The Theory of Unpleasant Symptoms and Alzheimer's disease

This article evaluates the emergent fit of the Theory of Unpleasant Symptoms for Alzheimer's Disease (AD) clients in an effort to evaluate the usefulness of the theory in thinking about AD and planning nursing interventions. Qualitative data from a 3-year study on the range and diversity of behavioral symptoms in AD and published research, treated as textual data, illustrate the theory. Although the components of the theory appear blurred when used with AD client behavior, the theory is useful because it emphasizes the complexity and interaction of symptoms and the interrelationships among symptoms, influencing factors, and symptom consequences/performance outcomes. These interrelationships make assessment more challenging than when symptoms are considered individually. The importance of the caregiver and the social and environmental context, called situational factors in the theory, emerge as especially relevant in AD. When symptoms are examined in their entirety, and nursing interventions take the interactive nature of symptoms, influencing factors and symptom consequences/performance outcomes into consideration, interventions should be client specific and, therefore, more effective.