Alzheimer's disease: a disabling neurophysiological disorder with complex nursing implications

Alzheimer's Disease (AD) is a very complex and devastating disorder of the brain that affects over 2 million people in the United States, mostly over age 65. Approximately one-half are taken care of at home by family members; the remainder are in institutions. Nearly 120,000 deaths are attributed to AD annually. While biomedical research continues to make headway in uncovering factors related to the disease, the causes, and therefore, the treatment remain just beyond our reach. In the meantime, persons with AD, their family members, and professional caregivers must learn to cope with this disabling disease on a day-to-day basis while waiting for a breakthrough. AD is characterized by a gradual decline in mental status and functional abilities over an extended period of time, from as short as 1 year to as long as 10 years or more. Eventually, all components of cerebral functioning are altered, with the neuronal losses exhibited at the cognitive and behavioral level. The nature and degree of decline depends on the extent of the progression of neuronal deterioration and, therefore, varies widely from patient to patient. The complex interactional patterns of pathophysiological brain changes and the concomitant cognitive/behavioral manifestations present careplanning and caregiving dilemmas. On the one hand, it is our responsibility as nurses to treat patients and teach others to care for patients in the least restrictive environment possible, while maintaining a choice of options, promoting optimal functioning, and fostering independence in the patient.(ABSTRACT TRUNCATED AT 250 WORDS)