alzheimers disease studentppt2011

7/31/2019 Alzheimers Disease Studentppt2011

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Alzheimers Disease

Agnes DiStasi DNP, RN, CNE

NUR 310


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What is Dementia?

What is the difference in Delerium vsDementia?

Delerium superimposed on dementia

What is Alzheimers Disease?http://www.alzheimers.org/rmedia/adanimation.htm
http://www.alzheimers.org/rmedia/adanimation.htmhttp://www.alzheimers.org/rmedia/adanimation.htm


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Steps to getting a diagnosis of AlzheimersDisease

No single diagnostic test

AD diagnosis is 80 90% accurate

Definitive diagnosis of Alzheimers Disease isupon autopsy


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Is it Alzheimers?

Ten Warning Signs of Alzheimers Disease

Alzheimers vs. normal age-related

memory changes


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The Stages of Alzheimers Disease

Handout 7 Stages

Other ways to stage Alzheimers disease

3 Stages: mild, moderate, severe General divisions: early-stage, mid-stage,late-stage

http://www.youtube.com/watch?v=7wbYEK7O14E
http://www.youtube.com/watch?v=7wbYEK7O14Ehttp://www.youtube.com/watch?v=7wbYEK7O14Ehttp://www.youtube.com/watch?v=7wbYEK7O14Ehttp://www.youtube.com/watch?v=7wbYEK7O14E


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Alzheimers Statistics

A person with Alzheimers Disease will live anaverage of eight years and as many as 20 years ormore from the onset of symptoms.

Alzheimers Disease is the 6th leading cause of deathin the US. 6 million Americans currently have thedisease.

Women are more likely than men to develop

Alzheimers. 16 million Americans will have Alzheimers Diseaseby 2050 unless a cure is found.

The cost of diagnosing and caring for people withAlzheimers Disease currently stands at $14.8 million.


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Alzheimers Disease Myths

Normal aging

Senility

Nothing can be done

Mental illness

Family burden

Genetic (< 5% is truly familial)


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Communication

The person with Alzheimers Disease will exhibitchanges in his/her usual pattern of expressinghim/herself.

Communication changes progress and abilitydecreases as the disease progresses.

The person who is in communication with aperson who has Alzheimers disease must

remember that patience is a virtue!! Do not dispute unless safety issue.


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Challenging Behaviors

Assessment of the behavior

i.e. repetitive actions, wandering

Nursing Interventions for Specific Behaviors

If it isnt harmful, let it be

answer the person, use memory aids, respond to theemotion behind the behavior

clothespins and washcloths

Evaluate

is the repetitive action decreased if that is the goal? Are other interventions needed?


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Assisting the person who has AlzheimersDisease with personal care

Bathing - Toileting

Dressing - Dental Care

Grooming - Eating

Implications for acute care environment

Person-centered care in long term care


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Caregiver Issues

Feelings of inadequacy/ feeling overwhelmed

Withdraw from family, friends, activities

Worry that the person with Alzheimers is safe

Anxiety about money and healthcare decisions

Denial of the impact of the disease and its effects on thefamily as a whole

Grief or sadness that relationship has changed

Frustration/anger toward the person with Alzheimers

Health problems of their own

Alzheimers Association (2008)


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http://www.youtube.com/watch?v=q1BkfV2h09g&gclid=COvLo_rnlJ0CFRpdswodOR

