GUIMARÃES, Mateus Henrique Dias [2]
GUIMARÃES, Mateus Henrique Dias. Alzheimer's disease: Role of nurses as Health promoter. Multidisciplinary Core scientific journal of knowledge. 03 year, Ed. 06, vol. 03, pp. 78-88, June 2018. ISSN:2448-0959
SUMMARY
Alzheimer's disease is one of the diseases that most affect the elderly. Considered as a negative effect of aging according to Alzheimer's Disease International (ADI, 2010), and there is a strong correlation to the advancement of age/aging and disease emergence mainly to the emergence of dementia. This study this is a literature review outlining as eligibility criteria: complete studies published with abstracts available in English and Portuguese language. The descriptors used were: Alzheimer's disease, nursing care. The study aims to identify the tasks of nursing to patients with Alzheimer's disease, where the nurse becomes essential in the care and describe the importance of your work.
Keywords: Alzheimer's disease, nursing care.
1. Introduction
1.1 Definition
As the world population ages, at the same time there is a significant increase in life expectancy, reduced birth rates and aging-related diseases increase such as: coronariopatias, neoplasms, osteoporosis and the neurodegenerative diseases, such as dementia. (Aprahamian, Martinelli & Paula 2009; IBGE, 2010). However, this correlation between aging and emergence of new diseases, Alzheimer's disease, as a negative effect of aging according to Alzheimer's Disease International (ADI, 2010). As population growth brings a change in your life, dynamics is necessary to meet these dynamics that may interfere with the quality of health of the population, as Alzheimer's disease, because it is a common chronic illness in the elderly ( Oliveira & Hawk, 2014).
Alzheimer's disease is one of the diseases that most affect senior citizens, but can't yet say that Alzheimer's disease is manifested due to advanced age but there is a strong correlation to the advancement of age/aging and disease emergence mainly to the emergence of dementia, considered as a family disease, because it affects the daily life of the members of this and that they are mainly responsible for observing the first signs and/or manifestations of the disease and for care of the carrier. (Almeida, milk & Hildebrandt, 2009).
1.2 clinical manifestations
Characterized by progressive brain degeneration and irreversible problems in speech and language, causing loss of memory and various cognitive disorders, reaching more than 2.5 million people and your prevalence varies from 1% to 1.5% between people of 60 the 65-year-old, and 45% in people over 90 years (FONSECA; Smith, 2007).
Disease of unknown etiology has your average length of 12 to 14 years, understanding of your initial and final stage of the disease. The survival rate is, on average, eight years after the onset of symptoms. Long-term and progressive disease, it is not difficult to realize that rarely is it possible to determine with precision the early symptoms (PLASSMAN & BREITNER, 2000; BERTOLUCCI, 2005).
Disorientation in time and space that occurs in 30 to 40% of patients, and 25% of the 10 people have hallucinations and most have symptoms such as sadness, apathy, irritability, distrust, and impatience, are significant features of the disease ( SILVA; FONSECA, 2010).
Among the risk factors for developing the disease, age, family history and Genetics (POLTRONIERE; CECCHETTO; Souza, 2011).
1.3 Pathophysiology
Biochemical and Neuropathological changes are observed. These changes include neurofibrillary tangles and senile plaques or neuríticas (plates that lodge in neurons). Injury occurs mainly in neurons in the cerebral cortex, resulting in decreased brain size. Similar changes are found in normal brain tissue, but to a lesser degree. The cells that use the neurotransmitter acetylcholine are primarily affected by the disease. Biochemical level, decrease of active enzyme in the production of acetylcholine, which is specifically involved in memory processing, according to Brunner & Suddarth, 2015).
1.4 Epidemiology
The World Health Organization considers dementia as a global health priority. An estimated 35.6 million people worldwide will live with dementia in 2010. This number is expected to nearly double every 20 years, reaching 65.7 million in 2030 and 115.4 million in 2050 the. This increase is due by the increase in the number of people with dementia in low and middle income countries (ADI, 2010).
Dementia is considered one of the leading causes of morbidity and mortality, for possible physical dependence, cognitive and emotional, having Alzheimer's disease (ad) as psycho more frequent disturbance (CELICH; BATISLELLA, 2007).
According to Ministry of health, Brazil (2010, p. 01):
There are about 15 million people with more than 60 years of age. 6% of them suffer from Alzheimer's disease, according to data from the Brazilian Association of Alzheimer's (ABRAZ). 15 million people worldwide have Alzheimer's disease, incurable disease accompanied by severe inconvenience to victims. In Brazil, three studies have investigated the prevalence and incidence of this illness, using community-based elderly samples and current diagnostic criteria. The prevalence of dementia in population with more of the 65 years was 7.1%, and was responsible for 55% of the cases. The incidence rate was 7.7 per 1,000 people-São Paulo study year and 14.8 per 1,000 people-year study of Rio Grande do Sul. Considering the prevalence of dementia in Brazil and the elderly population of approximately 15 million people, the estimate for dementia is 1.1 million.
1.5 Diagnosis
The precise diagnosis of the is done by examining the brain tissue obtained by biopsy/ecropsia, however, she can also be identified by blood test, with a marker test for the gene is on chromosome 19, producer of apolipoprotein E (ApoE4) that indicates risk of the individual have the disease; or is it done yet exclusion test, as for example: blood tests (hypothyroidism, vitamin B deficiency), history of dementia (depression, memory loss associated with age) and CT or MRI (multiple infarcts, hydrocephalus), exams cognitive, lumbar puncture and other tests (SH & Candide, 2014 APUD RIBEIRO, 2008).
