7.1 - Management of the Dementias Flashcards
The progressive nature of irreversible dementia rules out ________________ as a practical clinical objective for
most patients with dementia.
Restoration of lost abilities
What are the 3 Specific Deficit Areas seen in Dementia?
Pragmatics
Lexical-semantics
Syntax
What are the 6 Roles of SLP in Dementia?
Screening
Assessment
Diagnosis
Treatment
Education
Counseling
Whereas Medicare claims reviewers increasingly recognized that SLPs could appropriately treat speech and language disorders, they often failed to understand the necessity of treating __________ that caused the ___________ of dementia.
Cognitive deficits
Communication problems
What are 2 Other Management Considerations in Dementia Patients?
Depression
Polypharmacy
What are 6 Depressive Symptoms seen in Dementia?
Loss/increase in appetite/weight
Disturbances in sleep
Loss of interest/please; things previously enjoyed
Feelings of worthlessness and guilt
Impaired concentration/memory
Fatigue and loss of energy
What are 3 Depression Screening Tools?
Geriatric Depression Scale
Hamilton Rating Scale for Depression
Beck Depression Inventory
(All are in the public domain)
What are 3 Clinical Objectives for patients with Dementia?
Minimize disruptive effects of the dementia on the patient, caregiver and family members
Keep the patient healthy
Provide support and direction for the patient, caregivers and family members (most important objective)
What are 3 Management Principles for patients with Dementia?
Increase reliance on spared systems and decrease dependence on impaired ones
Strengthening of knowledge and processes that have the potential to improve
Evoke positive emotion (to reverse effects of depression)
What 6 Management Issues are seen in the EARLY STAGES of Dementia?
Memory
Communication
Anxiety + Depression
Behavior Changes
Denial
Sleep Disturbances
What 4 Interventions that can be used to manage the EARLY STAGES of Dementia?
Collaborative
Compensatory
Group Therapy
Working on Major Domains
Who can we collaborate with in the EARLY STAGES of Dementia?
3
Patient
Caregiver
SLP
What 3 Major Domains can we work on in the EARLY STAGES of Dementia?
Memory
Confusion
Communication
What 2 parts of the domain of MEMORY can we work on in the EARLY STAGES of Dementia?
Declarative
Prospective
How can we work on Declarative Memory in the EARLY STAGES of Dementia?
Memories which can be consciously recalled
such as facts and knowledge
What 2 parts of the domain of COMMUNICATION can we work on in the EARLY STAGES of Dementia?
Word retrieval
Comprehension
How can we intervene in MEMORY in the EARLY STAGES of Dementia?
Compensatory strategies
In what 2 ways can we intervene in COMMUNICATION in the EARLY STAGES of Dementia?
Adaptive
Facilitative
What 4 things can be address in Group Treatment in the EARLY STAGES of Dementia?
Stimulate self expression
Stimulate cognitive processes
Promote social integration
Enhance feelings of self worth
What Management Issue is seen in the LATE STAGES of Dementia?
Caregiver support
What 4 Management Issues are seen in the MIDDLE STAGES of Dementia?
Progessive Behavior Changes
Insight, Judgment, + Orientation
Physical Dependence
Communication
What 3 Interventions that can be used to manage the MIDDLE STAGES of Dementia?
Collaborative
Environmental control
Major domains
Who can we collaborate with in the MIDDLE STAGES of Dementia?
(2)
Caregiver
SLP
When collaborating with others during the management of the MIDDLE STAGES of Dementia, who is our focus on?
Caregiver
What 2 Major Domains can we work on in the MIDDLE STAGES of Dementia?
Behavior
Communication
What 3 parts of the domain of COMMUNICATION can we work on in the MIDDLE STAGES of Dementia?
Word retrieval
Automatisms + sterotypic utterances
Comprehension
How can we intervene in BEHAVIOR in the MIDDLE STAGES of Dementia?
(2)
Behavior management strategies
A.K.A., the 6 R’s
How can we intervene in COMMUNICATION in the MIDDLE STAGES of Dementia?
Stimulation
What 4 things can be address in Group Treatment in the MIDDLE STAGES of Dementia?
Maintaining orientation
Stimulating cognitive processes
Maintaining communicative abilities
Reinforcing appropriate interpersonal behavior
Whose burden increases in the MIDDLE STAGES of Dementia?
Caregiver
What are the 6 R’s?
Dementia Strategy 1 – RESTRICT
Dementia Strategy 2 – REASSESS
Dementia Strategy 3 – RECONSIDER
Dementia Strategy 4 – RECHANNEL
Dementia Strategy 5 – REASSURE
Dementia Strategy 6 – REVIEW
What is Dementia Strategy 1 – RESTRICT?
Stopping the behavior
What is Dementia Strategy 2 – REASSESS?
Figuring out what provoked the behavior
What is Dementia Strategy 3 – RECONSIDER?
Put yourself in dementia patient’s shoes
What is Dementia Strategy 4 – RECHANNEL?
2
Redirect the behavior into something less disruptive
Distract with a different activity
What is Dementia Strategy 5 – REASSURE?
Assure patient that everything is ok
What is Dementia Strategy 6 – REVIEW?
Think about how you managed the problem, what you did well, and what you can improve
What 3 Interventions that can be used to manage the LATE STAGES of Dementia?
Collaborative
Environmental control
Major domains
Who can we collaborate with in the LATE STAGES of Dementia?
2
Caregiver
SLP
When collaborating with others during the management of the LATE STAGES of Dementia, who is our focus on?
Caregiver
What Major Domain can we work on in the LATE STAGES of Dementia?
Behavior
How can we intervene in BEHAVIOR in the LATE STAGES of Dementia?
(2)
Environmental control
Behavior contingencies
What are DIRECT Interventions for Dementia?
SLP works with person with dementia to maintain communication
In what stage would DIRECT Interventions for Dementia appropriate?
Early stages
What are INDIRECT Interventions for Dementia?
Caregiver’s of person’s with dementia are trained to apply strategies to improve communication
In what stage would INDIRECT Interventions for Dementia appropriate?
Middle + late stages
