alzheimers/dementia

Question 1

at what stage of dementia does a person require substantial assistance for daily activities?

Answer 1

middle dementia

Question 2

dementia-like conditions that can be reversed

Answer 2

infections/immune disorders
Metabolic problems
Endocrine abnormalities
Nutritional deficiencies
Dehydration
Not getting enough thiamin (vitamin B-1)
Medication side effects
Subdural hematomas
Poisoning
Exposure to heavy metals

Question 3

disorders linked to dementia

Answer 3

• huntingtons
• TBI
• Parkinson’s disease

Question 4

at what ACL stage should dementia patients not drive?

Answer 4

4.6

Question 5

at what ACL stage should dementia patients require cues?

Answer 5

4.8

Question 6

at what dementia stage is safety a concern?

Answer 6

middle stages (wandering, cause fire, let stranger into house)

Question 7

what type of memory goes away first in early to mid dementia?

Answer 7

short term memory

Question 8

when do dementia patients have trouble with managing money?

Answer 8

early stage

Question 9

at what reisberg scale stage is dementia diagnosed by a doctor?

Answer 9

stage 4: moderate cognitive decline

Question 10

alzheimer’s disease

Answer 10

• most common cause of dementia
• plaques/tangles in the brain

Question 11

vascular dementia

Answer 11

• 2nd most common dementia, less severe than AD
• sudden symptoms SLOW progression
• Difficulties problem solving, slow thinking, focus, organization, gait issues
• More noticeable than memory loss

Question 12

lewy body dementia

Answer 12

• Abnormal balloon-like clumps of protein
• acetylcholine/dopamine decline
• GRADUAL ONSET
• Acting out one’s dreams in sleep, visual hallucinations, problems
• cognition, autonomic dysfunction, falls, rapid eye movement sleep behavior disorder
• uncoordinated/slow movement, tremors, rigidity (parkinsonism)
• early symptoms: EF, visuospatial, focusing/attention, memory issues
• later symptoms: aphasia, apraxia, spatial disorientation

Question 13

frontotemporal dementia

Answer 13

• Breakdown of nerve cells & their connections in frontal & temporal brain lobes
• Associated with personality, behavior, language
• IMMEDIATE, DISTINCT ONSET, PROGRESSIVE
• thinking, judgment, movement affected
• progressive aphasia
• muscle weakness/wasting
• corticobasal syndrome (arms/legs uncoordinated/stiff)
• progressive supranuclear palsy

Question 14

is dementia a disease?

Answer 14

no, it is an umbrella term with several causes
- general term for decline in memory, reasoning, other thinking skills

Question 15

reality orientation

Answer 15

• mild to mod cognitive impairment
• include date, location, surroundings into conversation to help with orientation

VIA
1. 24 hr reality orientation
2. group setting

Question 16

validation therapy

Answer 16

help client work through emotions behind challenging behaviors
- helps to communicate these emotions
- shows empathy
- for dementia, alzheimers, memory loss

Question 17

tailored activity program (TAP)

Answer 17

• home based OT intervention
• identifies interests/capabilities of dementia client
• develops/tailors activities to individual
• trains families in using activities in daily routine (collaborate with them)

Question 18

preventing wandering

Answer 18

• routine, plan activities during times of wandering
• reassure them if they feel disoriented (don’t correct them- use exploration and validation language)
• ensure all basic needs are met (bathroom, eating)
• avoid busy places
• disguise exit doors using murals, locks out of sight
• devices that signal when door/window is opened
• eliminate overstimulation, prevent understimulation
• safe uncluttered path with places to rest
• signage to orient environment (sign to the bathroom)

Question 19

if patient starts to wander during a group activity

Answer 19

redirect them back to area/activity with calm voice & simple directions

Question 20

difficulty remembering where things are, trouble coming up with words and forgetting to attend appointments if not written down are signs of

Answer 20

mild cognitive decline (age-related)

Question 21

if a patient with dementia is making up answers when asked, what should be done?

Answer 21

interview the patient’s caregiver

Question 22

during middle stage dementia, what are interventions like?

Answer 22

STRUCTURED with a balance for high vs low arousal, decrease agitation
- AVOID CHALLENGING THEM!!

Question 23

Which emotional/mood symptom might a client with early-stage dementia demonstrate?

Answer 23

increased irritability, depression, anxiety

Question 24

At what stage of Alzheimer’s disease does nerve cell damage cause significant motor impairments that limit the ability to complete life tasks?

Answer 24

late stage

Question 25

early stage dementia (stage 4 on Riesburg scale) deficits

Answer 25

- problem solving - remembering names & details - social withdrawal - motivation - interest in hobbies - try new things - change - judgement & decisions - routines are slow - irritable, depressed, anxious - lose items, blame others - self centered - no empathy - forget recent events - repeat themselves - poor money management

Question 26

middle stage dementia (stage 5-6 on Riesburg scale) deficits

Answer 26

- more forgetful with recent events - place/time confusion - lost if away from familiar surroundings - names, confuse people - SAFETY- leave stove on - WANDERING - inappropriate behavior repetitive - neglect hygiene - angry, upset, frustrated - pacing - difficulty choosing clothes - vulgar language

Question 27

late stage (Stage 7 on Riesburg scale) dementia deficits

Answer 27

- TD for ADLs - unable to understand/use speech - difficulty walking (wc, bedridden) - incontinent - unable to recognize family/friends - night disturbance - restless - aggressive when feeling threatened - can't remember occurrences even for a few minutes - can't recognize everyday objects - uncontrolled movements

Question 28

how to promote a safe environment in middle dementia

Answer 28

- avoid scatter rugs, extension cords, clutter - handrails, grab bars - locks on dangerous cabinets - check/lower temperature on water - keep dangerous items out of reach - supervised smoking (if they smoke)

Question 29

how to create a calm/relaxing environment in middle dementia

Answer 29

- remove stressors/clutter - put away visual items - evaluate whether living space is too loud/chaotic

Question 30

what are stress-inducing triggers for middle stage dementia patients?

Answer 30

noise, glare, background distractions (TV)

Question 31

what are "holistic" therapies for middle dementia patients?

Answer 31

music, art, pets, reminiscence (old photos, movies, videos of old TV programs)

Question 32

during which stage of AD do patients wander?

Answer 32

stage II (6 on Riesburg scale)

Question 33

during which stage of AD are patients unable to drive?

Answer 33

Stage II (5 on Riesburg scale)

Question 34

if a client is confused due to a potentially reversible cause, what should be done as an intervention?

Answer 34

- instruct caregivers on how to provide an environment that meets a person's sensory needs and/or cues that enable performance - referral to other specialist if needed