). By promoting self-awareness, the nursing process will be easy and feasible.

Nursing Care Plan for Alzheimer’s Disease


Doenges, Moorhouse & Curr (2008); Smeltzer & Bare (2004)

Nursing is helping the clients to move in the direction of self-awareness (Anonuevo et al., 2000), in AD cases—nurse-patient interaction, therapeutic and safe environment, nursing care and psychological interventions such as counseling, reflections, repetitions, reminding and retelling will help the AD victims bring back to health, may be not to the old health-self she had before but be able to achieve her potentials after the disease. Keys to the nursing process are encouragement of self-awareness, changes in behavior and reflections. In acute or chronic biological/psychological illness, patients need medical interventions—as the illness decreases, so to the need for medical services. However, this decrease, in turn, necessitates an increase in the requirement for nurturing and rehabilitative nursing. The moment the crisis is addressed, the need for medical intervention is replaced with the need for nurturing, support and education. It is thus argued that post-crisis patients’ needs are reasonably a nursing concern.

References:

  • Anonuevo, C.A. et al. (2000). Theoretical Foundations of Nursing. Philippines: UP Open University, 104–105, 22–36, 156–167, 169–178. Doenges, M.E., Moorhouse, M.F. & Curr, A.C. (2008).
  • Nurses Pocket Guide: Diagnoses, Prioritized Interventions, and Rationales, 11th ed. Philadelphia: F.A. Davis. Smeltzer, S.C. & Bare, B.G. (2004). Brunner & Suddarth’s Textbook of Medical-Surgical Nursing, 10th Ed., 205–211; 2075–2092; 181–182. PA: Lippincott Williams & Wilkins.
  • Street, J.S. et al. (2000). Olanzapine Treatment of Psychotic and Behavioral Symptoms in Patients With Alzheimer Disease in Nursing Care Facilities: A Double-blind, Randomized, Placebo-Controlled Trial. Archives of General Psychiatry, 57, 968–976. Taylor, B.J. (1992).
  • From Helper to Human: A Reconceptualization of the Nurse as Person. Journal of Advanced Nursing, 17(9), 1042–1049. Tomey, A.M. & Alligood, M.R. (2002).
  • Nursing Theorists and Their Work. 5th ed. Missouri: Mosby, 136–139, 98–108, 501–517, 299–316.
She is currently working as a medical-surgical nurse at Ministry of Health, Sultanate of Oman. A writer, blogger, researcher, correspondent and publication consultant for nursing journal and health-related educational websites. Her field of specialization focused on Intensive Care and Emergency Management. She is now taking up MAN major in Adult Health Nursing at the University of the Philippines Open University. A nursing professor for 8 years in the Philippines and served as a staff nurse at UST hospital. A caring and devoted nurse who introduced a “Pinay Nightingale” in the land of the pharaohs. A nurse by profession, an educator by devotion and a writer / researcher by passion.