Confusion Basics
Is dementia a normal part of aging?
Which direction should an NA always approach an Alzheimer's resident from?
Always approach from the front so as not to startle them.
What is "sundowning," and what is one way an NA can help manage it
Agitation/restlessness in late afternoon or night. Manage with adequate lighting before dark, soft music, removing caffeine, back massages, daily exercise,establish routine
What should an NA do if an AD resident resists taking a bath or shower?
Be flexible, give sponge baths instead, or offer a washcloth to hold as a distraction.
ACT IT OUT: Demonstrate how an NA should properly approach and initiate communication with a seated disoriented resident.
Approach from front, smile/look friendly, speak slowly in a low tone, identify self, and use resident's name.
(Blank) comes on suddenly and is usually temporary; whereas (Blank) can come on suddenly or gradually and can be temporary or permanent.
DELERIUM comes on suddenly and is usually temporary; whereas CONFUSION can come on suddenly or gradually and can be temporary or permanent.
An NA agrees with a resident who believes he is meeting his deceased wife for dinner and asks him what restaurant they are going to.
Validation therapy
Define "perseveration" and state how the NA should react to verbal perseveration.
Repeating words or actions over and over. Be patient, try not to silence/stop the resident, answer using the exact same words each time.
In what sequence should an NA lay out clothing for a resident with Alzheimer's disease?
In the order in which they should be put on
What is a Nursing Assistant legally required to do if they witness another staff member abusing a resident with Alzheimer's disease?
The NA is legally required to report the abuse immediately to a supervisor and escalate up the chain of command if the situation is not handled, report to state Abuse hotline.
Name 4 reversible physical causes of confusion or delirium listed in the textbook.
UTI, low blood sugar, dehydration, fever, lack of oxygen, head trauma, fluid imbalances, poor nutrition, or medications
A CNA asks a Korean War veteran to show his medals and describe his war buddy photos.
Reminiscence therapy
What is "elopement," and what is the immediate required action?
Elopement is leaving a facility unsupervised and unnoticed. The NA must tell their supervisor immediately.
List 3 examples of finger foods recommended for residents with AD who struggle with eating
Sandwiches cut in fourths, chicken nuggets/boneless chicken, fish sticks, cheese cubes, halved hard-boiled eggs, or cut fresh fruit/soft veggies.
ACT IT OUT: Demonstrate the difference between Reality Orientation vs. Validation Therapy
Reality Orientation: State date/location and point to calendar. Validation: Validate feelings without arguing/correcting.
Tangled nerve fibers and protein deposits form in the brain causing what disease
Alzheimer's Disease
How should an NA handle a resident who repeatedly asks to ""go home"?
Ask the resident to describe what home was like, then gently redirect conversation or activities
Why is rummaging/hoarding not considered stealing and how should an NA handle it?
Stealing requires conscious effort; AD residents collect aimlessly. Handle by labeling belongings, preparing families, and providing a rummage drawer.
Give 2 examples of specific strategies to help a resident with AD that is incontinent.
Note incontinence patterns over 2 to 3 days and check the resident every 30 minutes, encourage fluids, Mark the bathroom with a sign, make sure there is good lighting, take resident to bathroom on a schedule, put lids on trashcans
Describe how a CNA should to respond to inappropriate sexual behavior?
Stay calm, don't overreact, try to determine cause, redirect to a private area, report to the nurse, provide ways for phsyical stimulation like soft stuffed animals to cuddle, comforting blankets, appropriate physical touch.
Identify 2 non-modifiable risk factors for Alzheimer's disease.
Age, Women, Black or Hispanic race, family history (parent or sibling with AD)
What simple safe activity can an NA assign to a resident exhibiting disruptive behavior to help them feel in charge?
Independent activities like folding towels, knitting, or simple crafts.
If an AD resident becomes violent and attempts to hit an NA, what steps should the NA take?
Call for help, block blows without hitting back, do not restrain, step out of reach, stay calm, remove triggers, and never leave the resident alone.
Identify 3 strategies for an NA to help a resident with AD with eating.
encourage nutritions foods, have meals at regular times (routine), ensure proper lighting, reduce distrations, try smaller more frequent meels or finter foods, do not serve very hot foods/drinks, 1 item on the plate at a time, simple instructions, feed slowly small bites, make eating social, use single utensil and colorful bowl/plate.
ACT IT OUT: Demonstrate how to respond to hallucinations