Tips for Caring for Someone With Alzheimer's/Dementia: Nursing Care Tips for a Patient with Alzheimer's/Dementia

How does one care for a patient diagnosed with Alzheimer’s/dementia? 

With Alzheimer’s disease, there is mild to severe memory loss, that gradually increases and affects the way a patient functions, on a day-to-day basis. Coupled with increasing, cognitive impairment, leading towards the collective symptoms of dementia, there may be evidence of varying degrees of the loss of touch with reality.

At times, it may be difficult to separate the symptoms of Alzheimer’s disease, from the symptoms of dementia. Being aware of this is important, particularly in terms of patient care.

Here are some nursing care tips for a patient diagnosed with Alzheimer’s/ dementia.

First, always identify your patient correctly, as there may be partial or complete loss of self-identity on the part of the patient.

Memory loss, confusion and disorientation result in the loss of a patient's identity. He or she may not know, recognize or be able to give you his or her name. This might also include his or her date and place of birth, social insurance or social security number. He or she may not respond to the name that you use to identify him or her.  

Speak to the patient directly, always using his or her correct name in order to continue to re-familiarize the patient with his or her correct identity.        

Check the patient’s identification bracelet carefully, before administering any medications or treatments. If you do not know this patient and there is no identification bracelet on him or her, find someone, preferably a professional medical person or a family member, who can identify this patient correctly. Make certain that he or she has appropriate identification to avoid the recurrence of this kind of a scenario, in the future.        

This patient may appear to be confused with regard to both time and place. He or she may not be comfortable with his or her surroundings, particularly if they are relatively new. The patient may show evidence of feeling displaced or lost, even in an environment that he or she should recognize. Document all increasing evidence of memory loss, confusion or disorientation.

Note that Alzheimer’s disease coupled with dementia can result in extremely aggressive behavior, even though the patient usually appears to be non-aggressive. Document all evidence of increasing aggression. 

Fear or paranoia may surface at any time and be manifest in terms of aggressive words or actions, on the part of the patient. Unexpected or inappropriate behavior may occur. Document aggression and inappropriate behavior, as these may become recurrent patterns of behavior. 

Always speak to the patient politely, gently and kindly, as he or she may still comprehend what you are saying, even though he or she is not able to respond to it verbally. Document whatever indicates the patient does not comprehend what you are doing or saying.  

Patient safety, as well as the safety of others, is extremely important. The patient may need one-on-one care. The use of restraints may be necessary in order to protect the patient, as well as others. This patient may require medication or admission into a medical care facility or unit where he or she cannot harm family members or other patients.

A patient with Alzheimer’s disease, coupled with symptoms of dementia, may not recognize family members, at various times. This can depend upon the extent of the disease process, as well as the patient’s previous contact with family members. He or she may relate better to one person than to another.

The patient may continually try to escape from his or her surroundings or try to go home, even when he or she is in his or her own home. Memories of places where he or she has lived previously, even in earlier decades, may surface.

The patient may not always be able to complete his or her own personal care and may require varying degrees of assistance with the normal activities of daily living. This can include basics of patient care including meals, dressing, bathing and hair care. Do not ridicule or make fun of the patient, regardless of what he or she does.

Keep the patient clean, comfortable and warm. Note that the need for ongoing assistance will probably increase over time, as the disease progresses further. Be aware that no two patients will have exactly the same symptoms.

If it becomes necessary, feed the patient carefully, as he or she may choke on food or drinks. This has to do with possible, ongoing stroke activity and the loss of the ability to swallow properly. Offer only small amounts of foods and fluids, if difficulty swallowing is apparent. Document and report all evidence of this.

Fear or suspicion may surface with regard to medications, food or drinks, particularly something that is new or different. Do not force a patient to eat or drink. Offer that same food or drink later. Document the patient’s response to it, at that time.    

Speak softly and quietly to this patient. Be firm, but kind and gentle, at all times. Remember that a smile or a pat on the patient’s hand or back, can go a long way towards keeping the peace.

Note that this patient may repeatedly lose or misplace his or her glasses, dentures and other personal belongings. He or she may hide things in unusual or unexpected places. The patient may take or steal personal property that belongs to others, thinking that these items are his or hers, so make certain that the personal property of patients is identifiable. 

Try not to argue or fight with this patient, as this will only increase his or her aggressive tendencies.  Abuse of patients is never acceptable.    

Listen carefully to this patient, as he or she may try to tell you things that are important to him or her, even though he or she may not be able to speak properly. Note whether the patient is able to hear or see properly. He or she may lie to cover up memory loss.

Find appropriate, interesting and fun things that the patient can do, at various stages of this disease and reward him or her appropriately, for trying to do them.

Find entertainment that the patient enjoys, as a happy patient is much easier to take care of. Many patients enjoy listening to quiet, classical music or watching family-oriented movies. Avoid television programs that may be upsetting to the patient.

With these nursing care tips in mind, know that looking after a patient with Alzheimer’s dementia is often a challenge. It can become easier if one recognizes the reality that this patient will respond to loving, kind and compassionate nursing care administered in a positive way, even during the later stages of his or her disease.