Advances in Dementia Care: A Themed Issue
Algase, Donna L., Research and Theory for Nursing Practice
Industrialized countries around the world are experiencing unprecedented growth in the number and proportion of their citizens who are surviving to old age. Reduction in infant mortality, effective medications for many communicable diseases and acute illnesses, and a surge in the birth rate following World War II account for this shift in the classical demographic pyramid.
The downside of enjoying a longer life span has been a concomitant increase in chronic illness. Among the most devastating of chronic conditions is dementia, the most prevalent type being Alzheimer's disease (AD). More than 4.5 million people are affected in the United States alone (Hebert, Scherr, Bienias, Bennett, & Evans, 2003), where 1 in 10 families have a member with AD (Alzheimer's Association, 2006).
AD and related dementias slowly rob a person of the capacity to learn new information, to remember daily events, and eventually to recall their long-term memories. Over time, a person with AD may fail to recognize loved ones and often their own reflection in a mirror. Their capability for self-care deteriorates as well, proceeding to the most basic of activities, such as dressing, toileting, walking, and even eating. Over an extended course of illness-up to two decades in duration-family members, usually a spouse or grown children, provide the bulk of care for individuals with dementia. One could fairly say that AD and other dementias victimize the whole family.
Over the past two decades, the investment of billions of dollars in biomedical research has enabled tremendous advances in our understanding of the pathogenesis of the dementias. Nonetheless, prevention and effective treatment remain elusive and the need for care continues to mount. As the unfortunate diagnosis is conveyed to families, one by one, each faces a long and challenging road ahead as they seek to meet the ever-changing and increasing needs of an affected family member.
Nurses, who provide care to these people, have intimate knowledge of the toll imposed on them in living with dementia. Spurred by such knowledge, nurse scientists, often with far fewer resources than afforded to medical science, are making important discoveries to inform practice and care of dementia-affected families and to improve the quality of their lives. …