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

2. 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?

3. Drill answer
Systolic pressure is
Diastolic pressure is 60-80

4. A funny thing happened on my way to the dementia ward
(3:05)

5. 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.

6. 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.

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

8. 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.

9. 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.

10. 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

11. 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.

12. 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.

13. 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.

14. 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.

15. 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.

16. Understanding dementia: the caregivers’s notebook
(9:45)

17. 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

18. 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