Progress in Dementia Care as Treatments and Prevention Lag Behind

Chair exercise class at the Louis and Anne Green Memory and Wellness Center at Florida Atlantic University, Boca Raton. Photo courtesy of the Louis and Anne Green Memory and Wellness Center.

Dementia has long been a diagnosis dreaded by patients and families, as there is no cure. Despite decades of effort, scientists have had little success in developing effective treatments or methods to prevent or slow down the characteristic brain deterioration.

Nearly 6 million people in the United States, including about 14% of the population ages 71 years and older, are afflicted. Dementias, including Alzheimer disease, are among the most common causes of disability and dependency in older adults and projections of the actual number of Americans with dementia—as much as 13.8 million by 2060—suggest rapid growth as the population ages.

Some progress, however, has been made in understanding symptoms and progression of dementias. Recent studies have also shed light on potentially modifiable risk factors, identified new methods of diagnosis, and explored ways to slow disease progression and improve patients’ quality of life. Among […]

2022-06-15T10:13:05-04:00June 15th, 2022|family caregiving, Nursing|0 Comments

Becoming a Family Caregiver

Photo by Judith E. Bell, via Flickr.

For me, the saga began six years ago, when I offered to help a family member with some spring cleaning. I knew his place was a mess, but attributed this, stereotypically, to a single man’s lack of interest in housekeeping.

When I dove into the work, I was first puzzled and then fearful at what I found: hundreds of pieces of unopened mail, years old, randomly stacked around the apartment; threatening letters from the Internal Revenue Service; correspondence from the city about a tax lien on his condominium. This, in the home of a man who, as an actor and writer, memorized scripts in two languages, had served on the national board of his union, and could solve complicated math problems without using a calculator. Clearly, something was wrong well beyond the state of his apartment.

In AJN’s September original research article, “The Experience of Transitioning to a Caregiving Role for a Family Member with Alzheimer’s Disease or Related Dementia,” Kathleen Czekanski notes that “caregivers often assume the role of caregiving before they quite realize they are doing so.” In this qualitative study, Czekanski set out […]

2017-09-01T08:54:00-04:00September 1st, 2017|nursing research|0 Comments

AJN September Issue: Family Caregivers and Alzheimer’s, Older Adults and Driving, C. Diff. Prevention, More

The September issue of AJN is now live. Here are some articles we’d like to bring to your attention.

CE: Original Research: The Experience of Transitioning to a Caregiving Role for a Family Member with Alzheimer’s Disease or Related Dementia

This qualitative study explores the experiences of people who transitioned to the role of caregiver for a family member with Alzheimer’s disease or a related dementia. Vivid interview excerpts illuminate the inner struggles caregivers may experience as they navigate a radically changed existence as well as the strategies that have helped them find their way.

CE: Can Your Older Patients Drive Safely?

Many older Americans depend on their cars for independence and connection to the outside world. What are the driving risks associated with advanced age? What behaviors and situations put older drivers at greatest risk, and what are the key indicators of an older patient’s ability to drive safely? Nurses are in a position to raise patients’ awareness of these risks and inform them about transportation alternatives.

Six Things You Can Do Today to Prevent Hospital-Onset C. Difficile Tomorrow

What changes can you make in your practice to prevent transmission of this common bacterial infection?

Lessons Learned from Litigation: Legal […]

2017-08-25T09:03:28-04:00August 25th, 2017|Nursing|0 Comments

Watching a Friend Fade Away: A Nurse’s Account of the Progress of Dementia

Illustration by Eric Collins, ecol-art.com. All rights reserved. Illustration by Eric Collins, ecol-art.com. All rights reserved.

By Jacob Molyneux, senior editor

Alzheimer’s disease and dementia have been in the news. There have been major movies about what’s it’s like to suffer the gradual loss of the ability to understand and to negotiate the world around us, with leading roles played by stars like Julianne Moore. The challenges of caregiving are receiving increasing attention, as are the growing pressures on our medical system. Every month there’s a report of a new potential cure, or a potential cause, or ways we might be able to fend off the illness through exercise, mental calisthenics, diet, and medications.

The January Reflections essay, written by Deborah Lane, a critical care nurse and community volunteer in St. Augustine, Florida, is called “Watching a Friend Fade Away.” Here’s the opening paragraph:

Frankie was a fast wit, a ginger-headed joker, impeccably dressed, and the first to laugh. She was a master’s-educated teacher who developed programs for at-risk teens, teaching pregnant high school students skills for employment and effective childcare. She loved to cook and her home was warm with beautiful arts and crafts she had made. She was a wonderful friend. Disease changed it all.

The author brings the perspective of both a loving friend and a nurse to this short, beautifully told account of the changes in her friend over the years, the efforts of two couples to keep spending […]

A Nurse Ethicist’s Analysis of a Recent Nursing Home Sexual Consent Case

By Douglas P. Olsen, PhD, RN, associate professor, Michigan State University College of Nursing in East Lansing, associate editor of Nursing Ethics, and a contributing editor of AJN, where he regularly writes about ethical issues in nursing.

scales of justice/by waferboard, via Flickr scales of justice/by waferboard, via Flickr

An 78-year-old retired state legislator and farmer in Iowa is currently on trial for having sex with his wife, who has severe Alzheimer’s disease, in her shared room in a nursing home. He has been charged with rape.

The case highlights two ethical questions or conflicts:

  • When is protection needed and when is it intrusive and harmful?
  • What are the mental abilities required to consent to sex?

Consenting to sex is not the same as informed consent for treatment. In treatment, a clinician obtains consent to act on (treat) the patient in a way that will benefit the patient. By contrast, proper consent for sex is mutual and both parties benefit.

To extend the comparison: a patient’s decision to consent to treatment is generally made by balancing the benefits, harms, and risks to the individual patient. The decision to engage in sex often involves consideration of another’s satisfaction—it is not unknown for one spouse to agree to sex to please the other, even though he […]

2016-11-21T13:02:41-05:00April 21st, 2015|Ethics, Nursing, nursing perspective, Patients|4 Comments
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