Transcript CHAPTER 16 Cognitive Impairment, Alzheimer’s Disease, and Dementia Mosby items and derived items © 2006 by Mosby, Inc. Slide 1

CHAPTER 16
Cognitive Impairment,
Alzheimer’s Disease, and
Dementia
Mosby items and derived items © 2006 by Mosby, Inc.
Slide 1
Chapter 16
Lesson 16.1
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Slide 2
Lesson Objectives
• Describe two normal age-related changes in
cognition.
• Identify five main categories of confusion.
• Explain why medication use can lead to confusion in
older adults.
• Describe at least three signs or symptoms of delirium.
• Identify five symptoms of dementia.
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Slide 3
Normal Changes in Cognition
• Cognition comprises intelligence, learning, judgment,
reasoning, knowledge, understanding, and memory.
• Normal age-related changes in cognition
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Slower response times
Loss of short-term memory
• Confusion not a normal part of aging
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Slide 4
The Five “Ds” of Confusion
• Delirium – acute onset
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Causes
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Metabolic disorder
Infections
Fever
Dehydration
• Damage – acute onset
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Causes
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Stroke
Head injury
Exposure to chemicals
(Cont’d…)
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Slide 5
The Five “Ds” of Confusion
(…Cont’d)
• Deprivation – variable onset
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Causes
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Sensory impairment
Social interaction
• Depression – subacute onset
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Causes
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Loss
Metabolic imbalances
Drugs
Inner sadness
(Cont’d…)
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Slide 6
The Five “Ds” of Confusion
(…Cont’d)
• Dementia – slow onset
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Causes
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Cardiovascular disease
Metabolic problems
Alzheimer’s disease
HIV
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Slide 7
Delirium
• A sudden change of consciousness that occurs
rapidly
• Signs and symptoms
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Disorganized thinking
 Decreased attention span
 Lowered or fluctuating level of consciousness
 Disturbance in sleep-wake cycle
 Disorientation
 Changes in psychomotor activity
 Sometimes, delusions or hallucinations
 Usually, agitation and hyperactivity
 Sometimes, hypoactive behavior such as lethargy and
reduced activity
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Slide 8
Dementia
• Classified as Alzheimer’s or non-Alzheimer’s
• In early stages is difficult to differentiate from ageassociated memory impairment
• Decreasing ability to process new information and to
retrieve and use the information accumulated
throughout life
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Slide 9
Chapter 16
Lesson 16.2
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Slide 10
Lesson Objectives
• Describe the signs and symptoms seen during the
progression of Alzheimer's disease.
• List three mental health care goals for clients with
Alzheimer’s disease.
• Describe the need-driven dementia-compromised
behavior model.
• Identify two types of support groups for the caregivers
of clients with Alzheimer’s disease.
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Slide 11
Alzheimer’s Disease
• A progressive, degenerative disorder that affects
brain cells and results in impaired memory, thinking,
and behavior
• Cause is unknown
• 50% of all cases of dementia have Alzheimer’s
Disease.
• Some 250,000 new cases per year
(Cont’d…)
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Slide 12
Alzheimer’s Disease
(…Cont’d)
• Signs and symptoms
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Memory loss
Difficulty performing familiar tasks
Problems with language
Poor judgment
Problems with abstract thinking
Misplacing things
Disorientation to time and place
Loss of initiative
Changes in mood or behavior
Changes in personality
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Slide 13
Stages of Alzheimer’s Disease
• Early stage
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Begins with the loss of recent memory and progresses
to strange behaviors and mood swings
• Intermediate stage
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Clients cannot recall recent events or process new
information and eventually lose all sense of time and
place. They are still ambulatory but at high risk for falls
and injury.
• Severe stage
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Clients are unable to do anything and are entirely
dependent on others.
• End stage
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Clients slip into a coma.
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Slide 14
Health Care Goals for Clients with
Alzheimer’s Disease
• Provide for clients’ safety and well-being
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Bathing, grooming, eating, physical activity
Remember that clients have no sense of safety or
danger.
• Manage clients’ behaviors therapeutically
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Gently redirect clients who are behaving
inappropriately to less stressful activities.
Music therapy, validation therapy, and exercise help
reduce stress.
(Cont’d…)
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Slide 15
Health Care Goals for Clients with
Alzheimer’s Disease
(…Cont’d)
• Support for family, relatives, and caregivers
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Important sources of information about clients
Should be included in planning care for clients
Provide respite care
Informal support groups–family members, friends, and
people who knew the family member before AD
Formal support groups
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Offered by the Alzheimer’s Association, home care agencies,
and elder care centers
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Slide 16