Alzheimers Disease

Alzheimer's Disease
Name
Institution
Alzheimer's Disease
Pathophysiology Overview of Alzheimer’s
Alzheimer’s disease (AD) otherwise known as dementia is a condition that affects the brain making it hard for people to recall certain things. For a long time, clinicians have often stated that there exists a strong pathophysiology between that of normal aging and Alzheimer’s. There are pathologic hallmarks of Alzheimer’s found in aged people, but in certain cases these have also been found in perfectly healthy people. An example of this is in a study conducted in the United States where 76% of elderly patients that were perfectly healthy were found to have Alzheimer’s (International Psychogeriatric Association, 2013)
According to clinicians, Alzheimer’s affects the different processes that ensure that the neurons are functional. These processes are communication, metabolism, and repair. The progression of the disease starts when certain nerve cells in the brain become dysfunctional, lose touch with the rest of the nerve cells and finally die. The obliteration and demise of these cells bring about a loss of memory, personality transformations, as well as challenges in trying to complete the ordinary day-to-day tasks (Buhr, & White, 2012).
Research done by Buhr, & White (2012) has established that there is an accumulation of senile plaques (SPs) before the onset of Alzheimer’s. The disease is also accompanied by Neurofibrillary Tangles (NFTs) and the loss of neurons. Over the years, there has been widespread research that has been devoted towards explaining the configuration of SPs and NFTs to finds indications concerning the molecular pathogenesis and biochemistry of the disease. NFTs are mostly composed of the protein tau, which has a strong link to microtubules. In patients with Alzheimer’s, hyperphosphorylated tau gathers in the perikarya of the pyramidal neurons located in the brain. What has surprised most researchers is that the alteration of the tau gene does not lead to Alzheimer’s in certain families but instead leads to another type of dementia (US Centers for Medicare & Medicaid Services, 2011).
From the time that Alois Alzheimer’s discovered the disease, SPs have been known to comprise a substance that contains starch placed in the middle of the lesions. The starch like substance is in turn surrounded by a thin layer of neuritis and reactive glia that disappear after some time. In recent days, scientist have been able to characterize the protein as well as clone the gene encoding the precursor brain, thus bringing a lot of wealth in trying to demystify the disease. Despite these advancements, there is still a lot that remains unknown about Alzheimer’s disease (Buhr, & White, 2012).
Methods and Techniques used in the Assessment of Alzheimer’s
An effective diagnosis of Alzheimer’s should incorporate an assessment of the patient’s daily functioning as well as their cognitive behavior. The Katz Index of Independence in Activities of Daily Living (ADL) and the Functional Activities Questionnaire (FAQ) are the ones that are commonly used to assess the patient’s daily functioning. In general, the ADL test is used to monitor the patient’s daily activities such as bathing, dressing, going to the toilet, transfer continence and eating. This test is ideal as it helps in identifying the areas whether the patient needs assistance in conducting these six basic activities. Using the results from this scale, the clinician is able to determine whether the patient could be suffering from Alzheimer’s or not. The other tool that can be used to assess the patient’s daily functioning is the Functional Activities Questionnaire (FAQ). This test measures the ability of the patient to conduct certain day-to-day tasks, and the results can determine whether the patient has Alzheimer’s or not since the disease impairs the capability of an individual to undertake certain tasks. If the tests prove to be inconclusive, the clinician should turn to neuropsychological evaluation, which is known to provide a conclusive diagnosis (Sutor, Rummans, & Smith, 2011).
On the other hand, the tool that is used to measure an Alzheimer patient’s cognitive behavior is the Mini-Mental State Examination (MMSE). According to Madhusoodanan and Shah (2007), this tool has been designed as a realistic tool for grading the cognitive state of patients. This scale uses a set of 11 questions or simple tasks involving orientation, memory, attention and language to assess the cognitive state of the patient under examination. This tool is ideal for use in patients with Alzheimer’s as it is easy to administer and does not therefore require much time to administer. Clinicians should also adopt the use of the Geriatric Depression Scale (GDS) as well as the Single-Item Depression Indicator to measure the level of patient’s satisfaction with their life. The scorecard from these tests helps the clinician in determining the presence of Alzheimer’s in patients. This test is recommended as people who are developing Alzheimer’s have a higher likelihood of becoming depressed as compared to patients that are not (Burgio, et al, 2002) (Rabinowitz, et al, 2007).
Key Nursing Management Practices
Before any treatment of Alzheimer’s disease can begin, there is a need for a thorough assessment of the medical history of the concerned patient. This should be followed by an assessment of how the patient behaves in an attempt to put to an end any contributing illness. The contributing illnesses, in this case, might be inclusive of pain, urinary tract infection and in some cases pneumonia. There are various management practices that nurses can employ to help patients suffering from Alzheimer’s (Bharani, & Snowden, 2011).
Although there are many strategies that nurses can employ in caring for Alzheimer’s patients, the most crucial of this is maintaining a safe environment for the patient. Even at its early stages, Alzheimer’s hinders a person’s cognition (Dowling et al, 2007). This places the patient in a state where they are prone to hurting themselves or by things around them. To prevent this from happening, the nurse should ensure that the patient lives is secure to prevent them from falling or even wandering to areas where they can hurt themselves. These measures should also involve having proper lighting as well as ensuring that there is constant surveillance even as the disease gets in to the advanced stage (Deudon, et al, 2009).
The other management strategy that nurses can use to manage the disease is through ensuring that there is effective verbal communication. Ideally, communicating verbally is an ideal way of ensuring that patients pass across their needs. However, when this form of communication is hinder...