Master’s Advanced Curriculum (MAC) Teaching Module: Advanced Practice in Mental Health Settings Acknowledgement: The development of this PowerPoint was made possible through a Gero Innovations Grant from the CSWE Gero- Ed Center’s Master’s Advanced Curriculum (MAC) Project and the John A. Hartford Foundation.

 DEFINITION:  Group of symptoms that can be caused by many disorders.  Syndrome which refers to progressive decline in intellectual functioning severe enough to interfere with person’s normal daily activities and social relationships. (National Institute on Aging, 1995 No ) Dementia

 Progressive and irreversible declines in  memory  visual-spatial relationships  performance of routine tasks  language and communication skills  abstract thinking  Mathematical ability

 Two Types:  Reversible  Irreversible Dementia

 Reversible:  D= Drugs, Delirium  E=Emotions (such as depression) and Endocrine Disorders  M=Metabolic Disturbances  E=Eye and Ear Impairments  N=Nutritional Disorders  T=Tumors, Toxicity, Trauma to Head  I=Infectious Disorders  AAlcohol, Arteriosclerosis (Dick-Mulheke- Overview of Alzheimer's Disease) Dementia

 Irreversible:  Alzheimer’s  Lewy Body Dementia  Pick’s Disease (Frontotemperal Dementia)  Parkinson’s  Heady Injury  Huntington’s Disease  Jacob-Cruzefeldt Disease Dementia

 Irreversible:  Alzheimer's most common type of irreversible dementia  Multi-Infarct dementia second most common type of irreversible dementia  Death of cerebral cells  Blockages of larger cerebral vessels, arteries  Abrupt in onset  Associated with previous strokes, hypertension  Can be determined through diagnostic procedures Dementia

Changes Caused by Alzheimer's  Diminished blood flow  Neurofibrillary Tangles  Neuritic Plaques  Degeneration of hippocampus, cerebral cortex, hypothalamus, and brain stem

Theories Regarding Causes of Alzheimer's  Changes in Protein Synthesis  Changes in Neurotransmitters  Genetic Theories

Theories Regarding Causes of Alzheimer's  Genetic Theories  Metabolic Theories  Calcium Theories

Theories Regarding Causes of Alzheimer's  Environmental  Aluminum--Traces of metal found in brain.  Zinc--found in brains on autopsies.  Food borne poisons--amino acids found in legumes in Africa and India my cause neurological damage.  Viral  May be hidden in body and attack brain cells years later. (NIH-1995)

 Head Trauma  Head trauma increase the concentration of B-amyloid protein  Low Level of Education  Individuals with low level of education less able to compensate for cognitive deficits  Estrogen Deficiency Theories Regarding Causes of Alzheimer's

Diagnosis of Dementia Due to Alzheimer’s  Memory Impairment  Multiple cognitive deficits with at least one disturbance in the following areas:  Aphasia—loss of the ability to use symbols to communicate orally or in writing  Apraxia—inability to initiate complex learned motor movement or unable to perform activity on command  Agnosia---inability to recognize familiar objects by sight, touch, taste, smell or sound

Diagnostic Tests  Neurological Exam  Brain Imaging—shrinkage, atrophy of brain (CT or MRI)  Blood Work

Stages of Alzheimer’s Disease  Mild Stage  Memory Loss  Symptoms:  Confusion  Loss of Spontaneity  Loss of Initiative  Mood/Personality Changes  Poor Judgment  Takes Longer to Perform Routine chores

 Moderate Stage  Impairments in:  language  motor ability  recognition of objects  increasing memory loss and confusion Stages of Alzheimer’s Disease

 Moderate Stage  Symptoms:  P roblems recognizing family members, close friends.  Repetitive statements and/or movements.  Restless, especially in late afternoon and at night..  Problems organizing thoughts, thinking logically.  Can’t find right words; confabulation.  Reading and writing difficulties  May be suspicious, irritable, fidgety, teary or silly. Stages of Alzheimer’s Disease

 Severe Stage  Symptoms:  Weight loss, even with good diet.  Deterioration in self-care.  Difficulties in verbal - May put everything in mouth or touch everything.  Loss of bladder and/or bowel  May have difficult with seizures, swallowing, skin breakdown, infections. Stages of Alzheimer’s Disease

 Terminal Stage  Symptoms:  Loss of ability to ambulate.  Loss of ability to sit.  Loss of ability to smile.  Loss of ability to hold up head.  Loss of ability to swallow. Stages of Alzheimer’s Disease