x12A

http://www.youtube.com/watch?v=rsUlj2Ebc10&NR=1
http://www.youtube.com/watch?v=q1BkfV2h09g&gclid=COvLo_rnlJ0CFRpdswodORx12Ahttp://www.youtube.com/watch?v=67U6tA9v3zk&NR=1http://www.youtube.com/watch?v=q1BkfV2h09g&gclid=COvLo_rnlJ0CFRpdswodORx12Ahttp://www.youtube.com/watch?v=67U6tA9v3zk&NR=1http://www.youtube.com/watch?v=q1BkfV2h09g&gclid=COvLo_rnlJ0CFRpdswodORx12Ahttp://www.youtube.com/watch?v=67U6tA9v3zk&NR=1http://www.youtube.com/watch?v=rsUlj2Ebc10&NR=1http://www.youtube.com/watch?v=rsUlj2Ebc10&NR=1http://www.youtube.com/watch?v=rsUlj2Ebc10&NR=1http://www.youtube.com/watch?v=rsUlj2Ebc10&NR=1http://www.youtube.com/watch?v=q1BkfV2h09g&gclid=COvLo_rnlJ0CFRpdswodORx12Ahttp://www.youtube.com/watch?v=67U6tA9v3zk&NR=1http://www.youtube.com/watch?v=q1BkfV2h09g&gclid=COvLo_rnlJ0CFRpdswodORx12Ahttp://www.youtube.com/watch?v=67U6tA9v3zk&NR=1http://www.youtube.com/watch?v=q1BkfV2h09g&gclid=COvLo_rnlJ0CFRpdswodORx12Ahttp://www.youtube.com/watch?v=67U6tA9v3zk&NR=1http://www.youtube.com/watch?v=q1BkfV2h09g&gclid=COvLo_rnlJ0CFRpdswodORx12Ahttp://www.youtube.com/watch?v=67U6tA9v3zk&NR=1http://www.youtube.com/watch?v=q1BkfV2h09g&gclid=COvLo_rnlJ0CFRpdswodORx12Ahttp://www.youtube.com/watch?v=67U6tA9v3zk&NR=1


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Medications

Cholinesterase Inhibitors

Cognex

Aricept

Exelon

Razadyne

Cholinergics (Parasympathomimetics)

Slow the breakdown of acetylcholine

Effective in mild to moderate Alzheimers

VERY expensive


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NMDA Antagonist

Namenda N-methyl D-aspartate antagonist

Believed to regulate glutamate in the brain

Delays progression of some symptoms inmoderate to severe Alzheimers

Can be prescribed in combination withcholinesterase inhibitors

i.e. Exelon + Namenda

Aricept + Namenda


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Other Medications

Anti-depressants

Tranquilizers for severe agitation

Anti-oxidants such as Vit.E, anti-

inflammatories, and estrogen replacementtherapy in women are all currently being

studied


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Creative Storytelling

Timeslips method creativeexpression for people with

dementia through storytellingwww.timeslips.org
http://www.timeslips.org/http://www.timeslips.org/


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Music Therapy

Drumming Circles

Memories in the Making/ArtTherapy

Poetry


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Pain Management and Alzheimers Disease

ASPMN (2008)

Is pain alwayssubjective?

Pain behaviors to watch for

Pain assessment tools

Alzheimers Disease in the acute care setting

(Allen & Close, 2010)

NICHE Model


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Current Evidence

NHSwww.nurseshealthstudy.org

Insulin Levels and Memory (Okereke et al., 2006)

Stay tuned

Sleep Patterns and CognitiveFunction


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Diabetes and Alzheimers Risk

Relationship between diabetes and risk ofAlzheimers and other dementias (2011)

More than 1000 men and women subjects

over age 60

15-year study

People with diabetes were twice as likely to

develop Alzheimers within 15 years People with diabetes were 1.75 times more

likely to develop dementia of any kind

(Kiyohara et al., 2011)


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Additional Current Evidence

No relationship shown between statins anddecreased Alzheimers risk (Arvanitakis, 2008;Haan, 2009)

Drinking grape juice may help improve memory

function in older adults with early memorydecline (Krikorian, 2008)

NSAIDS may not protect cognitive function(ADAPT Research Group, 2008)

Vitamin E supplementation may lengthensurvival in Alzheimers Disease (AmericanAcademy of Neurology Annual Meeting, 2008)


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Additional Current Evidence

Atrial Fibrillation increases risk of AD

3045 subjects, 14 year study duration (Dublinet al., 2011)

Proton magnetic resonance spectroscopycan identify early changes in brain

chemistry linked to AD prior to cognitive

deficits (Kantarci et al., 2011 311 subjects in their 70s and 80s


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American Academy of Neurology www.aan.com Dementia/Alzheimers information

Alzheimers Association www.alz.org

Alzheimers Foundation of America www.alzfdn.org Excellence in Care Program
http://www.aan.com/http://www.alz.org/http://www.alzfdn.org/http://www.alzfdn.org/http://www.alz.org/http://www.aan.com/


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alzheimers disease studentppt2011

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