DEMENTIA 101
What is the definition of Dementia?
Dementia is a general term for a decline in mental ability severe enough to interfere with daily life. Memory loss is an example.
DEMENTIA IS A DECLINE IN COGNITIVE ABILITY CAUSED BY ...... SOMETHING
What is a behavior?
A sign of an unmet need
OR
An Emotional response to external or internal stimuli
Communication means more than talking. Good communication involves 3 things. Can you name them?
Active Listening
The timing and setting of the communication
Effective self expression
What steps should you take when your elder is refusing their shower?
Ensure that the elder's personal preferences have been taken into consideration.
DISCUSSION REFUSAL OF CARE VS PERSONAL PREFERENCE
Can you name 5 risk factors for Dementia?
advancing age
alcohol use
atherosclerosis
diabetes
family history
hypertension
mental illness
smoking
The end of the day can bring a common behavior for elders with dementia. What is the name for this syndrome?
Sundown Syndrome
a neurological phenomenon associated with increased confusion and restlessness in elders with delirium or some form of dementia.
Sundowning seems to occur more frequently during the middle stages of Alzheimer's disease and mixed dementia.
Research shows that 20–45% of Alzheimer's elders will experience some sort of sundowning confusion
Symptoms are not limited to but may include:
How long should you give an elder to respond to your question?
90 seconds
Name three activities that should be used to engage an elder with dementia?
THE ANSWER IS WHATEVER IS IMPORTANT TO THAT SPECIFIC ELDER
ACTIVITES NEED TO BE SUCCESS ORIENTED, FAILURE FREE, AND PURPOSEFULL.
True or False
A resident who suddenly shows signs of dementia may simply be dehydrated.
TRUE It can also be a UTI, or they may be depressed, or have had a recent medication change.
DELERIUM
WHAT ARE THREE WAYS THAT STAFF CAN INCREASE "BEHAVIORS" OR EMOTIONAL RESPONSES IN OUR ELDERS WITH DEMENTIA
RUSHING THROUGH A TASK
POOR COMMUNICATION SKILLS
POOR BODY LANGUAGE AND NON-VERBAL CUES
ELDER TALK
OVER-STIMULATING ENVIRONMENTS
What is Validation Therapy and why is it important?
The basic principle behind validation therapy is to communicate with respect, showing that their opinions and beliefs are heard, acknowledged, valued and esteemed, rather than dismissed or marginalized. It may require you to do so even when you don't agree with or believe what has been shared. Because this technique's emphasis is on empathy and listening, it's generally comforting and calming to a person who has dementia.
Your elder wants to wear his/her favorite outfit everyday and can become anxious during dressing. How do you handle it?
If the elder insists on one specific outfit, ask the family to get identical sets. This would allow for the elder to wear the desired outfit that provides comfort while ensuring the clothes are clean.
Other option can be to simplify the process by limiting choices. Your elder may only pick the same outfit daily because there are too many other choices.
You can also use RCA to identify why the elder is attached to that outfit and attempt other interventions, ie.. the color, fabric texture, design
What are the three functions of the hippocampus?
The hippocampus is a part of the limbic system. The limbic system is the area in the brain that is associated with MEMORY, EMOTIONS, AND MOTIVATION. The hippocampus itself is highly involved with our memories.
Name three reasons that an elder may exhibit increased agitation and aggression.
•Pain or discomfort
•Medical/Physical Illness
•Fatigue/Lack of adequate sleep
•Fear or a general loss of sense of control
•Hunger or thirst
•Impulsivity/Disinhibition
•Medication side effects
•Restlessness/Overstimulation
•Low stress threshold
•Responding to caregiver affect
•Overextending abilities
•Severity of dementia
It is important for staff to understand the non-verbal cues that an elder is becoming agitated. These include a clenched jaw, clenched fists, pacing, rocking, etc..
YOU SET THE TONE.
Name three interventions to help ensure a positive approach.
1. YOUR BODY LANGUAGE- facial expressions, body tension and overall mood
2. USE A CALM, GENTLE APPROACH- you set the tone for the interaction. model a relaxed manner.
3. DON'T BE DEMANDING- allow them choice
4. TRY USING TOUCH TO CONVEY YOUR MESSAGE- touch can show that you care and provide physical comfort; provides reassurance
5. BEGIN YOUR CONVERSATION SOCIALLY AND NOT TASK SPECIFIC
True or False
As dementia advances, religion and spirituality become less important parts of a dementia elders life.
FALSE-
THIS INFORMATION WILL HELP GUIDE YOU TO ESTALISH PERSON CENTERED INTERVENTIONS
WE CAN NOT HOLISTICALLY CARE FOR OUR ELDERS IF WE DO NOT REALLY KNOW THEM
What type of dementia causes early onset hallucinations and delusions?
Lewy Body Dementia
Their brains often distort their senses to make them think they are seeing, hearing, feeling, smelling or experiencing something that isn’t really there.
With illusions, an object is physically there, but dementia patients view it as something else. They might see a person in the corner instead of a coat tree, for example.
No object is present during hallucinations, but people’s brains tell them they are seeing children in the living room, hearing voices or feeling that there are strings in their mouths, to name a few common experiences.
Delusions, meanwhile, are fixed false beliefs or ideas that cannot be reasoned with. Capgras syndrome, in which the person with dementia thinks someone close to him or her is an imposter, is one such type of delusion. Another common delusion is blaming someone for stealing a misplaced item.
Elders with cognitive impairment often have difficulty sleeping. What should be the first approach?
Establish a bedtime schedule (using their history and preferences) and assist the elder to go to bed within 15 minutes of that time.
This is the main part of a sleep hygiene program. Here are some more tactics to consider
? *Get up from bed at the same time each day
? *Get regular exercise each day- there is research that proves regular exercise improves restful sleep
*Get regular exposure to outdoor or bright lights, especially in the late afternoon
? *Keep the bedroom dark enough to facilitate sleep
? *Keep the bedroom quiet – try thicker curtains, sleeping at the back of your house or even ear plugs to avoid being woken by noise
?*Use a relaxation exercise just before going to sleep or a relaxation tape
?
What information needs to be shared with the nurse when reporting an elder's behavior?
WHAT ACTUALLY HAPPENED.
WHAT HAPPENED JUST BEFORE THE INCIDENT
WHAT HAPPENED IMMEDIATELY AFTER THE INCIDENT
DID YOU FOLLOW-UP THE CARE PLAN?
Name five "preferences" that we should be asking at admit
WHAT DID YOUR DAYS LOOK LIKE?
WHAT IS SOMETHING THAT YOU CANNOT LIVE WITHOUT?
WHAT UPSETS YOU?
WHAT BRINGS YOU JOY AND COMFORT?
WHAT ARE YOUR FAVORITE FOODS?
DO YOU HAVE ANY CURRENT FEARS?
HOW CAN WE HELP YOU LIVE THE LIFE YOU WANT TO LIVE?