Dementia Care

Intellectual changes in dementia

Behaviours and Psychological Symptoms in dementia

Types of dementia

Care approaches

Medication use in dementia

100

A resident with this condition may return to first language; resist care because they have difficulty following verbal directions; appear frustrated with inability to express personal needs.

What is aphasia?

Loss of language (comprehension and expression).

100

Which of these can trigger responsive behaviors in a person with dementia?

a) Unmet physical needs
b) Environmental overstimulation
c) Changes in routine
d) All of the above

d) All of the above

100

What is the most common type of dementia?

Alzheimer's disease is the most common, affecting 60–80% of those with dementia.

100

If you had dementia, what is something important that you would want your caregivers to know?

There are many things that are helpful to know - understanding the whole person—their history, personality, values, and needs helps in planning care that is respectful and effective.

100

True or false- there are medication that are highly effective in treating dementia?

Unfortunately, false. Medications for dementia offer modest, variable effectiveness, typically slowing decline or managing symptoms rather than curing the disease, with benefits often small, lasting 6-12 months, and not working for everyone. New therapies like monoclonal antibodies (e.g., lecanemab) can target Alzheimer's pathology in early stages but are not a cure.

200

Describe behaviours you might see in a resident experiencing anosognosia.

Anosognosia is a lack of awareness or denial of one's illness. Loss of ability to be aware of the correct personal situation.

Possible behaviours can include denying having difficulty managing own care, may try to leave care home.

200

Why do we use the BSO-DOS© to track behaviours?

The BSO-DOS© provides objective data about a person’s behaviour. The data collected is used to identify patterns, trends, and contributing factors associated with responsive behaviours/personal expressions.

200

This dementia affects those who are under the age of 65.

What is Young Onset dementia?

This accounts for an estimated 2 to 8% of all dementia cases.

200

When communicating with someone with dementia, you should:
a) Use long, detailed sentences
b) Speak slowly and use simple words
c) Avoid eye contact
d) Repeat instructions loudly

b) Speak slowly and use simple words

200

Why do antipsychotic medications need to be used cautiously in persons with dementia?

Antipsychotic medications carry serious risks and side effects such as increasing the risk of stroke, have sedative effects, increased risk of falls and resultant fractures, myocardial infarction, heart failure etc

300

A resident appearing to resist care (unable to follow care instructions) may be experiencing what condition?

Apraxia- the loss of ability to move and coordinate body and limb movement in a purposeful way.

300

A resident with dementia repetitively calls out. What should I do?

a) ask the nurse to give them a medication.

b) see if they have any unmet needs.

b) See if they have any unmet needs- are they uncomfortable, in pain, need to toilet, thirsty, bored, frustrated, fearful, disoriented etc.?

300

This type of dementia typically affect the areas of the brain that involve thinking and movement.

Lewy body dementia

300

A resident is asking when her mother (who passed away 10 years ago) will pick her up. How do you respond?

Validation/Redirect: "You're looking for your mom. That sounds like you miss her very much. What was your favorite thing to do with her? Would you like to go for a walk with me instead?".
Gentle Reassurance: "I haven't seen her today, but you are safe here. Let's sit and talk about her".
Simple Question: "Are you waiting for her to pick you up? Can I help you with something while we wait?

300

Name 3 behaviours that are unlikely to respond to medications

Wandering

Vocally disruptive behaviour

Hiding & hoarding

Repetitive activity

Inappropriate voiding

Inappropriate dressing/undressing

Tugging at seatbelts

400

A person experiencing this has trouble perceiving the world around them correctly.

What is altered perception?

Examples include loss of depth perception, loss of ability to tell 3-dimensions from 2-dimensions (e.g. TV, pictures, loss of colour and visual perception

400

You are trying to provide care to a resident and they begin to get angry at you and refuse all care. What should you do?

If the person becomes aggressive when you suggest washing, change the subject or distract them and try again later.
Give them time and space to settle.
Allow them the right to refuse.
Inform the nurse.
Review their behavioral care plan for individualized care approaches.
See if a colleague who they are more familiar with can help.

400

What is the second most common type of dementia?

Vascular dementia is the second most common, affecting about 20% of persons with dementia.

400

Name 3 strategies to enhance communication with a resident living with dementia

-make sure they have clean glasses/working hearing aides if in use

-make eye contact and use their preferred name when addressing them

-reduce distractions in the environment ie. turn down the TV

-approach in a calm, relaxed manner

400

Name 3 Behavioural and Psychological Symptoms That May Respond to Medications

Anxiety

Depressive symptoms

Sleep disturbance

Manic-like symptoms

Delusions and/or hallucinations

Verbal aggression

Physical aggression

Sexually inappropriate behaviours

500

Describe behaviours you might see in a resident experiencing agnosia?

Agnosia is the loss of ability to recognize people/ self/objects, sounds, and taste resulting in misidentification (even when no loss of the five senses).

Possible behaviours may include putting non-food items in the mouth, yelling/being afraid of reflection in mirror, using objects incorrectly (e.g. combing hair with fork), may appear frightened when unable to recognize others.

500

Conversations with a person with dementia can be challenging- what are strategies to avoid arguing?

Avoid correcting or contradicting: The person's perception, even if inaccurate, is their current reality. Correcting them can cause embarrassment and anger.
Respond to feelings, not facts: The emotions behind their words are often more important than the literal content. Acknowledge and validate their feelings.
Enter their reality: Go with the flow of their conversation, rather than trying to pull them back to yours. This can help the person feel heard and understood.
Use simple, clear communication: Speak slowly, use a gentle tone of voice, and employ short, simple sentences. Avoid open-ended questions and instead offer limited choices, e.g., "Would you like the blue shirt or the red shirt?".
Use non-verbal cues: Maintain eye contact, smile, and use reassuring body language or gentle touch (if appropriate) to convey warmth and safety. Be mindful of your own body language and tone, as people with dementia often pick up on non-verbal distress.

500

This type of dementia primarily affects the frontal and temporal regions of the brain – the areas generally associated with personality and behaviour.

What is Frontotemporal dementia?

500

A resident you are caring for is refusing to have a bath. What are possible reasons?

-They might be shy or embarrassed; think about their personal space and privacy. Try uncovering only the part of their body that you are washing.
- They may forget when they last bathed, how to use facilities, or fail to recognize the need for hygiene.
-Sensory sensitivity: Some people become highly sensitive to sound, light, or touch, making the bathing environment overwhelming
- Fear and confusion: Water may seem frightening, the bathroom dark/scary, or the mirror reflection interpreted as a stranger.

500

Which medication class is commonly used to manage severe agitation in dementia but carries a black box warning for increased mortality?
a) SSRIs
b) Antipsychotics
c) Benzodiazepines
d) Cholinesterase inhibitors

b) Antipsychotics