MNA

Mosby’s Long Term Care Assistant Chapter 44Confusion and Dementia

CognitiveCognitiveMemoryThinkingReasoningAbility to

understandJudgmentBehavior

ConfusionConfusion

Many causesDrugs

Disease

Infection

Injury

Person may be

Angry

Restless

Depressed

Irritable

Caring for persons with Confusion

Follow care plan Provide safety Face person, speak clearly Explain procedures Maintain day/night cycle Be consistent Orient often Provide calm setting

Use clear, simple, easy to

understand instructions

Give time to respond

Give clear simple directions and answers

Dementia

Loss of cognitive functions

Interferes with daily activities

Dementia

Not normal part of aging

May be due to variety of diseases

Possible Causes:

Alcohol

Alzheimer's

Brain tumors

CVA

Multiple Sclerosis

Huntington’s Chorea

Parkinson's

Syphilis

Head Injury

Dementia

S&S

Memory Loss

Problems with language,

common tasks

Poor judgment

Getting lost in familiar places

Delirium

Sudden severe confusion, rapid

brain changes.

Occurs with physical or mental

illness

Usually temporary and reversible

Possible causes:

Infection

Poor nutrition

Hormone disorders

Alcohol, drugs

Alzheimer's Disease

Brain diseaseNerve cells are damaged and die

Effects:MemoryThinking, ReasoningJudgmentLanguageBehavior, MoodPersonality

Alzheimer's Disease

Gradual onsetGets worse and worse

Usually live 8 -10 years after onsetCause is unknown

S&SGradual loss of short term memoryAsking same question

over and over.Repeating the same storyForgetting how to do

everyday activitiesForgetting names, recent events, directionsGets lost in familiar

setting

Alzheimer's Disease

Progresses from memory loss to being totally dependent on others to coma to death

Alzheimer's Disease

Wandering

Disoriented, poor judgment. Allow to wander in safe areas.

Causes:May have no causeMay be looking for something or someoneDrugsStress, restlessness

anxiety

Alzheimer's Disease

SundowningS&S increase during hours of darkness.

Alzheimer's Disease

Approach in calm, quite mannerMake eye contactUse calm gently voiceUse simple easy to understand instructions

Use gestures and body languageSpeak slowlyDo not use baby talkDo not rushDo not criticize

Alzheimer's Disease

Do not try to reason with resident or ask why they are upset: they cannot

understand you.

Follow set routine

Ensure safety

Encourage activities early in the day

Alzheimer's Disease

Do not restrain

Aggression may be due to physical discomfort

(elimination?)

Sexual gestures may be due to physical discomfort (wet depends?)

X

Alzheimer's Disease

Remember, the resident with Alzheimer's Disease:

Did not choose to have this disorder

Deserves to be treated with respect

Has same rights as all other residents

Alzheimer's Disease

FamilyNeed support and encouragementOften feel helpless

and hopeless

Respite Care