As people have begun to live longer, there has been a corresponding increase in the prevalence of chronic illnesses associated with old age. One disease which occurs among the elderly is dementia. This highly variable syndrome is primarily characterized by mental deterioration. In addition though, it may also present with a concomitant decline in patients' general physical functioning. One particular dementia, senile dementia of the Alzheimer type, mainly involves diminished cognitive capacity. The prognosis for different dementia patients varies depending on numerous factors. Treatment should generally occur through a multidisciplinary, team approach. Such a therapeutic framework facilitates the nurse's ability to deliver effective health care.
In recent decades, there has been growing interest in the pathologic syndrome known as senile dementia. This disease has a characteristically insidious onset and may present with a variety of initial symptoms and signs. Early dementia typically interferes with patients' ability to present themselves to the world in a "consistent coherent manner" (McLean, 1992, p. 1764). The first signs may be difficult to detect. They usually involve subtle changes in a person's normal behaviors. Such behaviors may range from routine daily activities such as housecleaning or auto maintenance, to changes in the ways that the patient relates to others.
Similarly, the course of senile dementia is also quite variable. In fact, no "classic pattern" or "typical picture" for this disease has yet been established. As McLean (1992) states, "when you have seen one patient with dementia, you have seen one patient with dementia."
However, despite this variability, most patients' symptoms may be grouped into four broad classifications. The first of these subtypes involves deficit symptoms. These generally result from the loss of cognitive abilities. Patients may become forgetful, apath...