Caregivers that know how to assess neuro status of Alzheimer’s patients are important for early intervention. Medical doctors, neurologists, lab tests and psychologists determine the diagnosis and treatment; however, caregivers spend so much time with Alzheimer’s patients that their input is invaluable in spotting new or worsening symptoms.
A complete initial assessment of a person suspected to have Alzheimer’s Disease should be done by a team of health professionals to evaluate the patient’s overall condition. This evaluation will include:
- A complete medical history including family history and any drugs the patient may be taking
- A mental status examination to see if the patient knows who they are, where they are, who the president is, etc.
- A complete physical examination to rule out any other causes of the patient’s symptoms such as cardiac, respiratory, thyroid, liver and kidney problems
- A neurological examination to rule out Parkinson’s Disease, brain tumors or fluid on the brain. The neurologist will also check for the patient’s coordination, eye movement, muscle strength and tone, sensory abilities and speech
- CT scans or MRIs to rule out possibilities such as tumors, blood clots, or stroke
- Laboratory tests to rule out any other possible disorders that may be causing symptoms
- Psychological examination to rule out depression which can cause symptoms of memory loss
This Alzheimer's neurological assessment can be used as a guideline to help doctors and caregivers identify any new or worsening symptoms in the patient.
- Caregivers need to check the status of the patient on a daily basis or when starting their shift. The following assessments should be made and entered in the caregiver’s notes.
- Level of consciousness. Instead of trying to use medical terms to describe the condition of the patient, it is important for the caregiver to document whether the patient is alert, unresponsive or drowsy, by describing their observations. Their notes might say something like “the patient was difficult to awaken and even after awakened was not able to understand commands and kept falling back asleep.” This can be far more helpful than figuring out what word to use to describe the condition.
- Awareness of surroundings. If the patient is awake, the caregiver needs to ask who she is, where she is, what day it is, why she is there and things of that nature to see where her intellectual functioning is. The patient’s pupils also need to be checked to see if they are small, large or reactive. If there is pressure on the brain, it will show in the pupils. A notation should be made in the notes.
- Motor movement. The caregiver should have the patient do things like: squeeze the caregiver’s fingers; bend and straighten each arm; lift each leg and hold it straight; and bend and straighten both feet. The observations should be entered in the notes.
- Sensory ability. In order to check sensation, the caregiver can use their fingertips or items such as earbuds, safety pins (do not break the skin or scratch the patient), and blunt objects to see if the patient can feel pain and identify dull or sharp sensations. Tests for temperature, vibrations and position can also be done if necessary.
- Check balance and gait. Have the patient stand with her eyes open, arms at her side and feet together. Watch and see if she sways. Next, have her close her eyes in the same position and see if she sways or begins to fall.
Alzheimer’s disease affects over 4.8 million Americans. How it affects individuals varies. The disease can last from two to 25 years, but the average is four to eight years. The end result is the same, with the patient losing their mental and physical capabilities and becoming unable to care for themselves. Getting the proper diagnosis is important for the treatment of Alzheimer’s patients. Since there is no way to confirm a diagnosis of Alzheimer’s except by an autopsy of the brain, a diagnosis of probable Alzheimer’s may be given. This diagnosis is approximately 90% accurate.
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