Alzheimers patient’s symptoms are often labeled as “behaviors” and may go untreated or treated incorrectly. Many times these patients reside on an “Alzheimer’s unit” in a long term care or speciality facility. They are monitored by certified nurses aides and nurses on the unit. The nurse on the unit must be able to identify changes in status and communicate with the physician and family to determine the cause.
There are many factors that may inhibit an accurate assessment or diagnosis. The staff may be new and not know the patient’s well enough to recogonize a “change”. The doctor may get the wrong information or not enough information from the nurse reporting it. On a busy unit, the staff may not have enough time during the shift to perform an accurate assessment or identify a slight change. When subtle changes are ignored or unnoticed they may turn into behaviors as the patient does not know how to communicate them. At this point the patient is causing a “disruption” on the unit and interfering with the daily routine or care of others and the reporting nurse only communicates the “new behavior”. Often the incorrect information leads to unnecessary antipsychotic medications being added. These medications carry their own side effects and can actually lead to more behaviors at times.
Identifying the root cause is very important for accurate treatment. It can be challenging depending on the stage of Alzheimer’s and severity of confusion. This is why it is very important for the family to be involved in the daily care. They know the patient best and may notice these slight changes in condition before the staff will. Maintaining consistent staff on the unit that are appropriately trained is a big factor as well. Routine exams, laboratory tests, and monitoring of medications aide in performing an accurate assessment and determining root causative factors. One main symtom that is overlooked during the assessment is pain. The patient may be experiencing pain and not able to communicate it except by “acting out”. Basic needs should be ruled out as well such as thirst, hunger, temperature, toileting, or hygiene needs. More assessments and tests may be needed to aide in an accurate determination. Behavior changes do occur as well and if no other symptoms are identified may require treatment.
There are many avenues of education available for those interested in learning more about the disease. There are also support groups for families of Alzheimers patients. These are just a few basic steps to help families stay involved and loved ones to remain comfortable during the stages of this debilatating disease.