Alzheimer’s disease (AD) is a chronic, progressive, degenerative disease of the brain characterized by deterioration in memory and other aspects of cognition

Alzheimer’s disease (AD) is a chronic, progressive, degenerative disease of the brain characterized by deterioration in memory and other aspects of cognition

Alzheimer’s disease (AD) is a chronic, progressive, degenerative disease of the brain characterized by deterioration in memory and other aspects of cognition

Alzheimer’s disease (AD) is a chronic, progressive, degenerative disease of the brain characterized by deterioration in memory and other aspects of cognition. The etiology of AD is unknown but is likely a combination of genetic and environmental factors. Pathologic changes associated with AD include neurofibrillary tangles, ?-amyloid protein plaques, loss of connections between neurons, and neuron death.

The initial manifestations of AD are usually related to changes in cognitive functioning. Patients may have complaints of memory loss, mild disorientation, and/or trouble with words and numbers. Memory loss includes both recent and remote memory as AD progresses and ultimately affects the ability to perform self-care.

There is no definitive diagnostic test for AD. The diagnosis of AD is made when all other possible conditions that can cause cognitive impairment have been ruled out. A definitive diagnosis of AD can be made at autopsy when the presence of neurofibrillary tangles and neuritic plaques are found. At this time there is no cure for AD. Interprofessional care is aimed at controlling the undesirable behavioral manifestations that the patient may exhibit and providing support for the family caregiver.

Objectives

Differentiate delirium from dementia.
Select signs and symptoms suggestive of elder abuse.
Discuss nursing responsibilities related to suspected elder abuse.
Discuss diagnostic tests used for Alzheimer’s disease (AD).
Identify relevant assessment data for a patient with AD.
Prioritize nursing care of a patient with AD.
Appropriately delegate nursing care of a patient with AD.
Describe the interprofessional care of a patient with AD.
Develop an individualized teaching plan for caregivers of a patient with AD.
Case Study

An older Hispanic woman is admitted to the emergency department (ED) by ambulance. The paramedics inform the staff that they were notified by an anonymous source regarding an older woman who “looked lost” in the neighborhood. When they arrived, they found her bleeding from scrapes on the palms of both hands and the anterior aspects of both knees. She would not tell them her name or where she lived, and she was mildly combative, batting them away from her as they approached. She has no identification.

In the ED she is disoriented, agitated, and suspicious of attempts to assess her. You observe that she has poor personal hygiene. She is wearing two different colored socks, and her shirt is inside out. She has extensive bruises circling her wrists and a large bruise on her left neck. Her gait is stable with no limb rigidity or flexor posturing. She denies any knowledge of her own health history, exclaiming, “I’m as healthy as a bat, and I can take care of myself!”

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Alzheimer's disease (AD) is a chronic progressive degenerative disease of the brain characterized by deterioration in memory and other aspects of cognition