Bridging the Gap: Alzheimer’s Disease and Acute Care Nursing in the Medical-Surgical Environment

According to the Alzheimer's Association, there are more than 7 million people who have Alzheimer’s Disease (AD) in the United States. As reported in the 2025 Alzheimer’s Disease Facts and Figures, recent data shows that 1 in 3 patients die with Alzheimer's or other types of dementia. The mortality rate of AD is higher than breast cancer and prostate cancer combined. It is important to know about this disease and how to help people and families who are affected.

In a medical-surgical unit, nurses commonly encounter patients with AD. Having the knowledge and skills to provide care for this condition is a crucial step toward creating a supportive environment for patients as well as their families. Medical-surgical nurses can offer hope and dignity to individuals navigating the challenges of AD.

Raising Awareness About Alzheimer’s Disease

AD is the most common cause of dementia. Changes in the brain that occur with AD include unwarranted accumulation of beta-amyloid plaques and formation of protein tau inside the neurons. These changes affect the memory, cognition, and behavior of a person with the disease.

Different Ways to Diagnose

Brain changes are the biomarkers of AD. These brain changes can be identified by testing the cerebrospinal fluid for abnormal levels of beta-amyloid and tau.

A positron emission tomography (PET) scan can also be used to see where beta-amyloid and tau are in the brain.

There is also ongoing research for blood tests to diagnose AD. Recent progress in dementia care includes blood-based biomarkers for Alzheimer’s disease. Reliable tests for amyloid-β, phosphorylated tau, and neurofilament light now allow the AT(N) classification via blood. These biomarkers are accurate for detecting AD, aligning well with established diagnostic methods such as neuropathology, cognitive assessment, CSF analysis, and neuroimaging (Karikari, 2022).

Cognitive, behavioral, and functional tests can be conducted by a neuropsychologist to evaluate function, judgment, attention, and language.

Lastly, computerized cognitive tests are being developed to help providers evaluate cognition and function. The National Institutes of Health Toolbox for Assessment of Neurological and Behavioral Function (NIHTB) provides a concise yet comprehensive tool for consistent assessment in research and clinical settings. Its Cognition Battery (NIHTB-CB) includes tests across cognitive domains such as episodic memory, working memory, attention, executive functions, processing speed, and language (Jutten et al., 2025).

How Medical-Surgical Nurses Manage Care for Patients With Alzheimer’s Disease

Memory loss is one of the common symptoms that a patient with AD will experience. This can be characterized by symptoms such as forgetting important dates and events or repeating questions. To facilitate care for these patients, it is best to provide them with memory aids, such as placing family photos with names and relationships labeled or using calendars, clocks, and whiteboards to orient them with the time and date. Allow family members to help with care when patients get confused. Sometimes, talking about past events will help them remember.

Patients may have difficulty completing familiar tasks. Nurses should provide one instruction at a time, with short and concise phrases. Instead of saying “Get dressed,” say, “Here is your shirt; you can put it on.” Encourage the patient to try the task even if it takes longer, and step in only when it is necessary.

Changes in mood and personality, such as confusion, suspicion, depression, or anxiety, may be experienced by patients. They also may experience “sundowning,” which involves increased confusion or agitation in the evening. It is crucial to focus on their safety. This is one of the challenges that medical-surgical nurses, especially those on the night shift, face. By creating a calm, low-stimulation environment at night, this might be prevented. The fall precautions intervention should be implemented for patients at high risk of falling, including bed alarms and non-slip mats to ensure their safety.

Decrease in judgment, such as important and simple decision-making, also is common. Offer simple, limited choices, such as “Would you like coffee or juice?” instead of “What do you want to eat?” Documentation of unsafe poor judgment, such as using utensils improperly, may also be necessary as this will impose a safety risk for the patient.

There is no cure for AD, but several clinical studies have received traditional approval from the Food and Drug Administration to treat early signs and symptoms. The medications Lecanemab (Leqembi) and Donanemab (Kisunla) are administered via intravenous infusion therapy. Both medications have antibodies that decrease the beta amyloid in the brain. This can give patients more time to live life independently.

Having a loved one with AD is difficult. Families of these individuals will need resources and support to navigate life with someone with AD. Nurses should provide support as much as possible, such as education on how to manage care at home and plan for the end of life. Also, there is a 24/7 helpline to call whenever they need more help and assistance. The number is (800) 272-3900.

Let’s all help each other. Together we can face AD with care and compassion.

References

2025 Alzheimer's disease facts and figures. (2025). Alzheimer's & Dementia, 21(4), e70235. https://doi.org/10.1002/alz.70235

Karikari T. K. (2022). Blood Tests for Alzheimer's Disease: Increasing Efforts to Expand and Diversify Research Participation Is Critical for Widespread Validation and Acceptance. Journal of Alzheimer's Disease: JAD, 90(3), 967–974. https://doi.org/10.3233/JAD-215730

Jutten, R. J. J., Ho, E. H., Karpouzian-Rogers, T., van Hulle, C., Carlsson, C., Dodge, H. H., Nowinski, C. J., Gershon, R., Weintraub, S., & Rentz, D. M. (2025). Computerized cognitive testing to capture cognitive decline in Alzheimer's disease: Longitudinal findings from the ARMADA study. Alzheimer’s & Dementia: Diagnosis, Assessment & Disease Monitoring. Advance online publication. https://doi.org/10.1002/dad2.70046