Chapter 19
Is Alzheimer's disease a normal part of aging or not a normal part of aging?
Alzheimer's disease is not a normal part of aging.
An irreversible disease can or can not be cured?
An irreversible disease cannot be cured
Being what is important for residents who are confused and easily upset?
Being consistent is important for residents who are confused and easily upset.
State an appropriate response to the given situation: Blake is helping Mr. Collins get ready to go to dinner. Blake asks him to put his shoes on, but Mr. Collins does not understand what Blake wants him to do.
Break the activity into simple steps. Blake could ask Mr. Collins to sit up in bed, put one shoe on his foot, put the other shoe on, then go to dinner. Also Blake should encourage Mr. Collins to do everything he can by himself.
Cognitive impairment affects what?
Concentration and memory
What are degenerative diseases?
Degenerative diseases are diseases that get continually worse, causing a greater loss of health and abilities
State an appropriate response to the given situation: Mrs. Hays, a resident with Alzheimer's disease, has awakened from her nap and does not recognize her room or anyone around her.
Gently remind the resident where they are and who you are.
List four resources available to people with Alzheimer's disease and their families
Organizations, books, counseling, and support groups are available to people with Alzheimer's disease and their families.
Identify the therapy that the nursing assistant is using in the given situation: Ms. Lee misses her husband, who has been dead for ten years, very much. Lisa, 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 Lisa stories about what they did when they were young and how happy she was when they were together.
Reminiscence therapy
If a resident perseverates, this means he is doing what?
Repeating words, phrases, questions, or actions
What two major resources affect the ability of a resident's family to cope with AD?
The families emotional and financial resources affect the ability of a resident's family to cope with AD.
List 6 Bad Ideas for residents with Alzheimer's disease.
1. Always bathe the resident at the same time every day, even if she is agitated. 2. Do not attempt to groom the resident; he most likely does not care about his appearance anyway. 3. If the resident is incontinent, do not give him fluids because it makes the problem worse. 4. Do not encourage exercise, as this will make the resident more agitated. 5. Serve new kinds of foods as often as possible to stimulate the resident. 6. Do not encourage independence, as this can lead to aggressive behavior.
The loss of ability to think logically and clearly is called?
Cognitive impairment
Identify the behavior that the resident with Alzheimer's disease is exhibiting and describe one way of dealing with it: Mrs. Leone 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.
Hoarding and rummaging. Try to label all personal belonging with the resident's name and room number.
Identify the behavior that the resident with Alzheimer's disease is exhibiting and describe one way of dealing with it: 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.
Inappropriate sexual behavior. Try to determine the cause of the problem.
Name four possible causes of delirium
Infections, disease, fluid imbalances, and poor nutrition are all possible causes of delirium.
Is dementia a normal part of aging?
No, dementia is not a normal part of aging
When communicating with a resident with Alzheimer's disease, the NA should do what?
Speak slowly, using a lower tone of voice than normal
Identify the behavior that the resident with Alzheimer's disease is exhibiting and describe one way of dealing with it: Mrs. Donne gets upset at about 9:00 p.m. every night. She repeatedly asks for snacks or drinks and refuses to go to bed.
Sundowning. One way to deal with sundowning is to avoid stressful situations during this time and provide snacks.
How do symptoms of Alzheimer's disease typically appear?
Symptoms of Alzheimer's disease typically appear gradually.
Take care of yourself, both what and physically?
Take care of yourself, both mentally and physcially
If a resident repeatedly asks if he can go home, the NA should do what?
The NA should ask the resident to talk about what his home was like.
If a resident is frightened or anxious, what should the NA do?
The NA should check her body language so she does not appear tense or hurried.
What is the most common disease that causes dementia in the elderly?
The most common cause of dementia in the elderly is Alzheimer's disease
How do doctors diagnose Alzheimer's disease?
There are multiple tests that are performed to diagnose someone with Alzheimer's disease
Identify the therapy that the nursing assistant is using in the given situation: Mr. Elking tells Lisa that he has a date with Nora, the pretty girl who lives across the street. He is going to take her dancing and out to a movie. Lisa knows that Nora lived in his neighborhood when he was a teenager and he has not seen her for years. She also knows that Mr. Elking rarely gets out of bed. Instead of correcting him, Lisa asks him what kind of movie they are going to see and what he thinks he should wear.
