Alzheimer’s and Delirium
What is it?
Alzheimer’s disease is a progressive, degenerative brain disorder that affects memory, thinking, and behavior. It is the most common form of dementia and is characterized by the gradual loss of cognitive functioning. The disease affects neurons in the brain, leading to their death and the formation of plaques and tangles, which disrupt communication between brain cells and ultimately lead to brain damage.
| Delirium is Curable | Alzheimer's (No Cure) | |
|---|---|---|
| Risk Factors | Acute/Sudden onset that may last from hours to days Hospitalizations ICU Polypharmacy Old age Stroke Surgery Restraints Electrolyte imbalances Infection Substance Abuse | A decline of function that occurs from months to years. Part of the umbrella term of dementia Genetics Head Injury with lasting effects Advanced age Poor lifestyle (inactivity, obesity, & poor diet) |
| Symptoms | Disorientation that occurs mostly at night ↓ Memory Anxiety and agitation Delusional thinking Lethargy Hypervigilance | Symptoms occur through stages: Mild: memory lapses, misplacing things, poor focus, can still care for themselves. Moderate: Now symptoms noticeable to others. Personality changes. Gets lost and wanders. Can do some ADLs. Short-term memory loss Severe: Needs help with ADLs, unable to walk, swallow, and may eventually die. |
| Nursing Interventions | Safety first Prevent harm to self Avoid restraints  Meet physical needs Anti-anxiety & Anti-psychotics Treat the cause: O2 for hypoxia, antibiotics for infection | Complex care is required May need extended care Optimize nutrition, weight & fluid status. Maintain quiet environment Cholinesterase Inhibitors: Do not cure. Just help with symptoms: Donepezil (Aricept), galantamine (Razadyne), Rivastigmine (Exelon). They prevent an enzyme called acetylcholinesterase from breaking down acetylcholine in the brain. They are cholinergis. As a result, an increased concentration of acetylcholine leads to increased communication between nerve cells. Communication: Speak slowly. Give one direction at time. Don't ask complex or open ended-questions. Ask simple questions. Face client when speaking.  |
