Caring for Patients With Dementia and Alzheimer’s: Tips & Resources for Nurses
Nurses entrusted with the care of dementia and Alzheimer’s patients face unique challenges. This comprehensive guide offers insights into providing quality care for these patients while safeguarding your own well-being. Globally, over 55 million people are living with dementia. According to the World Health Organization, dementia, including Alzheimer’s disease, stands as a primary cause of disability for the elderly and ranks as the seventh leading cause of death. The demand for nurses equipped with the expertise and sensitivity to care for these patients has never been more significant.
Whether you are beginning your nursing career or focusing on gerontological nursing, this guide outlines the realities of working with dementia and Alzheimer’s patients. Additionally, it provides tips and resources to help you offer exceptional care to dementia patients while maintaining your own emotional balance in this demanding field.
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Dementia and Alzheimer’s: A Comprehensive Overview
While dementia primarily affects the elderly, aging alone doesn’t guarantee a diagnosis. Factors such as genetics, lifestyle choices, and underlying health conditions also contribute. Nevertheless, with the increase in life expectancy, dementia’s prevalence among the aging population presents a major challenge to caregivers and healthcare providers. Shockingly, one out of three seniors succumbs to some form of dementia. Notably, Alzheimer’s disease leads to more fatalities than both prostate and breast cancer combined.
—”One in three seniors dies of some form of dementia. Alzheimer’s disease causes more fatalities than prostate cancer and breast cancer combined.” – alz.org
According to Ann Kriebel-Gasparro, a faculty member in Walden University’s master of science in nursing program, dementia is not a specific disease but a cluster of symptoms. This encompasses various conditions affecting memory, problem-solving, and decision-making abilities. Cognitive function loss related to dementia symptoms impedes everyday activities such as driving, financial tasks, and independent living. Alzheimer’s, the most prevalent type of dementia, impacts 60-80% of all diagnosed dementia cases.
Recognizing Warning Signs and Symptoms of Dementia and Alzheimer’s
Given that initial warning signs can mirror typical age-related behaviors like forgetfulness or misplacing items, caregivers and family members may struggle to identify the symptoms.
Kriebel-Gasparro underscores that nurses trained in dementia and Alzheimer’s care with gerontological patients can provide effective medical attention for tracking and managing symptoms. Detecting dementia early and addressing concurrent health concerns can prolong independence and mitigate symptom progression.
The shared early-stage symptoms of dementia and Alzheimer’s include:
Symptoms of Dementia
- Changes in short-term memory
- Impaired judgment and decision-making
- Uncharacteristic behavior
- Difficulty with routine or familiar tasks
- Alterations in mood and personality
Symptoms of Alzheimer’s
- Challenges in planning and solving problems
- Losing track of time and dates
- Disorientation and difficulty recognizing familiar locations
- Visual perception issues, spatial relationships, and balance difficulties
- Trouble with speech or writing
The Nursing Role in Providing Care to Dementia and Alzheimer’s Patients
The global elderly population has grown consistently. The elderly not only enjoy increased life expectancy but also grapple with chronic conditions demanding specialized geriatric care. Consequently, the demand for Alzheimer’s and dementia nursing care continues to escalate. Nurses with gerontology expertise and training in these conditions play a pivotal role in helping patients sustain their quality of life and autonomy for as long as possible.
Given the absence of a dementia cure, patients depend on the care management provided by nurses in clinical and home-based settings. Nurses deliver direct patient care, easing the load on family members and other caregivers. A critical component of Alzheimer’s and dementia nursing care revolves around education and communication concerning treatments, symptom progression, interventions, and coordination of services with other specialists.
Nursing Responsibilities and Duties
- Develop comprehensive care plans and establish daily routines.
- Aid in patient self-care, including hygiene, eating, toileting, and exercise.
- Extend support with daily activities for patients with cognitive impairments or motor function deficits.
- Evaluate patient safety to prevent disorientation-related risks.
Address behavioral issues, anxiety, and anger. - Promote socialization time with family and friends.
Tips for Nurses Providing Care to Dementia or Alzheimer’s Patients
Among healthcare professionals, nurses tending to dementia and Alzheimer’s patients encounter some of the most formidable challenges. They must demonstrate patience and empathy as the disease advances while also prioritizing their own well-being. Practical suggestions can enhance patient care quality and reduce caregiver stress.
1. Effective Communication
As dementia progresses, Kriebel-Gasparro advises nurses not to assume a patient’s communication and comprehension abilities. Dementia and Alzheimer’s symptoms manifest differently in each person, particularly in the early to moderate stages. Patients deserve kindness and support, and communication should encompass:
- Direct one-on-one interaction with sustained eye contact.
- Patience and reassurance when patients err or feel embarrassed.
- Clear, simple queries requiring yes or no responses to minimize confusion.
- Avoidance of interruptions and arguments.
- Engagement in conversations in quiet spaces devoid of distractions.
2. Establish Routine Care Plans
The significance of routines and familiarity cannot be underestimated for dementia and Alzheimer’s patients. Creating care plans helps reduce restlessness, anxiety, and challenging behaviors. Before structuring a daily plan, nurses should familiarize themselves with their patients, considering their capacities, preferences, and aversions. They must account for optimal functioning times
during the day and moments requiring breaks or diversions.