Validation therapy
Identify the behavior that the resident with Alzheimer's disease is exhibiting and describe one way of dealing with it: Mr. Noble is playing chess with a friend and becomes angry when he loses the game. He shoves his friend, and when the nursing assistant approaches them, he tells her he is going to hit her.
Violent behavior. One way to deal with this is to call for help if needed and step out of reach and stay calm.
Are men or women more likely to have Alzheimer's disease?
Women are more likely to have Alzheimer's disease than men.
State what personal attitude should be used in this situation: Ms. Yancy has Alzheimer's disease. She is still in the very early stages of the disease, but she gets very depressed when she thinks about what will happen to her later. She has not opened up to her NA about things that she likes to do or talk about, and the NA would like her to be more comfortable with her. She notices that when Ms. Yancy's daughter visits, she always brightens up a bit.
Work with family members because family members can help the NA understand why Ms. Yancy isn't opening up. Also try to make sure Ms. Yancy sees her daughter frequently because that provides comfort for her.
State what personal attitude should be used in this situation: On Monday afternoon, Mr. Kotter was lively and friendly. He said that he was looking forward to a Tuesday afternoon card game that he was going to play with his two best friends. On Tuesday when an NA stops by his room to get him ready to go to the card game, he says he hates cards and he does not like any of the people who are playing. He would prefer to go for a walk by himself.
Work with the symptoms and behaviors noted. Note changes in behavior, mood, or independence. Each person will show different symptoms at given times.
Can Parkinson's disease cause dementia?
Yes, Parkinson's disease may cause dementia
What are ten actions that a nursing assistant can taken when helping care for a resident who is confused?
1. Do not leave a confused resident alone 2. Stay calm and provide a quiet environment 3. Speak in a lower tone of voice and speak clearly and slowly 4. Introduce yourself each time you see the resident and remind the resident of his or her location and name, as well as the date. a calendar can help 5. Explain what you are going to do, using simple instructions. 6. Be patient and do not rush the resident. 7. Talk to confused residents about plans for the day. keeping a routine may help. 8. Promote self-care and independence. 9. Encourage the use of eyeglasses and hearing aids. 10. Do not leave cleaning agents or personal care products where the resident can access them.
List 12 Good Ideas for resident with Alzheimer's disease
1. Use nonslip mats, tub seats, and handholds to ensure safety during bathing. 2. Break tasks down into simple steps, explaining one step at a time. 3. Choose clothes that are simple to put on. 4. Mark the bathroom with a sign or picture as a reminder of when to use it and where it is. 5. Check the skin regularly for signs of irritation. 6. Follow Standard Precautions when caring for the resident. 7. Serve finger foods if the resident tends to wander during meals. 8. Schedule meals at the same time every day. 9. Put only one kind of food on the plate at a time. 10. Use plain white dishes for serving food. 11. Protect privacy by keeping the resident covered, even if he is unaware of what is happening. 12. Reward positive behavior with smiles and warm touches.
State what personal attitude should be used in this situation: A resident tells an NA that she hates having to see him every morning. She says that she does not know how anyone was foolish enough to hire him and that she will complain to the nurse about him every day until he is fired.
Do not take things personally. This resident does not have control over their words and actions. Remember that the behavior is due to the disease.
Identify the therapy that the nursing assistant is using in the given situation: Mr. Tennant sometimes gets depressed, especially in the evenings. Lisa knows that he loves classical music, so he 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.
Activity therapy.
Identify the behavior that the resident with Alzheimer's disease is exhibiting and describe one way of dealing with it: Mrs. Martin gets very upset every time she sees the president on television. She yells at the screen and tells everyone what a poor state our country is in.
Agitation. One way to deal with this is to try to remove the trigger which is the television.
Describe what Alzheimer's disease does to the brain
Alzheimer's disease causes tangled nerve fibers and protein deposits to form in the brain, eventually causing dementia.
