3. Dementia & Delirium

Question 1

Delirium

Answer 1

acute confusion

risk factors:
-UTI
-constipation
-urinary retention 
-med side effects
-withdrawal from alcohol 
ect

2 types:

1. hyperactive:
   - agitation
   - hallucination
   - restlessness
   - laughing
   - swearing
   - fast/loud speech
   - anger
2. Hypoactive:
   - lethargy
   - decreased motor activity
   - staring
   - emotional lability
   - unresponsiveness
   - sleeping a lot
   - drowsy

Question 2

Assessment of Delirium

Answer 2

CAM (confusion assessment method)

• diagnosis = feature 1 and 2 and either 3 or 4
• Feature1: acute onset
• Feature 2: Inattention
• Feature 3: Disorganized thinking
• Feature 4: Altered level of consciousness

4AT

• alertness
• AMT 4
• attention
• acute change
• score 4+= delirium

Question 3

Delirium Interventions

Answer 3

Pharmacological

• not recommmended, last resort
• sedative and antipsychotic for non-alcohol related delirium

Non-pharm

Physiological:

• hydration
• nutrition
• sleep
• remove restraints
• remove catheters
• glasses
• manage pain

Environmental:

• manage noise
• lighting

Communication:

• ID yourself
• speak clearly
• speak slowly
• provide explanation
• use gestures
• allow time to respond

Question 4

Dementia

Answer 4

• irreversible loss of cog. function
• a group of brain disorders dt damage or loss of nerve cells and their connection to brain
• affects:
• memory
• understanding
• judgement
• decision-making
• communication
• changes in personality and behaviour

Question 5

4 types of dementia

Answer 5

1. Alzheimer
   - atrophy in many areas in the brain
2. Vascular
   - death of nerve cells in the regions nourished by the diseased vessels
3. Lewy Body
   - includes Parkinson’s disease, is the presence of clumpy abnormal proteins (Lewy bodies) in the brain that eventually damage the neurons
4. Frontotemporal
   - neurodegeneration of the frontal or temporal lobes

Question 6

Assessment for dementia

Answer 6

MOCA and MMSE
-initial tools

BPSD (behaviour and. psychological symptoms of dementia)

Question 7

Interventions

Answer 7

Pharm
-meds

Non-pharm

• education
• environmental modifications
• communication skills
• therapies