7.1 - Management of the Dementias Flashcards

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1
Q

The progressive nature of irreversible dementia rules out ________________ as a practical clinical objective for
most patients with dementia.

A

Restoration of lost abilities

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2
Q

What are the 3 Specific Deficit Areas seen in Dementia?

A

Pragmatics

Lexical-semantics

Syntax

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3
Q

What are the 6 Roles of SLP in Dementia?

A

Screening

Assessment

Diagnosis

Treatment

Education

Counseling

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4
Q

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.

A

Cognitive deficits

Communication problems

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5
Q

What are 2 Other Management Considerations in Dementia Patients?

A

Depression

Polypharmacy

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6
Q

What are 6 Depressive Symptoms seen in Dementia?

A

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

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7
Q

What are 3 Depression Screening Tools?

A

Geriatric Depression Scale

Hamilton Rating Scale for Depression

Beck Depression Inventory

(All are in the public domain)

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8
Q

What are 3 Clinical Objectives for patients with Dementia?

A

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)

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9
Q

What are 3 Management Principles for patients with Dementia?

A

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)

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10
Q

What 6 Management Issues are seen in the EARLY STAGES of Dementia?

A

Memory

Communication

Anxiety + Depression

Behavior Changes

Denial

Sleep Disturbances

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11
Q

What 4 Interventions that can be used to manage the EARLY STAGES of Dementia?

A

Collaborative

Compensatory

Group Therapy

Working on Major Domains

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12
Q

Who can we collaborate with in the EARLY STAGES of Dementia?

3

A

Patient

Caregiver

SLP

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13
Q

What 3 Major Domains can we work on in the EARLY STAGES of Dementia?

A

Memory

Confusion

Communication

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14
Q

What 2 parts of the domain of MEMORY can we work on in the EARLY STAGES of Dementia?

A

Declarative

Prospective

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15
Q

How can we work on Declarative Memory in the EARLY STAGES of Dementia?

A

Memories which can be consciously recalled

such as facts and knowledge

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16
Q

What 2 parts of the domain of COMMUNICATION can we work on in the EARLY STAGES of Dementia?

A

Word retrieval

Comprehension

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17
Q

How can we intervene in MEMORY in the EARLY STAGES of Dementia?

A

Compensatory strategies

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18
Q

In what 2 ways can we intervene in COMMUNICATION in the EARLY STAGES of Dementia?

A

Adaptive

Facilitative

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19
Q

What 4 things can be address in Group Treatment in the EARLY STAGES of Dementia?

A

Stimulate self expression

Stimulate cognitive processes

Promote social integration

Enhance feelings of self worth

20
Q

What Management Issue is seen in the LATE STAGES of Dementia?

A

Caregiver support

21
Q

What 4 Management Issues are seen in the MIDDLE STAGES of Dementia?

A

Progessive Behavior Changes

Insight, Judgment, + Orientation

Physical Dependence

Communication

22
Q

What 3 Interventions that can be used to manage the MIDDLE STAGES of Dementia?

A

Collaborative

Environmental control

Major domains

23
Q

Who can we collaborate with in the MIDDLE STAGES of Dementia?

(2)

A

Caregiver

SLP

24
Q

When collaborating with others during the management of the MIDDLE STAGES of Dementia, who is our focus on?

A

Caregiver

25
Q

What 2 Major Domains can we work on in the MIDDLE STAGES of Dementia?

A

Behavior

Communication

26
Q

What 3 parts of the domain of COMMUNICATION can we work on in the MIDDLE STAGES of Dementia?

A

Word retrieval

Automatisms + sterotypic utterances

Comprehension

27
Q

How can we intervene in BEHAVIOR in the MIDDLE STAGES of Dementia?

(2)

A

Behavior management strategies

A.K.A., the 6 R’s

28
Q

How can we intervene in COMMUNICATION in the MIDDLE STAGES of Dementia?

A

Stimulation

29
Q

What 4 things can be address in Group Treatment in the MIDDLE STAGES of Dementia?

A

Maintaining orientation

Stimulating cognitive processes

Maintaining communicative abilities

Reinforcing appropriate interpersonal behavior

30
Q

Whose burden increases in the MIDDLE STAGES of Dementia?

A

Caregiver

31
Q

What are the 6 R’s?

A

Dementia Strategy 1 – RESTRICT

Dementia Strategy 2 – REASSESS

Dementia Strategy 3 – RECONSIDER

Dementia Strategy 4 – RECHANNEL

Dementia Strategy 5 – REASSURE

Dementia Strategy 6 – REVIEW

32
Q

What is Dementia Strategy 1 – RESTRICT?

A

Stopping the behavior

33
Q

What is Dementia Strategy 2 – REASSESS?

A

Figuring out what provoked the behavior

34
Q

What is Dementia Strategy 3 – RECONSIDER?

A

Put yourself in dementia patient’s shoes

35
Q

What is Dementia Strategy 4 – RECHANNEL?

2

A

Redirect the behavior into something less disruptive

Distract with a different activity

36
Q

What is Dementia Strategy 5 – REASSURE?

A

Assure patient that everything is ok

37
Q

What is Dementia Strategy 6 – REVIEW?

A

Think about how you managed the problem, what you did well, and what you can improve

38
Q

What 3 Interventions that can be used to manage the LATE STAGES of Dementia?

A

Collaborative

Environmental control

Major domains

40
Q

Who can we collaborate with in the LATE STAGES of Dementia?

2

A

Caregiver

SLP

40
Q

When collaborating with others during the management of the LATE STAGES of Dementia, who is our focus on?

A

Caregiver

41
Q

What Major Domain can we work on in the LATE STAGES of Dementia?

A

Behavior

42
Q

How can we intervene in BEHAVIOR in the LATE STAGES of Dementia?

(2)

A

Environmental control

Behavior contingencies

43
Q

What are DIRECT Interventions for Dementia?

A

SLP works with person with dementia to maintain communication

44
Q

In what stage would DIRECT Interventions for Dementia appropriate?

A

Early stages

45
Q

What are INDIRECT Interventions for Dementia?

A

Caregiver’s of person’s with dementia are trained to apply strategies to improve communication

46
Q

In what stage would INDIRECT Interventions for Dementia appropriate?

A

Middle + late stages