Chapter 5 Flashcards
Can you apply lotion to areas receiving radiation therapy?
No
Confusion
Not being able to think clearly and logically
Can you leave a confused resident alone?
No
How should you speak to a confused resident
Normally but quietly
What should you remind a confused resident about
Location, date , name
Calendar can help
Delirium
Sudden, severe confusion, usually short term
What causes delirium
Infections, disease, fluid imbalance, poor nutrition , drugs and alcohol
Symptoms of delirium
Agitation
Anger
Depression
Irritability
Disorientation
Trouble focusing
Speech problems
Consciousness
Sensation and perception
Cognition
Ability to think logically and clearly
Cognitive impairment
Loss of cognition
Affects concentration and memory
Normal or abnormal: trouble using words
Abormal
Normal or abnormal: slower reaction time
Normal
Normal or abnormal: sleeping less
Normal
Dementia
Serious loss of mental ability, can’t think, remember, reason, communicate
AD stands for
Alzheimer’s disease
Most common cause of dementia in elderly
Alzheimer’s disease
_____are more likely to have AD and dementia
Women
Causes tangled nerve fibers and protein deposits to form in the brain
Alzheimer’s disease
Skills a person used over their lifetime are kept ____
Longer
Always approach AD residents from
Front
What should you do to help AD residents complete complex tasks
Break them down
Preservation
AD residents repeating words or questions
If resident can’t find words to use
Suggest words
If resident doesn’t understand basic words or instructions
Ask them to repeat
Look at non verbal cues
Use pictures and signs
If resident wants to say something, but cant
Ask to point or act out
If can’t explain, try to comfort or distract
If resident can’t remember basic tasks
Break activity in simple tasks with simple directions
If resident insists on doing something that is not allowed,
Redirect activities towards something else
If resident hallucinates, is paranoid or accusing
Don’t take personally,
Redirect or ignore behavior
Will usually pass quickly
If resident is depressed or lonely
Ask how they’re feeling and listen
Involve resident in activities
If resident asks to go home
Ask what their home was like.
Redirect conversation towards something they like
If resident is verbally abusive
Ignore language and redirect attention
If resident lost most verbal skills, use
Nonverbal skills, smile
People with AD can understand more than they can express t/f?
True
Being ____ is important for taking care of residents who are confused and easily upset
Consistent. Develop a routine and stick to it
If a resident has problems bathing
Schedule bathing when resident is least agitated
Prepare him for what you’re about to do
Walk with them and stop at bath if needed
If resident has problems with grooming and dressing
Help them
Avoid interruptions
Show them their clothes
How should clothes be laid out?
In order of dressing
Never withhold or discourage fluids because of incontinence t/f?
True
Mark bathroom with
Sign or picture
Note when resident is incontinent after ___-___ days
2-3
How to determine bathroom times
Check incontinent residents every 2-3 mins
Take resident to bathroom after drinking ___. Before and after ____ and before ____
Fluid
Before and after Meals
Bedtime
Meals should be served at
Same time
What kind of foods make eating simple?
Finger foods
Table setting for AD residents should be
Simple
True of false: multiple kinds of food on a plate might be overwhelming
True
Pain assessment in advanced dementia scale
Measures pain in dementia patients
Agitation
Excited, restless or troubled resident
Trigger
Leads to agitation
Sundowning
Getting agitated in the late afternoon
To avoid sundowning
Encourage regular clothes vs PJs
Low caffeine
Calming activity before bed
Catastrophic reactions
Person with AD overreacts
Wandering
Walking around aimlessly around facility
Pacing
Walking back and forth in same area
Elope
Leave facility unnoticed
Hallucinations
Seeing, hearing, smelling or tasting things that aren’t there
Delusions
Believing things that aren’t true
Should you pretend to see hallucinations?
No
Inappropriate social behavior
Try to find what caused it
Hoarding
Collecting and putting things away in a guarded way
Rummaging
Goings through drawers or personal items of self or others
Rummaging and hoarding should not be considered
Stealing
People with AD commonly collect things that catch their attention t/f?
True
To help resident find his own door, door should be
Labeled
True false: you should ask family to let someone know if they find items that don’t belong to resident
True
How to handle sleep disturbance
Help resident get excercise
Discourage sleeping during day
Reduce light and noise as much as possible
If an NA needs help with coping to take care of AD residents they should
Ask supervisor for resources
Validation therapy
Let residents believe they live in the past
Reminisce therapy
Encouraging residents to remember and talk about past
When is validation therapy useful?
Advanced dementia
When is reminisce therapy useful
Moderate to advanced dementia
Activity therapy
Uses activity resident enjoys to prevent boredom and frustration
Useful in most stages of AD
Is there a cure for AD?
No
T/f symptoms of AD typically appear suddenly
False
Resident keeps asking same question when you want to bathe him
Answer him the same way until he stops
If a resident is frightened or anxious, what should an NA do?
Check body language so he doesn’t appear tense or hurried
Can you leave violent resident alone?
No
How do you deal with delusions
Ignore harmless ones
Reassure residents
Do not argue
Redirect thoughts
Be calm
How to deal with hoarding
Label belongings
Label door
Tell family to tell staff about unfamiliar items.
Give rummage drawer
How to handle inappropriate sexual behavior
Don’t overreact
Distract or guide to private area
How do you deal with a pacing resident?
Remove causes
give snacks
Excercise routine
Maintain elimination schedule
Wander in safe area
Watch them
Suggest walk together
How to deal with disruptiveness
Gain attention
Be calm and friendly
Direct resident to more private area
Ask resident
Inform changes early
Involve resident in developing routines
Encourage to join activities
How to deal with depression
Report signs immediately
Encourage independence
Self care
Activity
Listen
Encourage socializing
Deal with aggression
Remove triggers
Constant routines
Soothing familiar activities
Low, soothing voice
Deal with violent behavior
Removes triggers
Never hit back
Block blows or step out of way
Soothing familiar activity
Use low, soothing voice
Dealing with Sundowning
Remove triggers
Give snacks or encourage rest
Avoid stressful situations.
Limit activities, appointments,
Trips,
Play soft music
Set and keep bedtime routine
Remove caffeine
Distract with simple calm activity
Causes of confusion
UTI
Low blood sugar
Injury
Low temp
Low O2
Meds
Infection
Tumor
Lack of sleep
Seizures
Common causes of dementia
AD
Cvas
Lewy body dementia
Parkinson’s
Huntingtons
Diagnosing AD requires many
Physical and mental tests
Only sure way to determine AD is through
Autopsy
Average life expectancy with AD
4-8 years or as long as 20
T/f other words can be used when a resident forgets
Yes nap, lie down instead of bed
