Chapter 5 - Confusion, Dementia, and Alzheimer's Disease

Mr. Tennant sometimes gets depressed, especially in the evenings. Keisha knows that he loves classical music, so she starts playing it for him in the evenings a little before he usually starts feeling sad. He sorts through albums and places them in stacks. What type of therapy is being used?

Activity Therapy (music therapy)

Always bathe the resident at the same time every day, even if she is agitated

Bad idea

Dementia is the loss of mental abilities such as thinking, remembering, reasoning, and communicating

true

Each person with Alzheimer's disease will show different signs at different times

true

Dementia is something that happens as every person gets older

false

What are 10 actions that a nursing assistant can take when helping care for a resident who is confused?

1. Do not leave the resident alone 2. Stay calm. Provide a quiet environment 3. Speak in a low tone of voice. Speak clearly/slowly 4. Introduce yourself each time you see the resident 5. Remind resident of his location, name and the date 6. Explain what your doing, using simple words 7. Be patient. Do not rush the resident 8. Talk to the resident about the plans for the day. Keep a routine 9. Promote self-care and independence 10. Report observations to the nurse

Name 4 possible causes of delirium

1. infections 2. disease 3. fluid imbalances 4. poor nutrition

Whenever a female resident comes into the television room, Mr. Radcliffe tells her that he loves her and starts removing his clothes. If she stays in the room long enough, he will ask her to take off her clothes too. What AD behavior is this? How would an NA deal with it?

The resident is displaying Inappropriate Sexual Behavior. One way to deal with it is stay calm and get the Charge Nurse

Use plain white dishes for serving food to residents

good idea

follow standard precautions when caring for the resident

good idea

put only one kind of food on the plate at a time

good idea

reward positive behavior with smiles and warm touches

good idea

schedule meals at the same time every day

good idea

If a resident perseverates, this means he is

repeating words, phrases, questions, or actions

Alzheimer's Disease causes tangled nerve fibers and protein deposits to form in the brain, eventually causing dementia

true

Alzhheimer's Disease is the most common cause of dementia in the elderly

true

Most Alzheimer's disease victims will eventually need constant care

true

there is no cure for Alzheimers disease

true

There is one simple exam that is performed to diagnose Alzheimers disease

true - autopsy

Do not attempt to groom the resident; most people with Alzheimers disease do not care about their appearance

Bad idea

If a resident is frightened or anxious, which of the following should the NA do

Check his body language so he does not appear tense or hurried

If a resident does not remember how to perform basic tasks, the NA should

Encourage the resident to do what he can

Symptoms of Alzheimers disease typically appear suddenly

False - appears gradually

Break tasks down into simple steps, explaining one step at a time

Good idea

Use nonslip mats, tub seats, and hand holds to ensure safety during bathing

Good idea

Ms. Lee misses her husband, who has been dead for 10 years, very much. Keisha, an NA, who works with her, always asks about her life with her husband and what it was like. Ms. Lee seems to enjoy telling Keisha stories about what they did when they were young and how happy she was when they were together. What type of therapy is being used?

Reminiscence Therapy

When communicating with a resident with AD, the nursing assistant should

Speak slowly, using a lower tone of voice than normal

Mrs. Martin gets very upset every time she sees the president on television. She yells at the screen and tells everyone how poor a state our country is in. What AD behavior is this? How would an NA deal with it?

The resident is displaying Agitation. One way to deal with it is try to remove triggers, keep a routine, and avoid frustration. Redirect the attention to something else

Mr. Bullis tells his NA that his wife has just called him. She is coming to pick him up, and they are going to dinner at the place they went on there first date. The NA knows his wife has been dead for several years and their favorite restaurant has long since closed down. What AD behavior is this? How would an NA deal with it?

The resident is displaying Hallucinations or Delusions. One way to deal with it is to not argue with the resident who is imagining things. She should acknowledge his hallucinations but redirect his thoughts elsewhere.

About an hour before dinner every night, Ms. Foley starts walking up and down the halls as quickly as she can. She doe not speak to or acknowledge anyone else while she is doing this. What AD behavior is this? How would an NA deal with it?

The resident is displaying Pacing. One way to deal with it is to let the resident pace and wander in a safe and secure (locked) area. Staff should keep an eye on him

Ms. Storey is walking around the facility asking everyone she meets what time it is. Even though she has been told several times, she still seems unsatisfied and keeps asking the question. What AD behavior is this? How would an NA deal with it?

The resident is displaying Perseveration or Repetitive Phrasing. One way to deal with it is to be patient and try not to silence or stop the resident.

Mrs. Rowling loves the color red. She has a lot of red clothing that she enjoys wearing. Whenever she sees a piece of red clothing, even in another resident's room, she picks it up and takes it back to her room. What AD behavior is this? How would an NA deal with it?

The resident is displaying Rummaging/Hoarding. One way to deal with it is label all personal belongings with residents name and room number. That way there is no confusion on what belongs to who.

Mrs. Donne gets upset at about 9:00 every night. She repeatedly asks for snacks or drinks and refuses to go to bed. What AD behavior is this? How would an NA deal with it?

The resident is displaying Sundowning. One way to deal with it is to recognize when sundowning occurs, a calming activity can be done just before

Ms. Desmond used to enjoy talking to people and reading, but lately she does not seem to enjoy anything. She sleeps most of the day and never talks to anyone unless she is asked to. What AD behavior is this? How would an NA deal with it?

The resident is displaying depression. One way to deal with it is to listen to the resident if she wants to share her feelings or talk about her mood

Whenever Mr. Fejer does not like what is being served for dinner, he bangs on the table with his fists and shouts about how much he hates his food. When people try to get him to stop, he only grows louder. What AD behavior is this? How would an NA deal with it?

The resident is displaying disruptiveness. One way to deal with it is to gently direct the resident to a private area

Mr. Noble is playing chess with a friend and becomes angry when he loses the game. He shoves his friend, and when the NA approaches them, he tells her he is going to hit her. What AD behavior is this? How would an NA deal with it?

The resident is displaying violent behavior. The NA should call for help if needed or try to remove the triggers.

Mr. Elking tells Keisha that he has a date with Rose, the pretty girl who lives across the street. He is going to take her dancing and out to a movie. Keisha knows that Rose lived in his neighborhood when he was a teenager and that he has not seen her for years. Keisha knows that Mr. Elking rarely gets out of bed. Instead of correcting him, Keisha asks him what kind of movie they are going to see and what he thinks he should wear. What type of therapy is being used?

Validating Therapy

Do not encourage exercise, as this will make the resident more agitated

bad idea

Do not encourage independence, as this can lead to aggressive behavior

bad idea

If the resident is incontinent, do not give him fluids, because it makes the problem worse

bad idea

Serve finger foods if the resident tends to wander during meals

bad idea

serve new kinds of foods as often as possible to stimulate the resident

bad idea

Men are more likely to have Alzheimer's disease then women

false - women are more likely

Check the skin regularly for signs of irritation

good idea

Choose clothes that are simple to put on

good idea

Mark the bathroom with a sign or picture as a reminder of when to use it and where it is

good idea