1 / 26

CHAPTER 17 Cognitive Impairment, Alzheimer’s Disease, and Dementia

CHAPTER 17 Cognitive Impairment, Alzheimer’s Disease, and Dementia. Normal Changes in Cognition. Cognition comprises intelligence, learning, judgment, reasoning, knowledge, understanding and memory. Normal age-related changes in cognition Slower response times Loss of short-term memory

alaric
Download Presentation

CHAPTER 17 Cognitive Impairment, Alzheimer’s Disease, and Dementia

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript


  1. CHAPTER 17Cognitive Impairment, Alzheimer’s Disease, and Dementia

  2. Normal Changes in Cognition • Cognition comprises intelligence, learning, judgment, reasoning, knowledge, understanding and memory. • Normal age-related changes in cognition • Slower response times • Loss of short-term memory • Confusion not a normal part of aging

  3. The Five “Ds” of Confusion • Delirium– acute onset • Causes • Metabolic disorder • Infections • Fever • Dehydration • Damage – acute onset • Causes • Stroke • Head injury • Exposure to chemicals (Cont’d…)

  4. The Five “Ds” of Confusion (…Cont’d) • Deprivation – variable onset • Causes • Sensory impairment • Social interaction • Depression – subacute onset • Causes • Loss • Metabolic imbalances • Drugs • Inner sadness (Cont’d…)

  5. The Five “Ds” of Confusion (…Cont’d) • Dementia – slow onset • Causes • Cardiovascular disease • Metabolic problems • Alzheimer’s disease • HIV

  6. Delirium • A sudden change of consciousness that occurs rapidly • Signs and symptoms • Disorganized thinking • Decreased attention span • Lowered or fluctuating level of consciousness • Disturbance in sleep-wake cycle • Disorientation • Changes in psychomotor activity • Sometimes, delusions or hallucinations • Usually, agitation and hyperactivity • Sometimes, hypoactive behavior such as lethargy and reduced activity

  7. Finding the Cause • Pain • Constipation • High or low body temp (extreme) • Alcohol use • Lack of oxygen to brain • malnutrition

  8. Treatment • Depends on cause • Treat the source • Supportive Care • Low stimuli environment • Have them wear hearing aids/glasses • Clocks and calendars • Ambulate often if allowed

  9. Dementia • Classified as Alzheimer’s or non-Alzheimer’s • In early stages is difficult to differentiate from age-associated memory impairment • Decreasing ability to process new information and to retrieve and use the information accumulated throughout life

  10. Dementia • Causes- • More than 60 • Metabolic problems • Hormonal • Infections • Brain trauma • Tumors • Pain • Sensory deprivation • Chemical • Anemia • Drug interactions

  11. Dementia • Slow gradual onset • Attempt to hide impairments • Most common early symptom is declining memory

  12. Sundowners • Group of behaviors characterized by confusion, agitation and disruptive actions that occur IN LATE AFTERNOON OR EVENING • Cause is unknown • Associated with dementia, physical or social stressors • Box 16-3

  13. Alzheimer’s Disease • A progressive, degenerative disorder that affects brain cells and results in impaired memory, thinking, and behavior • Cause is unknown • 50% of all cases of dementia have Alzheimer’s Disease. • Some 250,000 new cases per year • Post mortem the brain reveals shrunken and with abnormal tangles of nerve fibers (Cont’d…)

  14. Left- normal Right – Alzheimer’s

  15. Alzheimer’s Disease (…Cont’d) • Signs and symptoms • Memory loss • Difficulty performing familiar tasks • Problems with language • Poor judgment • Problems with abstract thinking • Misplacing things • Disorientation to time and place • Loss of initiative • Changes in mood or behavior • Changes in personality

  16. Stages of Alzheimer’s Disease • Early stage • Begins with the loss of recent memory and progresses to strange behaviors and mood swings • Intermediate stage • Clients cannot recall recent events or process new information and eventually lose all sense of time and place. They are still ambulatory but at high risk for falls and injury. • Severe stage • Clients are unable to do anything and are entirely dependent on others. • End stage • Clients slip into a coma.

  17. Losses of Alzheimer’s • Robbed of “personhood” • Affective loss- drain of one’s personality • Conative loss- inability to carry out plans for the simplest activities • Catastrophic reactions- minor anxiety cascade • Confused • Agitated • fearful

  18. Health Care Goals for Clients with Alzheimer’s Disease • Provide for clients’ safety and well-being • Bathing, grooming, eating, physical activity • Remember that clients have no sense of safety or danger. • Manage clients’ behaviors therapeutically • Gently redirect clients who are behaving inappropriately to less stressful activities. • Music therapy, validation therapy, and exercise help reduce stress. (Cont’d…)

  19. Health Care Goals for Clients with Alzheimer’s Disease (…Cont’d) • Support for family, relatives, and caregivers • Important sources of information about clients • Should be included in planning care for clients • Provide respite care • Informal support groups–family members, friends, and people who knew the family member before AD • Formal support groups • Offered by the Alzheimer’s Association, home care agencies, and elder care centers

  20. Therapeutic Interventions • Provide for safety and well-being • Manage behaviors therapeutically • Proved support for family and caregivers • Gentle redirection • Music therapy, validation, sensory stim

  21. Interventions by stage • Early- • Cholinesterase inhibitors • P 175 top • Cognitive training • Orientation • Monitor personal hygiene • Daily routine • Home eval for safety

  22. Middle/Late Stage Behavior gradually becomes disorganized personal hygiene, eating and elimination neglected Wandering is most serious problem 60% will wander and become lost in commun. Offensive behaviors need to looked at as COMMUNICATION OF UNMET NEED

  23. As late stage progresses • High risk for : malnutrition, pneumonia and pressure related wounds

  24. Caregivers • Support • 70% of alzheimer’s are cared for in the home by family, friends and home care staff • Find a balance between personal needs and those of the loved one • Informal support groups • Formal support groups • Education- • Stress levels decrease with adequate training

More Related