Confusion and Dementia Chapter 46 Confusion and Dementia Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

objective SWBAT describe confusion and explain the differences between delirium, depression, and dementia IOT care for patients with these diagnoses. Drill 1. What are the normal systolic and diastolic blood pressure ranges for an adult?

Drill answer Systolic pressure is 90-120 Diastolic pressure is 60-80

A funny thing happened on my way to the dementia ward https://www.youtube.com/watch?v=5nDx2PJafDc (3:05)

Changes in the Brain Changes in the brain and nervous system occur with aging and diseases Cognitive function and quality of life may be affected. Cognitive function involves: Memory Thinking Reasoning Ability to understand Judgment Behavior Cognitive relates to knowledge. Review the contents of Box 46-1 on p. 741 in the Textbook.

Confusion Confusion is a change in mental status in which a person is not able to think with his or her usual level of clarity Causes Diseases and infections Hearing and vision loss Drug side effects Brain injury Age-related changes resulting in reduced blood supply to the brain With aging, blood supply to the brain is reduced: personality and mental changes can result; memory and the ability to make good judgments are lost; some people gradually lose the ability to perform daily activities; behavior changes are common.

The confused person The person may be: Angry Restless Depressed Irritable

Confusion (cont’d) Acute confusion (delirium) occurs suddenly It is usually temporary Causes include infection, drugs, illness, surgery, and injury Treatment is aimed at the cause Confusion from physical changes cannot be cured Some measures help to improve function Review the contents of Box 46-2 on p. 741 in the Textbook. You must meet the person’s basic needs.

Dementia Dementia is the loss of cognitive function that interferes with routine personal, social, and occupational activities Dementia is a group of symptoms that may occur with certain diseases or conditions Dementia is not a normal part of aging Most older people do not have dementia The person with dementia may have changes in personality, mood, or behavior.

Early warning signs of Dementia Recent memory loss that affects job skills Problems with common tasks Problems with language; forgetting simple words Getting lost in familiar places Misplacing things and putting things in odd places Personality changes Poor or decreased judgment Loss of interest in life

Reversible Dementia If brain changes have not occurred, some dementias can be reversed. Treatable causes include: Drugs and alcohol Delirium and depression Tumors Heart, lung, and blood vessel problems Head injuries Infection Vision and hearing problems When the cause is removed, so are the signs and symptoms.

Dementia (cont’d) Permanent dementias result from changes in the brain. They have no cure. Alzheimer’s disease is the most common type of permanent dementia Pseudodementia = false dementia The person has signs and symptoms of dementia No changes in the brain This can occur with delirium and depression Both can be mistaken for dementia Review the Causes of Permanent Dementia listed in Box 46-3 on p. 742 in the Textbook. With permanent dementias, function declines over time.

delirium Delirium is a state of sudden, severe confusion and rapid changes in brain function Usually temporary and reversible From physical or mental illness Often lasts about one week Causes include: Acute or chronic illness Surgery Drug or alcohol abuse Infections Delirium is an emergency It signals physical illness The cause must be found and treated Although delirium has a short course, it may take several weeks for normal mental function to return. See Box 46-4 on p. 742 for signs and symptoms.

depression Depression is a feeling of deep sadness that affects the body, mood, and thoughts The most common mental health problem in older persons Often overlooked Depression, aging, and some drug side effects have similar signs and symptoms Review the signs and symptoms of depression in older persons listed on p. 732 in Chapter 45 in the Textbook. The person or others may notice the problems associated with MCI.

Mild cognitive impairment Mild cognitive impairment (MCI) is a type of memory change The person with MCI has problems with memory, language, and other mental functions. However, the problems do not interfere with daily life. The person with MCI is at risk for Alzheimer’s disease.

Understanding dementia: the caregivers’s notebook https://www.youtube.com/watch?v=YDDSk-L-R90 (9:45)

Did we meet our objective? SWBAT describe confusion and explain the differences between delirium, depression, and dementia IOT care for patients with these diagnoses. CONFUSION DELIRIUM DEPRESSION DEMENTIA

CONFUSION DELIRIUM DEPRESSION DEMENTIA Confusion is a change in mental status in which a person is not able to think with his or her usual level of clarity The state of sudden, severe confusion and rapid changes in brain function A feeling of deep sadness that affects the body, mood, and thoughts The loss of cognitive function that interferes with routine personal, social, and occupational activities Temporary and reversible; Lasts about 1 week May be temporary or permanent