MNA Mosby’s Long Term Care Assistant Chapter 44 Confusion and Dementia

Cognitive Memory Thinking Reasoning Ability to understand Judgment Behavior

Confusion Many causes Person may be Angry Drugs Restless Disease Depressed Irritable Many causes Drugs Disease Infection Injury

Caring for persons with Confusion Follow care plan Provide safety Face person, speak clearly Explain procedures Maintain day/night cycle Be consistent Orient often Provide calm setting Use clear, simple, easy to understand instructions Give time to respond Give clear simple directions and answers

Dementia Loss of cognitive functions Interferes with daily activities

Dementia Not normal part of aging May be due to variety of diseases Possible Causes: Alcohol Alzheimer's Brain tumors CVA Multiple Sclerosis Huntington’s Chorea Parkinson's Syphilis Head Injury Not normal part of aging May be due to variety of diseases

Dementia S&S Memory Loss Problems with language, common tasks Poor judgment Getting lost in familiar places

Delirium Possible causes: Infection Poor nutrition Hormone disorders Alcohol, drugs Sudden severe confusion, rapid brain changes. Occurs with physical or mental illness Usually temporary and reversible

Alzheimer's Disease Effects: Memory Thinking, Reasoning Judgment Brain disease Nerve cells are damaged and die Effects: Memory Thinking, Reasoning Judgment Language Behavior, Mood Personality

Alzheimer's Disease Gradual onset Gets worse and worse S&S Gradual loss of short term memory Asking same question over and over. Repeating the same story Forgetting how to do everyday activities Forgetting names, recent events, directions Gets lost in familiar setting Gradual onset Gets worse and worse Usually live 8 -10 years after onset Cause is unknown

Alzheimer's Disease Progresses from memory loss to being totally dependent on others to coma to death

Alzheimer's Disease Wandering Disoriented, poor judgment. Causes: May have no cause May be looking for something or someone Drugs Stress, restlessness anxiety Disoriented, poor judgment. Allow to wander in safe areas.

Alzheimer's Disease Sundowning S&S increase during hours of darkness.

Alzheimer's Disease Approach in calm, quite manner Make eye contact Use calm gently voice Use simple easy to understand instructions Use gestures and body language Speak slowly Do not use baby talk Do not rush Do not criticize

Alzheimer's Disease Do not try to reason with resident or ask why they are upset: they cannot understand you. Follow set routine Ensure safety Encourage activities early in the day

X Alzheimer's Disease Do not restrain Aggression may be due to physical discomfort (elimination?) Sexual gestures may be due to physical discomfort (wet depends?) X

Alzheimer's Disease Remember, the resident with Alzheimer's Disease: Did not choose to have this disorder Deserves to be treated with respect Has same rights as all other residents

Alzheimer's Disease Family Need support and encouragement Often feel helpless and hopeless Respite Care