Though standard care plans encompass set waking, sleeping, meal, and bathing times, they should remain adaptable to allow nurses to adjust and experiment with activities that bring joy and meaning. The most effective plans integrate activities linking patients to their pre-dementia lives, such as watching favorite shows. With disease progression, nurses should ensure that activities align with patients’ capabilities.
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When formulating daily plans, nurses should also prioritize their own self-care by including stress-reducing activities, such as music or walks.
3. Cultivate a Support System and Practice Self-Care
Nurses engaged in dementia and Alzheimer’s care often work with the same patients over extended periods, forming personal connections with patients and their families. As patients navigate disease stages, nurses may experience a range of emotions including anxiety, sadness, guilt, anger, and depression.
Managing self-care is crucial in handling these emotions. Left unaddressed, stress can lead to physical issues (headaches, high blood pressure) or emotional and behavioral changes (irritability, insomnia). If symptoms arise, nurses should seek guidance from medical professionals or mental health specialists. Proactive stress management through relaxation techniques and arranging temporary respite care with the patient’s family can be beneficial.
Many caregivers alleviate stress by connecting with peers and joining professional organizations. The Alzheimer’s Association offers networking opportunities and caregiving resources. ALZConnected, an online community, provides access to resources, programs, and support.
Nurses who prioritize their well-being are better equipped to provide consistent, high-quality care. It’s vital to recognize that patient needs evolve as dementia and Alzheimer’s progress. Nurses should prepare for these changes by accepting that their patients might require diverse healthcare options, including greater home care assistance or residential placement.
4. Engage in Ongoing Education
As the population ages and dementia cases rise, healthcare practitioners must stay updated on new treatments and techniques. Kriebel-Gasparro recommends professional development and continuous education focusing on dementia and Alzheimer’s care. She also suggests pursuing advanced practice nursing graduate degrees with adult-gerontology specializations in acute care or primary care.
Numerous organizations offer continuing education credits and certifications to keep nurses informed about treatment and care developments:
- The Gerontological Advanced Practice Nurses Association (GAPNA) offers a gerontological specialist certification. They also provide diverse continuing education options, covering cognitive degeneration and impairment signs, behavior changes, diagnosis, treatment, and management of dementia.
- The Portal of Geriatrics Online provides toolkits, competency-based case modules, continuing education courses, and geriatric nursing education materials.
- Engage-IL, managed by the University of Illinois at Chicago, delivers evidence-based training and geriatric continuing education modules. The platform offers free mobile apps for identifying behavioral dementia symptoms and links to activity toolkits and national support services.
5. Prepare for End-of-Life Care
Nursing care for dementia and Alzheimer’s patients becomes particularly vital in the advanced stages, marked by memory loss, depression, hallucinations, and psychosis. Kriebel-Gasparro underscores the significance of skilled nurses with profound dementia and Alzheimer’s knowledge at this phase. Nurses not only provide treatment but also aid families in end-of-life preparation.
While families might struggle with these discussions, nurses equipped with gerontology training can guide them through crucial decisions. Nurses can facilitate conversations about engaging elder-law attorneys and preparing documents like living wills, medical power of attorney, and end-of-life directives. Emotional support for families and recommendations for emotionally preparing for this stage are also crucial.
Resources for Dementia and Alzheimer’s Care
Numerous organizations provide educational materials, helplines, and diagnostic and treatment resources geared toward dementia and Alzheimer’s. The following resources exemplify the types of services available to nurses and caregivers.
Hartford Institute for Geriatric Nursing (HIGN) Geriatric Nursing Protocols and Symptoms
This interactive tool, featured on the HIGN website hosted by New York University Rory Meyers College of Nursing, empowers nurses to search for evidence-based nursing protocols for best practices based on conditions or symptoms. HIGN also offers healthcare providers continuing education courses, case study lessons, and webinars.
Alzheimer’s Association 24/7 Helpline
Operational 24 hours a day, this hotline staffed by specialists and master’s level clinicians extends decision-making support, crisis assistance, and education covering legal, financial, and treatment concerns. The hotline serves individuals with dementia, caregivers, families, and the general public, catering to speakers of more than 200 languages.
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Centers for Disease Control and Prevention (CDC) Caregiving Resources
The CDC’s Alzheimer’s Disease and Healthy Aging Program (AD+HAP) offers multiple resources to educate caregivers for older adults. The REACH OUT community-based action guide supplies tips, websites, and additional references.
Family Caregiver Alliance (FCA)
The FCA supports caregivers of dementia-afflicted adults through direct care assistance, assessment and care planning, legal and financial consultations, respite services, and other resources. The FCA provides support in several languages, including Spanish, Chinese, and Vietnamese.
Fall T.I.P.S.
The Fall TIPS tool enhances dementia patient safety in hospitals by engaging patients and families in preventing and mitigating falls and addressing underlying causes. The website aids nurses in implementing Fall TIPS training, assessing safety outcomes, and offering feedback to clinical staff.
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