Ch. 9 Caring For People With Dementia Exam

Dementia - ANSWER The permanent and progressive loss of mental functions (such as thinking, reasoning, and remembering), caused by damage to the brain tissue What may be some problems a person with dementia may experi ...

Dementia - ANSWER The permanent and progressive loss of mental functions (such as thinking, reasoning, and remembering), caused by damage to the brain tissue What may be some problems a person with dementia may experience? - ANSWER 1. Problems with memory, especially short-term memory 2. Difficulty communicating 3. Problems with judgement (the person is not able to make good decisions) 4. Disorientation (the person is not oriented to a person, place, or time) 5. Inability to manage ADLs T/F- Dementia has a very gradual onset, with symptoms that occur immediately. - ANSWER FALSE- Dementia has a very gradual onset, with symptoms appearing over a period of several months or a few years On average, a person with dementia will live how long after the first symptoms appear? - ANSWER 8 to 10 Years What are the 3 major stages of Dementia and what are the symptoms/signs associated with each stage? - ANSWER 1. Early Stage -begins to experience memory loss -may become fearful, angry, nervous because of these memory changes 2. Middle Stage -difficulty communicating -difficulty recognizing familiar people and things -difficulty remembering the steps that are necessary to complete familiar tasks (ex: getting dressed) -personality may change; may begin to behave differently (often in challenging ways) -begins to experience incontinence (inability to hold urine in the bladder) 3. Late Stage -loses the ability to walk and sit independently and eventually becomes bedridden -no longer able to speak, swallow, or smile -becomes totally incontinent or urine and feces -the person dies T/F- Although medications are available that may help slow the progression of Dementia, there is currently no cure. - ANSWER TRUE Studies have shown that an estimated ______% of older adults suffer some form of Dementia. - ANSWER 5% Delirium - ANSWER A temporary state of confusion What is Delirium a symptom of? - ANSWER An underlying disorder, such as an infection (or also possibly a side effect or medication). What are the 4 most common causes of Dementia? - ANSWER 1. Alzheimer's Disease 2. Vascular Dementia 3. Lewy Body Dementia 4. Frontotemporal Dementia Alzheimer's Disease - ANSWER The most common type of Dementia (60% of all cases); characterized by the permanent and progressive loss of the ability to think and remember caused by damage to the brain Alzheimer's Disease usually occurs when in people? - ANSWER People older than 65 years (however people as young as 40 years may also get the disease) At what age are people at the highest risk for developing Alzheimer's Disease? - ANSWER Because the risk increases with age, people 85 years and older are at the highest risk How was Alzheimer's Disease named? - ANSWER It was named after Alois Alzheimer, German doctor who discovered the disease in 1906. What did Doctor Alzheimer discover about his patient who died showing unusual mental changes and behaviors? - ANSWER He performed an autopsy on her and found that certain areas of her brain seemed soft and shrunken. In addition, he saw abnormal deposits of protein (plaques/ tangles), especially in parts of the brain that function in memory. Plaques & Tangles - ANSWER Abnormal protein deposits found in the brain What effect does plaques/ tangles have on neurons within the brain? - ANSWER They affect the ability of the nerve cells in the brain to communicate with each other. The neurons start to die. As a result, the brain shrinks in size, and brain activity decreases. What is the cause of Alzheimer's Disease? - ANSWER Researches do not know what exactly causes it What is the most significant risk factor for developing Alzheimer's Disease ? - ANSWER Age What are some other risk factors for developing Alzheimer's Disease ? - ANSWER 1. Family History 2. Those who have had serious head trauma 3. Heart Diseases (such as Hypertension, Hypercholesterolemia, Diabetes) What may contribute to the onset of Vascular (Multi-Infarct) Dementia? - ANSWER Damage to the blood vessels that supply the brain which affect the delivery of oxygen to the brain tissue Vascular (Multi-Infarct) Dementia - ANSWER A type of Dementia caused by the loss of function in multiple areas of the brain due to tissue death caused by a lack of adequate oxygen and nutrients (20%-25% of people with dementia) Infarction - ANSWER Death of tissue due to lack of oxygen and nutrients MID (Multi-Infarct Dementia) most often affects people between the ages of what? - ANSWER 55 to 75 years (most commonly occurring in people who are 70 years old). T/F- MID is more common among women than men. - ANSWER FALSE- more common among men What are some conditions that put a person at risk for developing Vascular Dementia? - ANSWER 1. History of a myocardial infarction 2. Hypertension 3. Diabetes Mellitus 4. Peripheral Vascular Disease 5. Transient Ischemic Attacks 6. Obesity 7. Smoking 8. Hypercholesterolemia What can a person do to slow the progression of the irreversible and incurable Vascular Dementia? - ANSWER Keep the person's blood pressure, blood glucose, and blood cholesterol levels within normal limits Lewy Body Dementia - ANSWER A disorder characterized by the build-up of abnormal protein deposits (Lewy bodies) in areas of the brain that are responsible for thinking and movement; in addition to a progressive decline in mental abilities, also have problems controlling body movement similar to those seen in people with Parkinson's Disease, visual hallucinations, and distinct changes in mental alertness (20% of all cases of Dementia) Frontotemporal Dementia - ANSWER A disorder characterized by damage to the frontal and temporal lobes of the brain; in addition to a progressive decline in mental