1.6 Treatment
Avila, (2003) says that the medication and the use of cognitive rehabilitation techniques, in addition to information about the disease and support for families and caregivers is of fundamental importance to reverse the clinical picture and symptomatic of the disease. According to Chu LW (2012), the pharmacological treatment of Alzheimer's patients have the same importance that the pharmacological in improving the quality of life of patients and caregivers.
Treatment goals are:
- Relieve the cognitive symptoms
- Behavioral and psychological ease the symptoms of dementia
- Slow the progression of the disease.
1.7 nursing assignments
The tasks of the nurse must have focus in various aspects and to be carried out the professional need to refresh and recycle their knowledge about the care of Alzheimer's disease (RAO ET AL., 2007). In this context this work is justified by the fact of identifying the tasks of nursing to patients with Alzheimer's disease, where the nurse becomes essential in the care and describe the importance of your work.
2. Method
This is a literature search, which according to Rodrigues (2007), is the search for information and data available in other publications, such as in national or international articles, theses and materials made available on the internet, this being performed by other researchers. And for Gil (2010), "bibliographical research is developed from material already prepared, consisting mainly of books and scientific articles. (p. 50)
This article is a bibliographical study of descriptive character, using the method of integrative literature review for collection and analysis of data.
The sources for obtaining the search information based on databases, access to sites, which contained virtual journals with publications and journals addressed such matters. The descriptors used were: Alzheimer's disease, nursing care, where every time you have direct or indirect citations, the author will be quoted as bibliographical reference.
Outlining as eligibility criteria: complete studies published with abstracts available in English and Portuguese language, were also consulted the American Organization data sources Alzheimer's.
After getting the articles that addressed the theme, texts were selected based on the content contained in your abstract and that reflected the objective outlined in our review. However, fichamentos were carried out, being of utmost importance, which allowed select the materials so that was used the most relevant information for the preparation of the text of the existing content.
3. Development
3.1 Roles of nurses outside the bearer of Alzheimer's disease
The improvement of living conditions and health care, has increased gradually over the years, where the life expectancy has also increased, growing the number of people with degenerative diseases. Among these is a significant contingent of people with dementia. Dementia can have different causes and invariably leads to progressive change in the behavior and dependence for conducting day-to-day activity (BERTOLUCCI, 2012).
The caregiver's role is of extreme importance to the carrier, the caregiver is one who serves and provides other feeling of comfort and well-being, and being sensitive to realize the pain and their respective limitations, put the patient has a high degree of dependency. The familiar poses as "caretaker" for greeting to patients, especially those who are dependent (BINI et al., 2006).
The nurse is the professional who acts directly on the educational activities provided to the community, playing a role of fundamental importance in society in order to provide and promote the empowerment of users seeking care alternative ways, which may cause in attitudes that they provide full health in your broader sense (SILVA, DAYS & RODRIGUES, 2009).
The tasks of the nurse must have focus in various aspects and to be carried out the professional need to refresh and recycle their knowledge about the care of Alzheimer's disease (RAO ET AL., 2007).
The nurse is indispensable in support for caregivers of the elderly with Alzheimer's Disease, are aimed at the individual and your family by guiding him to deal with the adversities that come up front to watch, key questions about the disease, as well as the major evolutionary features, and also, how to deal with the treatment, what is the need for medicines administered, and yet, how come with the routine hygiene and food habits, the best way to overcome the modifications due to functional diseases and the impacts generated in the family unit (VASU et al., 2012; FONSECA SOARES, 2007 &).
There is a need to establish public health policies covering aspects related to the disease and the nurse strategize, to reduce vulnerability and the changes of disease decursiva (POLTRONIERE; CECCHETTO; Souza, 2011).
The nurse should provide caregivers means that facilitate care throughout the process, avoiding damage to your own health. It is believed that the nurse has this virtue to be a facilitator for being a professional who establishes a link between care and patient care near the adoecida person and the caregiver layman, in addition to integrating with the educational activities geared to the care of health, health education. (ROACH 2003).
In the advanced stage of the disease, the nursing care becomes more complex, Because the sum of physical and emotional changes, including the commitment of your identity (RICHARD ET ALL, 2009).
Through interventions in health education and advice that enable the caregiver to deal with the suffering of the patient and/or help caregivers assess the suffering is beneficial for the patient (GREGG CH, ROBERTUS JL, STONE JB, 1989).
Conclusion
Through this present study it was observed that in the literature there are many studies on the role of the nurse on the health care of the patient and caregiver health of patients and the nurse is the professional who have their powers provided to the patient and family of Alzheimer's as a means indispensable in the process working directly in the educational activities provided to the community, playing a role of fundamental importance in society, thus promoting the empowerment of the users, and being the facilitator for the family as regards the doubts as to the other matters penitents that the family might have regarding care always seeking alternative ways, which may lead in attitudes that they provide full health in your broader sense.
There is also that prevention is a way to deal with the large increase of incidences of the disease, focusing on healthy lifestyle, practice of physical exercise and stress reduction, these can act on and or delay the emergence of the disease. Therefore, the nurse, through actions of health, has to inform the society about the characteristics, treatments and preventions of pathology is the best way to combat the high rates of Alzheimer's disease.
Nursing should act together between patient and family, and the nurse is the health professional that has a link between patient and family. The Watch has the patient how to stimulate and involve the family to individualism, self care, promotion of physical security, the reduction of anxiety and agitation.
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[1] Literature review
[2] Bachelor's degree in nursing from the Faculty of Aracaju-Aracaju, Sergipe, VERY KNIFE, Brazil
