Dementia❗️❗️❗️

Question 1

characteristic of Alzheimer’s disease

Answer 1

• progressive impairment of memory, EF, attention, language, visual processing, praxis
• behavioral disturbances

Early stage: memory lapses/forgetting words

Middle stage: frequent forgetfulness, mood change, poor decision making, disorientation, wandering

Late stage: x carry on conversation, assistance for daily activities

Question 2

characteristic of Vascular dementia

Answer 2

• cog decline ~ AD but less severe memory involvement
• gait disturbance
• stepwise decline

Question 3

characteristic of Fronto-temporal dementia

Answer 3

• progressive aphasia, cortico-basal syndrome
  ~Parkinsons
• affect judgement, decision making, EF more than memory

Question 4

characteristic of Dementia with Lewy bodies

Answer 4

• progressive deficits in attention and EF, memory impairment, cluctuating cog, visual hallucination, parkinsonism, autonomic dysfunction, rapid eye movement, sleep behavior

Question 5

Example of BPSD (behavioral and psychological symptoms of dementia)

Answer 5

◦ Specific behavioral symptoms: based on observation – wandering, agitation, disinhibition, catastrophic reaction, complaining and negativism

◦ Specific psychological symptoms: assessed through interviews with persons with dementia and their relatives – delusion, hallucination, depression, apathy and anxiety

Question 6

Sundowning behaviors

Answer 6

an increase in activity and often agitation that begins in the late afternoon and extends into the evening or night. Simplify interactions and the environment during sundowning.

a. Use adequate lighting; shadows can create confusion.

b. Provide a safe area for physical activity during the day.

c. Provide reassurance in a calm and caring manner.

d. Provide the client with fluids during the day to reduce the cognitive changes brought on by dehydration.

e. Reduce noise and clutter.

Question 7

Wandering

Answer 7

a. Assess and address the reason for wandering.

b. Provide signs in the environment for cueing (e.g., stop sign).

c. Use distraction techniques to interrupt pacing (e.g., familiar pictures on the wall).

d. Provide opportunities for activities and movement, walk with client and keep areas uncluttered and safe

e. Monitor fatigue, fluid intake.

f. Monitor the client’s feet wounds, including cuts, lacerations, bruises.

g. Have an identification bracelet made with client’s name, address, telephone number and person to be contacted

h. Provide reassurance, attentiveness, and acceptance.

i. Put on door licks to prevent client from wandering away, but be sure that there is an exit in the event of fire

j. door alarm, bed alarm, wall or door poster to hide door handle and lock, placing side bolt high out of client’s reach

Question 8

Pillaging劫掠, rummaging亂翻, and hoarding囤積

Answer 8

a. Learn the client’s favorite hiding places.

b. Give the client a familiar item to hold.

c. Involve the client in valued occupations that involve sorting items.

d. Provide the client with rummaging翻找 closets or areas.

e. Do not scold, tease, or punish the client or respond with anger.

f. Modify the environment to be more engaging (e.g., fish tank).