abilities, may have extreme changes in behavior and personality, and difficulties with language, or both (5% of all cases of Dementia) Which area of the brain is responsible for personality and behavior? - ANSWER Frontal Lobe Which area of the brain is responsible for language? - ANSWER Temporal (Broca's- speech function; Wernicke's- understanding language) T/F- Caring for a person with Frontotemporal Dementia can be particularly challenging because the disease may cause the person to say or do things that are socially inappropriate or they lack motivation and energy. - ANSWER TRUE When does memory loss begin with Frontotemporal Dementia? - ANSWER Unlike other forms of Dementia, memory is often spared until later in the disease process What are the "4 A's" of Dementia? - ANSWER 1. Amnesia (difficulty remembering) 2. Aphasia (difficulty speaking or understanding language) 3. Agnosia (difficulty recognizing information obtained using the five senses) 4. Apraxia (difficulty coordinating the steps needed to complete a task) During the early stage of Dementia, memory loss generally only affects what? - ANSWER Short-Term Memory What may be some actions/reactions of a person with short-term memory loss? - ANSWER 1. Accuse others of larceny (because they cannot remember where they put their belongings) 2. Ask for a meal after they have eaten (they do not remember eating) 3. Stop in the middle of a task (they have forgotten what they were doing) 4. Ask the same question over and over again (they cannot remember asking the question and cannot remember the answer you gave them) T/F- If you insist that what the Long-Term Memory Loss resident believes to be true is not real, they will not lose their trust in you since you are only trying to help them. - ANSWER FALSE-they will lose trust in you! (Instead use validation therapy) Validation Therapy - ANSWER A technique used for interacting with people who have dementia, in which the caregiver acknowledges the person's reality; rather than correcting the person, the caregiver attempts to distract the person and redirect the conversation whenever possible Validation Therapy does what for the resident and what for the caregiver? - ANSWER Resident- protects the feelings and beliefs of the person with dementia and helps the person to retains sense of self-worth and dignity Caregiver- helps understand what the person with dementia is experiencing When does a person begin to experience aphasia? - ANSWER During the Middle Stage of dementia What is the difference between expressive aphasia and receptive aphasia? - ANSWER Expressive- difficulty using words Receptive- difficulty understand words If you cannot understand a resident with expressive aphasia (ex: "my twig had a cap and the nose was had indeed!"), how should you respond? - ANSWER Respond to the mood or feeling that the person is conveying through their body language or tone of voice How can you convey a message to a resident with receptive aphasia? (ex: asking the person to go to the dining room with you) - ANSWER Using gestures may help the person to understand the message (ex: pointing toward the dining room or pretend to pick up a fork and eat) What must a caregiver be very careful of when caring for people with agnosia? - ANSWER To keep cleaning solutions, personal care items, medications, equipment, and other potentially dangerous items in a secure place What are some common behaviors in people with Dementia? - ANSWER 1. Wandering 2. Pacing 3. Repetition 4. Rummaging 5. Delusions and Hallucinations 6. Agitation 7. Catastrophic Reactions 8. Sundowning 9. Inappropriate Sexual Behaviors T/F- A resident who tends to wander may wear a bracelet or an anklet that will set off an alarm if the resident tries to leave the facility through a doorway that leads to an unsafe area. - ANSWER TRUE Why might a resident with dementia pace back and forth? - ANSWER Often, the person is pacing because they have a physical need that is not being met (ex: hungry or need to use the toilet), or in response to a noisy, overstimulating environment, or because they are feeling lost or scared. Perseveration - ANSWER The inappropriate and constant repetition of a phrase or act; often seen in people with dementia (Can be a sign that the person is bored) Delusions - ANSWER A belief or impression that is firmly believed despite being contradicted by what is generally accepted as reality or rational argument; typically a symptom of dementia Hallucination - ANSWER Seeing, hearing, tasting, or smeeling something that is really not there; typically a symptom of dementia People with dementia often lose the ability to communicate effectively with others, so how do they express themselves? - ANSWER Through behavior What may cause agitation? - ANSWER 1. Pain 2. Infection 3. Unmet physical need 4. Noisy environment Catastrophic Reaction - ANSWER An extreme reaction to a situation that would normally cause minimal or no stress; often seen in people with dementia When do catastrophic reactions usually occur? - ANSWER When the person feel threatened or overwhelmed Sundowning - ANSWER The worsening of a person's behavioral symptoms in the late afternoon and evening, as the sun goes down Why do people think sundowning occurs? - ANSWER Some people think it is brought on by fatigue, while other think it occurs because the person cannot see as well once the sun has gone down, increasing confusion and agitation OBRA states that a resident of a long-term care facility must be allowed to fulfill their sexual needs with another consenting resident. How can this be a problem with residents that have dementia? - ANSWER A resident with dementia is not able to give consent Why is it important to try and determine the cause of difficult behavior, rather than just accepting it as a normal part of the person's dementia process? - ANSWER Because a change in the person's behavior might be the first and only sign of a medical problem.