State what personal attitude should be used in this situation: An NA has been working all day and is very tired. He has a headache and has not had time to eat a decent meal. He does not know how he will summon the energy to come back to work tomorrow and take care of Mrs. Jones, a resident with Alzheimer's disease whose behavior has been very challenging lately.
Be aware of the difficulties associated with care giving because even though caring for someone with AD causes emotional and physical exhaustion. NA's should take care of themselves so they can continue to provide the best care.
State what personal attitude should be used in this situation: A resident becomes very depressed one morning while his NA is helping him shave. He tells the NA she is lucky that she does not need someone to help her do everyday tasks. He says that he hopes she appreciates her good health.
Be empathetic. As an NA try to understand how hard and frustrating it must be to need help with everyday tasks.
State an appropriate response to the given situation: Blake, an NA, has been trying to give Mr. Collins, a resident with Alzheimer's disease, a bath. Mr. Collins has become agitated and is asking Blake, "Who are you?" over and over again, although Blake has already identified himself twice.
Blake should identify himself again to Mr. Collins. He should keep identifying himself until Mr. Collins stops asking. Also keep explaining the procedure and do not force Mr. Collins to take a bath.
State an appropriate response to the given situation: Mrs. Hays has been telling Blake a story about her niece. She is showing him a necklace that her niece gave her as a gift. She is having trouble remembering the word necklace and is getting upset.
Blake should suggest the word "necklace" to Mrs. Hays and ask if that word sounds correct.
Identify the behavior that the resident with Alzheimer's disease is exhibiting and describe one way of dealing with it: Mr. Montoya tells his nursing assistant that his wife just called him on the phone. She is coming to pick him up, and they are going to dinner at the place they went on their first date. The NA knows that his wife has been dead for several years, and their favorite restaurant has long since closed down.
Delusions. Ignored harmless delusions.
Define dementia
Dementia is the loss of mental abilities such as thinking, remembering, reasoning, and communicating.
Identify the behavior that the resident with Alzheimer's disease is exhibiting and describe one way of dealing with it: 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.
Depression. Encourage independence, self-care, and activity.
Develop a what and stick to it?
Develop a routine and stick to it
Will each person with Alzheimer's disease show different signs at different times?
Yes, each person with Alzheimer's disease will show different signs at different times.
Nursing assistants can help elderly residents with memory loss by doing what?
Encouraging them to make lists of things to remember
Will most Alzheimer's disease victims be dependent on others for care?
Eventually most Alzheimer's disease victims will be dependent on others for care
What stage of Alzheimer's disease lasts the longest?
Generally speaking, middle-stage Alzheimer's disease lasts the longest of the three stages
Identify the behavior that the resident with Alzheimer's disease is exhibiting and describe one way of dealing with it: Whenever Mr. Henderson 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.
Inappropriate social behavior. Try to find out what caused the behavior or disruptiveness.
Why might it be difficult for families of people who have AD?
It may be difficult for families of people who have AD because of the stress of caring for a loved one, difficult to watch a loved one's personality change, the feeling of guilt when placing a loved one in a facility, and if the loved one is living alone there is fear that they might get hurt.
Should the nursing assistant no longer encourage independence once a resident is in late-stage Alzheimer's disease?
No, the nursing assistant should always encourage independence no matter what stage of Alzheimer's the resident is in
Is there a cure for Alzheimer's disease?
No, there is no cure for Alzheimer's disease.
Identify the behavior that the resident with Alzheimer's disease is exhibiting and describe one way of dealing with it: About an hour before dinner every night, Ms. Lordes starts walking up and down the hall as quickly as she can. She does not speak to or acknowledge anyone else while she is doing this.
Pacing and wandering. Try to redirect attention to something the resident enjoys, such as suggesting going on a walk together.
Promote what? This will help residents what with a difficult disease like Alzheimer's disease?
Promote self-care. This will help residents cope with a difficult disease like Alzheimer's disease.
Identify the behavior that the resident with Alzheimer's disease is exhibiting and describe one way of dealing with it: 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.
Repetitive phrasing. Be patient with the behavior and do not try to silence or stop the resident.
What skills will a person keep longer after the onset of Alzheimer's disease?
Skills that a person has used often throughout their life are usually kept longer after the onset of Alzheimer's disease
