Mental Health Nursing I NURS 1300 Unit II Cognitive Impairment in the Elderly

Objective 1 Discuss concepts as they relate to the aged individual Aging is characterized by the declining ability to respond to stress, an increase in homeostatic imbalance, and increased risk of disease. Ageism is the process of systematic stereotyping and discrimination against people because of their age.

Objective 2 Define delirium and dementia Delirium is a short-term confusional state that has a sudden onset and is typically reversible. Dementia is the progressive decline in cognitive function due to damage or disease in the brain beyond what might be expected from normal aging.

Objective 3 Compare characteristics of delirium and dementia Characteristics of delirium: inability to focus attention confusion disoriented memory formation disturbance hallucinations delusional thought

Objective 3 (cont’d) Characteristics of dementia: inability to concentrate decrease in problem-solving skills confusion disoriented loss of memory agnosia apraxia insomnia altered sensation or perception anxiety depression hallucinations delusions

Objective 4 List the stages and symptoms of Alzheimer’s dementia

Stage 1 = No impairment No apparent symptoms No decline in memory Stage 2 = Very mild decline Forgetfulness May lose things or forget people’s names Stage 3 = Mild decline Interference with work performance May get lost when driving

Stage 4 = Moderate decline May forget major events in personal history Declining ability to perform tasks or manage personal finances May use confabulation to hide memory loss May withdraw socially and become depressed

Stage 5 = Moderately severe decline Loses ability to perform ADLs independently May forget address, phone numbers, and names of close relatives Frustration, withdrawal, and self- absorption common

Stage 6 = Severe decline Loses ability to recall recent major life events or name of spouse Disoriented to surroundings, date, and time Urinary and fecal incontinence Sleep disturbances Wandering Obsessiveness Agitation and aggression Communication difficult

Stage 7 = Very severe decline Unable to recognize family members Probably confined to bed Aphasic Immobile with related problems decubiti contractures

Objective 5 Identify medical treatments for clients with cognitive impairment

Diagnostic tests to rule out underlying medical condition Assessment tools (Mental Status Exam) Medications to control symptoms cognitive functioning agitation/wandering depression anxiety sleep disturbances

Objective 6 Identify nursing interventions for clients with cognitive impairment Promote client safety Preserve dignity of client Help client’s family/primary caregivers to facilitate care Assist in dealing with caregiver burnout