How to Handle a Patient With Alzheimer's Disease
Marijke Durning | NursingLink
Nursing the Patient
Regardless of our feelings of how Molly ended up in our care, it’s up to us to set those feelings aside to focus on the patient at hand. We’ve all seen what these traumatic situations can do to the fragile mental state of someone with Alzheimer’s, which makes the care these patients get even more important.
The nursing staff is on the frontline when it comes to patients who have AD. Other than the patient’s family, nobody else gets as close or as intimate with the patients. The day-to-day nursing care brings a sense of familiarity between the patient and the nurse. Often, it is members of the nursing staff who sense when deterioration is happening or when something just isn’t right.
Home Care of Someone with AD
With AD, knowing that that “something just isn’t right” feeling isn’t always something you can put your finger on. For someone who is physically ill, when something’s wrong it’s often obvious – the patient has more pain, they have a high fever, or they’re hypotensive. But, if someone like Molly deteriorates, the changes are more subtle, making it difficult to identify exactly what’s the problem. And this is where a regular caregiver, a nurse who knows Molly well, is invaluable.
Of course, a home health nurse knows that a patient like Molly is slowly losing her mental competence. But when he goes to see her, she’s as pleasant as can be. She likes to talk about her kids, long grown and moved away, and her job as a teacher many years ago.
The nurse performs his tasks and assessments as Molly tells him about a school recital gone wrong many years ago. At times, he may be the only person who will really listen to Molly, because her family just has heard this story so many times, that they tune her out now.
Caring for a patient with AD at home can be a long, drawn out process, or it can end quickly. As patients like Molly deteriorate slowly, there may come a time when the home health nurse has to start making plans for when Molly can’t live alone any longer. Here is where the nursing job may get tricky: What if Molly doesn’t want to leave?
It would almost be better if something drastic were to happen, making it easier on the family and patients like Molly to accept the transition to an assisted living facility or long-term care hospital. While we don’t wish harm on our patients, if Molly became suddenly ill (developing severe pneumonia, or falling and breaking a bone for example), then she wouldn’t have a choice at all and would be sent to a hospital.