alzheimers/dementia Flashcards
at what stage of dementia does a person require substantial assistance for daily activities?
middle dementia
dementia-like conditions that can be reversed
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
disorders linked to dementia
- huntingtons
- TBI
- Parkinson’s disease
at what ACL stage should dementia patients not drive?
4.6
at what ACL stage should dementia patients require cues?
4.8
at what dementia stage is safety a concern?
middle stages (wandering, cause fire, let stranger into house)
what type of memory goes away first in early to mid dementia?
short term memory
when do dementia patients have trouble with managing money?
early stage
at what reisberg scale stage is dementia diagnosed by a doctor?
stage 4: moderate cognitive decline
alzheimer’s disease
- most common cause of dementia
- plaques/tangles in the brain
vascular dementia
- 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
lewy body dementia
- 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
frontotemporal dementia
- 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
is dementia a disease?
no, it is an umbrella term with several causes
- general term for decline in memory, reasoning, other thinking skills
reality orientation
- mild to mod cognitive impairment
- include date, location, surroundings into conversation to help with orientation
VIA
1. 24 hr reality orientation
2. group setting
validation therapy
help client work through emotions behind challenging behaviors
- helps to communicate these emotions
- shows empathy
- for dementia, alzheimers, memory loss
tailored activity program (TAP)
- 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)
preventing wandering
- 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)
if patient starts to wander during a group activity
redirect them back to area/activity with calm voice & simple directions
difficulty remembering where things are, trouble coming up with words and forgetting to attend appointments if not written down are signs of
mild cognitive decline (age-related)
if a patient with dementia is making up answers when asked, what should be done?
interview the patient’s caregiver
during middle stage dementia, what are interventions like?
STRUCTURED with a balance for high vs low arousal, decrease agitation
- AVOID CHALLENGING THEM!!
Which emotional/mood symptom might a client with early-stage dementia demonstrate?
increased irritability, depression, anxiety
At what stage of Alzheimer’s disease does nerve cell damage cause significant motor impairments that limit the ability to complete life tasks?
late stage
early stage dementia (stage 4 on Riesburg scale) deficits
- 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
middle stage dementia (stage 5-6 on Riesburg scale) deficits
- 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
late stage (Stage 7 on Riesburg scale) dementia deficits
- 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
how to promote a safe environment in middle dementia
- 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)
how to create a calm/relaxing environment in middle dementia
- remove stressors/clutter
- put away visual items
- evaluate whether living space is too loud/chaotic
what are stress-inducing triggers for middle stage dementia patients?
noise, glare, background distractions (TV)
what are “holistic” therapies for middle dementia patients?
music, art, pets, reminiscence (old photos, movies, videos of old TV programs)
during which stage of AD do patients wander?
stage II (6 on Riesburg scale)
during which stage of AD are patients unable to drive?
Stage II (5 on Riesburg scale)
if a client is confused due to a potentially reversible cause, what should be done as an intervention?
- 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
