1. Nursing Assistant Monthly Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Delirium, dementia, depression: The 3 Ds March 2009

2. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Delirium, dementia, depression: the 3 Ds March 2009 2 Why the 3Ds? Delirium, Dementia and Depression can “look” the same. All of these conditions can cause a resident to be:  Confused  Disoriented  Compative, or  Withdrawn

3. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Delirium, dementia, depression: the 3 Ds March 2009 3 But it gets more complicated! A person can have delirium, dementia, or depression OR any combination of these conditions at the same time.

4. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Delirium, dementia, depression: the 3 Ds March 2009 4 What is an “delirium”?  Delirium is usually of sudden onset.  Delirium often causes a change in level of consciousness.  Delirium can result in very agitated behavior or the opposite—very subdued behavior.  Symptoms of delirium usually fluctuate (change) over the course of the day.  Delirium can be caused by medications, low oxygen levels, infection, or pain.

5. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Delirium, dementia, depression: the 3 Ds March 2009 5 More on delirium Delirium can lead to dementia if unrecognized and untreated therefore your observations are important!

6. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Delirium, dementia, depression: the 3 Ds March 2009 6 Your role as CNA CNAs can help by:  Watching for and reporting sudden changes in a resident’s behavior Also, remember to:  Approach confused residents calmly  Keep the environment quiet  Avoid overwhelming the resident with too many choices

7. Copyright © 2009 Delmar, Cengage Learning. All rights reserved. Delirium, dementia, depression: the 3 Ds March 2009 7 CNAs know the residents Your observations are valuable because you know the resident best. You can detect changes in behavior that could mean:  New or worsening dementia  New or worsening depression  Delirium