1. Dementia:
Loss of abilities include memory ,language & ability to think
Defect judgment & abstract thought
Broad term
Group of symptom
Sever loss of intellectual function
Behavioral changes
Personality changes
Affect ADL
Defect socialization & work
Level of consciousness not change

2. Causes of dementia; 1-Primary AD
2-secondary :more than60 cause of memory loss as
HIV-
Stroke
CVS disease
Problem in brain circulation
Metabolic problem
Hormonalabnormalities
Infection

4. Brain tumor
Alchol reaction
Anemia
Chemical intoxication
Drug interaction
Nutritional deficiency vit B12 deficency ,folic acid ,niacin

5. Main types of dementia;
vascular dementia AD
vascular dementia:
complication of cardiovascular disease
inadequate blood supply to brain tissue
symptoms of dementia;
eitherADor nonAD
inteligance person
social situation disturbance
defect in judgment & abstract thinking
slow gradual onset
depression
repeated the question ,forget the answer
lost problem solving approach
problem in communication

6. sundown syndrome:
group of behavior ccc by confusion ,agitation ,& disruptive action
occur late afternoon or evening
unknown cause
loss of cognitive function
associated with social stressor
confused irritable agitated
box 17-3
gather information from family member about their behavior

8. AD:الزهايمر
Affect brain cells ,progressive ,degenerative ,result from impaired in memory thinking, behavior comes after 60yrs
ADis part of aging process
Cause unknown can live 20 yrs after dx of AD WITH TWO TYPES
Early onset
Late onset
Symptoms & course ;
Rule out drug interaction or reaction
History
Physical examination
MSE
Skin test
Brain MRI
Genetic study

9. Gradual death of brain function
Decrease of intellectual function
Learning new skills ,require more time & practice
Losses of AD:
Disjoined speech
Difficult to take decision
Loss of responsibility
Child like behavior
Antisocial
Labile emotion

10. Some times delusion hallucination
Feeling of paranoia
Difficulty dressing grooming ,bathing
Increase stress anger feeling ,fatigue ,frustration
Every thing seems tobe happening for the first time
Fear ,confused ,agitated ,inability to manage stress

11. Stages of AD; EARLY STAGE Intermendiate stage Sever stage
inability to learn
loss of recent memory
language problem
irritability hostility ,agitation ,active in society
family report : mood sings ,& strange behavior

12. * intermediate stage; Remote memory affected Aphasia: loss of language
Apraxia:inability to perform daily activity
Visual agnosia: loss of recognition familiar people ,object
Forgetful
Require assistance ( bathing ,toileting ,dressing ,eating
Lost sense of time & place
Able to walk risk for falling down or accident

13. * sever stage: Inability to do any thing ,incontinent Unable to walk
Dependant on other
Loss of recent & remote memory
Inability to swallow risk for pneumonia ,malnutrition ,
Mutism:inability to speak

14. * end stage ; Coma, death ,from pneumonia ,infection ,bed sore
After dx of AD 2-20 yrs can live average 8 yrs
Points;
Protect client safety
Assist him in dressing grooming ,bathing ,ADL
Don’t leave him alone
Family member support

15. Management of AD;
Provide physical & emotional support
Drug therapy
Vit E
Coenzyme
Ginkobiloba
Music therapy
Audiotapes of family member
Management stages of AD;

16. Early stage : Maintain mental abilities
Acetylcholine decrease ( cholinesterase inhibitor )
Frequent orientation x3
Calendar

17. Clock large size
Personal hygiene
Safe environment to avoid falling or injury
Compare past & present behavior
Environment support ( home 0
Keep environment calm
Simple physical exercise :objectives :
Maintain balance
Induce fatigue & restful sleep
Prevent constipation

18. Reduce wandering
Middle & late stage focus on:
ADL
Dementia
Communication improvement
Social interaction
Stress management