The three data-based papers in this symposium focused on a critical condition—dementia in general and Alzheimer’s disease (AD) in particular. The rapid growth of the aging population coupled with forecasts that up to 47% of the aged population may develop AD, makes advances in caring for this vulnerable group of patients particularly important. Each of the papers is stunning in the practical relevance of their findings. Looking at creating safer home environments is a needed addition to the existing body of knowledge regarding safety in general, and especially among people with dementia. To date, work in AD has emphasized safety in regard to driving and wandering. The findings in the home safety project are powerful both in regard to their genuine interdisciplinary genesis as well as their practicality. The role of family caregivers in safeguarding the home environment is enhanced by the knowledge generated in this study. Knowing what safety interventions families’ best receive creates a pragmatically powerful framework for safely allowing people with dementia to remain in the familiar surroundings of their homes. Bathing is basic to hygiene, and it is an activity of daily living that must be carried out to prevent complications such as skin problems and infection. However, bathing is often a source of stress for patients and an enormous challenge for caregivers of individuals with dementia. By examining 4 different techniques for bathing, researchers attempted to identify the best nursing intervention to alleviate or minimize resistiveness to care and discomfort during the bath. Again, the practicality of this topic and its importance as a nursing intervention are self-evident. Pain has become a highly visible concern, typified by its recent identification as the 5th vital sign. Pain management is a challenge even for people whose verbal and cognitive skills are intact. This challenge escalates when caring for individuals with advanced AD who are unable to verbalize their needs for pain relief. The challenge is compounded by the pragmatic reality that nursing assistants who lack the assessment skills of professionals most often render care for people with AD. Hence, the need for an easy-to-administer pain assessment tool that could be used for patients with reduced verbal and cognitive skills and by unlicensed care providers is of immense clinical importance. Collectively and individually, the findings from these studies portend promise for enhancing the care of people with AD. The refreshingly pragmatic utility of these works offers a very strong example of the research/practice link. Although there is longstanding caution about changing practice based on one study, a more pertinent concern at present relates to the rules of evidence based upon the tenets of evidence-based practice (EBP). Given the intense interest surrounding EBP, it is important to achieve a sense of where these highly relevant studies with enormous practical implications fall in the evidence-based schema. In the concluding presentation of this symposium, therefore, four key components of EBP will be briefly reviewed: 1) its purpose, 2) definitions, 3) evidence hierarchies, and 4) systematic reviews. Each of the three studies will be assessed using evidence hierarchies from medicine and nursing to explore whether these discoveries essential to the care of patients with AD would be admissible in an evidence-based analysis. This will, in part, demonstrate possible effects of subscribing to those EBP paradigms in which methods other than Randomized Controlled Trials risk being deemed inadmissible. Questions will also be raised regarding whether nursing should be bound by the rules of evidence from other disciplines or whether there is a need to sculpt rules that better suit nursing. Consequently, the closing section of this symposium will promote audience participation by raising questions. The entire panel will participate in discussing the issues with the attendees.
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