Module 6, Review #6 CH.39 ALZHEIMER'S AND DEMENTIA

What happens during sun downing?

Signs of AD increase during times of darkness. As daylight ends and darkness begins confusion, restlessness, anxiety and other symptoms of AD increase.

What is the most common cause of permanent dementia?

Alzheimer's disease.

Other than dementia, what are some of the causes of confusion in the elderly?

Diseases, infection, hearing and vision loss, and medication side effects. Brain injury can also be a cause of confusion.

What is the correct way to gain the attention of a person with Alzheimer's disease?

Approach the person in a calm, quite manner, approach them from the front, make eye contact.

What actions would you take first with a resident who is anxious, agitated, or has a change in behavior?

Be calm and quiet when talking to the person, try to find out what is making them anxious so you can adjust the environment.

When helping a person with Alzheimer's disease get dressed, what should you do?

Choose clothing that is simple to put on, offer simple choices for them to choose from, lay clothing out in order that it should be put on, do not rush them, be patient, choose comfortable shoes.

What is the definition of cognitive function?

Cognitive function involves memory, thinking, reasoning, ability to understand, judgment, and behavior.

Why is it important to encourage independence in a confused resident?

Confused residents should be treated with the same dignity and respect as anyone else. Independence is important for the same reasons it is important for any resident—to promote optimal levels of functioning and high quality of living.

Define delirium. What is the most important fact for the CNA to remember about delirium?

Delirium is a state of sudden, severe confusion and rapid brain changes. It is acute, unlike dementia which is chronic. Delirium should be reported immediately. It is not a normal part of aging.

Why are residents with dementia always considered at greater risk for injury?

Dementia causes wandering and residents may stray out of their living environment and into an unsafe area. Residents with dementia have poor judgment and are unable to tell what is safe or dangerous. They do not make good choices.

What is the loss of cognitive function that interferes with routine personal, social, and occupational activities?

Dementia.

What techniques are used to promote independence in residents with dementia?

Help the resident communicate. Give the resident options. Give them cues to help them figure things out. Focus on the resident's strengths and past successes. Make sure the resident feels useful, worthwhile, and active.

What types of "triggers" might lead to changes in behavior for a person with Alzheimer's disease?

Illness, infection, medications, lack of sleep, constipation, hunger, thirst, poor vision or hearing, alcohol and caffeine. Triggers in the person's setting could include a strange setting they are not familiar with, loud noise, something that disrupts their depth perception (going from carpet to wood floor). They don't always understand warning signs (like seeing a sign that says WET FLOOR). Mirrors can confuse them as well.

What is the goal in providing activities for residents with dementia?

It helps with self esteem by helping the resident feel useful. This can help lift depression. Activities help the person move so they don't fall prey to pressure sores, etc. It helps them mentally and physically.

What communication techniques will promote the most helpful interactions with residents who have dementia?

Make eye contact, call the person by name, speak in a calm, gentle voice, hold the person's hand while you speak.

What does OBRA have to say about secured or locked units?

Secure units are physical restraints. You must use the least restrictive approach. Dementia diagnoses and doctor's order are needed to place a person on a secure unit. If you do not have a doctor's order. Every 90 days the health team reviews the person's need for a secure unit. (Care plan is updated every 90 days). Patient's rights are always protected.

What are the characteristics of each of the three stages of dementia? (Mild, Moderate, and Severe).

Stage 1: Mild - memory loss, difficulty following directions, mood swings, exhibits poor judgment, difficulty being independent, disoriented. Stage 2:Moderate - sun-downing, increased memory loss, requires assistant with ADLs, increased communication problems, increased behavioral issues, urinary and fecal incontinence, auditory and visual hallucinations, requires full time supervision. Stage 3: Late/Severe -- Loose ability to verbalize needs, may groan, grunt, or scream, does not recognize self or family members, becomes bed bound, total dependence for ADLs, body function gradually declines, death.

During what stage of Alzheimer's would you see wandering?

Stage 2: Moderate

What usually happens when a combative and agitated resident with Alzheimer's disease is restrained?

They become more agitated, they may resist your efforts to apply restraints, they may try to get free, serious death and injury can occur.