1. Cognitive Disorders

2. Recent Memory Impairment Disorientation Poor Judgment Confusion General loss of intellectual functioning May have: Hallucinations, delusions, personality changes, secondary emotional reactions Produced by medical, biochemical, or neurological alteration in brain

3. Three Cognitive Disorders Delirium- reduced awareness of E Dementia- deterioration of intellectual functioning Amnestic Disorders-Memory impairment

4. Delirium Disorientation and Memory Loss (recent) not accounted for by dementia Difficulty focusing, sustaining or shifting attention. Often is easily distracted Develops over a few hours to a few days, fluctuates during the day, and tends to worsen at night This is a disorder that IS due to a medical condition or substance

5. Delirium Speech may include: Dysarthria- can’t articulate Dysnomia- can’t name objects Dysgraphia- can’t write Perceptual disturbances can include: Hallucinations Illusions-inanimate object seen an animate one Misinterpretations

6. Delirium May also frequently exhibit Psychomotor disturbances Emotional disturbances Sleep-wake cycle disturbances Elderly and children are at highest risk Get to physician Orient X4 (brief and frequent) Prevent self harm

7. Delirium Conduct MSE thru out day Catch early to avoid death or brain damage

8. Dementia Tends to have more gradual onset Memory loss for recent events usually goes first, then getting lost Personality changes and loss of impulse control and judgment are common Agnosia-can’t name objects, aphasia-difficulty understanding language, concentration difficulties effect speech, apraxia-can’t perform simple motor tasks

9. Dementia Loss of executive functioning Many will try to hide the difficulties or deny them Alzheimer’s is one type Vascular, medical or substance induced Differentiate from delirium and depression Prevention and early treatment reduce long term damage

10. Dementia Once dementia has taken it’s course, help patient to be comfortable, safe, and calm

11. Amnestic Disorders Only memory is effected IS due to medical condition or substance Marked impairment and change from previous functioning