Base your initial post on the paragraph below, your readings and research on this topic.
Alzheimer’s disease is a condition with increasing incidence in our population. There is
no differential diagnosis, so the onset of the disease may go unnoticed by others. By the
time the patient reaches the moderate stage of the disease, manifestations are quite
apparent to others and the required level of care often places tremendous strain on the
caregiver. Caregiver role strain is a nursing diagnosis that is frequently applied in the
situation.
After reading the above information, discuss the following points (minimum of 250
words):
Since patient wandering and confusion are common for the patient with moderate-to-
severe Alzheimer’s disease, what would the RN teach the family about maintaining a
safe environment? Provide three examples.
How would the RN adjust the teaching teaching based on the family’s educational level,
socioeconomic status or culture? Provide two examples
What are common symptoms of caregiver role strain?
Provide one nursing diagnosis statement (statement must include an actual nursing
diagnosis, related factor and as evidenced by) that may be appropriate for a patient
with moderate-to-severe Alzheimer’s disease.
Alzheimer’s disease
Since patient wandering and confusion are common for the patient with moderate-to-
severe Alzheimer’s disease, what would the RN teach the family about maintaining a
safe environment? Provide three examples.
The RN should teach the family that patients diagnosed with Alzheimer can comfortably live
in their homes, provided the safety measures are put in place. The family members must be
educated on ways Alzheimer disease causes changes in the patient’s brain and body
functions. This affects the patient reasoning, judgement, physical ability, behaviour, cognitive
functions and sense of time (Bridenbaugh, Monsch & Kressig, 2012).
The family should be taught on ways to identify the possible dangers. The hazardous areas
should be locked. Drugs and other chemical substances should be stored out of reach, in
lockable cupboards. The family must be ready for emergencies. This implies that they should
keep emergency phone numbers such as fire departments and local police helplines. The
family members should ensure that the safety devices are working. These include smoke
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detectors and carbon monoxide detectors and fire extinguishers. Walkways should be well lit
to prevent falls. All weapons such as guns or other types of weapons must be removed.
Basically, the home must be well lit, ventilated and free from hazards. The home should not
be too restrictive, but one that encourage social interaction and independence (Schneider,
2011).
To prevent the patient from wandering, the patient’s relatives and care givers should be
taught the following strategies. To start with, they should create a daily activity plan. This
helps identify the times of the day that wandering occurred. The patient must be reassured
whenever they feel lost, disoriented or abandoned. The care giver must refrain from using
correcting the patient using harsh voice. All patients’ basic need must be met. They should
not allow the patient to go places that trigger confusion and disorientation such as grocery
stalls, malls or other venues that are busy. The doors must remain locked, and keys including
car keys put out of sight. The patient must never be left alone i.e. they should always be
under supervision. If the main issue is night wandering, devices that signal motions should be
used (Lacey, Jones, Trigg & Niecko, 2012).
How would the RN adjust the teaching based on the family’s educational level,
socioeconomic status or culture? Provide two examples
Despite the increase emphasis on patient centred care, when it comes to coping strategies for
Alzheimer, the healthcare provider should focus on family centred care. In this case, the RN
must conduct a family assessment to understand patient structure as well as style. This helps
RN formulate effective teaching plan (Skoog, 2011).
To begin with, the RN should evaluate the barriers that would hinder the family ability to
deliver health care. This includes the ages, sex and health status of the family member. The
family socioeconomic status influences the teaching strategy. People from high
socioeconomic status are most likely to be educated, thus basic healthcare can be used during
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the teaching process. However, those from low income households tend to have low level of
education which determines people’s attitudes and perceptions of care. Additionally, some
family members lack basic knowledge of the disease. Cultural backgrounds could make some
patients to believe in folk medicine. These factors must be addressed when teaching the
patient’s family members (Trigg, Jones, Lacey & Niecko, 2012).
What are common symptoms of caregiver role strain?
The demands of giving care to Alzheimer patients are very taxing which can lead to care
givers strain and burnout. These are manifested through stress, anxiety, exhaustion, and sleep
disturbances. Other common symptoms of care giver role strains include changes in appetite,
depression, withdrawal and mood swings (Trigg, Jones, Lacey & Niecko, 2012).
Provide one nursing diagnosis statement (statement must include an actual nursing
diagnosis, related factor and as evidenced by) that may be appropriate for a patient
with moderate-to-severe Alzheimer’s disease.
Anxiety related to stress and situational crisis as evidenced by insomnia, restlessness,
memory loss, and cognitive functions deficits.
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References
Bridenbaugh, S., Monsch, A., & Kressig, R. (2012). How does gait change as cognitive
decline progresses in the elderly?. Alzheimer’s & Dementia, 8(4),
Lacey, L., Jones, R., Trigg, R., & Niecko, T. (2012). Caregiver burden as illness progresses
in Alzheimer’s disease (AD): Association with patient dependence on others and other
factors—Results from the Dependence in Alzheimer’s Disease in England (DADE)
study. Alzheimer’s & Dementia, 8(4),
Schneider, L. (2011). Agitation and Alzheimer’s disease. Alzheimer’s & Dementia, 7(4), S92.
Relationship between patient self-
assessed and proxy-assessed quality of life (QoL) and patient dependence on others as
illness progresses in Alzheimer’s disease: Results from the Dependence in Alzheimer’s
Disease in England (DADE) study. Alzheimer’s & Dementia, 8(4), P250-P251.