Dementia Flashcards
everyone is different and has different factors influencing their experience of dementia: what are they?
- the person they are
- environment
- changes to brain and brain function
- physical and psychological health
- personal life experience and coping
- relationships
what are sensory changes that can occur
visual agnosia
visual aphasia
decline in spatial awareness
sensitivity to bright lights
what are signs and symptoms of dementias? (not one disease!!)
significantly impaired:
- memory
- communication and language
- ability to focus and pay attention
- reasoning and judgement
- visual perception
many dementias are progressive with symptoms starting slowly and gradually getting worse
how can a nurse reduce a patient with dementia’s stress relating to communication?
difficulty communicating can exclude a person from their own care, leaving them upset and frustrated.
where possible approach the person from the front
minimise potential distractions
maintain eye contact
have open body language
speak clearly and calmly in short sentences
allow time to process questions
how can a nurse reduce a patient with dementia’s stress relating to washing and bathing
it’s important to be sensitive and tactful. Talk them about how they feel and how they would prefer you to do things. Ask them about the normal routine
maintain dignity, keep covered as much as possible
The rush of water from an overhead shower can be frightening or disorientating - particularly when hitting the head. A hand held shower or bath may be a preferred alternative for some people with dementia.
Use the time to chat and reassure the person with dementia. Explain what you are doing or about to do if even if you don’t think they will understand
how can a nurse reduce a patient with dementia’s stress relating to incontinence
Incontinence can be humiliating for the person with dementia and upsetting for those around them. Hygiene is a very personal issue, becoming incontinent can make it feel as if one is losing control. This can affect a person’s sense of dignity and self esteem.
check they know where the toilet is- show them, have signs with pictures at eye level
remind them or take them to the toilet regularly
Be aware of signs that the person want to go to the toilet such as fidgeting, getting up and down or pulling at their clothes
If it becomes too difficult for the person to get to the toilet an aid such as a commode might be helpful in maintaining continence.
how can a nurse reduce a patient with dementia’s stress relating to moving and walking about
Many people with dementia feel compelled to walk about or leave their home. People with dementia can experience problems with orientation which can be accentuated by unfamiliar environments like a hospital ward.
Some people with dementia find it comforting to walk. It’s important that this need is accommodated where possible.
People often walk about if they are bored, ensure the person with dementia has enough things to do. Being occupied, both mentally and physically, gives a sense of purpose and self worth for everyone so involve the person in suitable activities on the ward.
Help the person find their way about the ward. They may be confused by the unfamiliar setting. It could be they are walking because they are trying to find a toilet, so ask them if they need to go and take them there.
People often walk when in pain, in attempt to ease their discomfort.
If a person is feeling agitated or anxious they may want to walk about. They may also be responding to hallucinations or issues with visual perception, which are a common symptom of some types of dementia. Try to encourage the person to tell you about their anxieties and reassure them in whatever way you can.
Short-term memory loss can lead a person with dementia to go walking and become confused. They might embark on a journey for a specific purpose, with a particular goal in mind, and then forget where they were going and find themselves lost. This can be particularly distressing.
how can a nurse reduce a patient with dementia’s stress relating to challenging behaviour or aggression
all behaviour is a form of communication. If you can establish what the person with dementia is trying to communicate, it may prevent them from feeling frustrated and acting aggressively.
A person with dementia may behave aggressively if they are in physical discomfort or pain or simply thirsty, hungry or want to go to the toilet.
Try to stay calm and don’t enter into an argument. Reassure the person and try to distract their attention.
Look out for warning signs, such as anxious or agitated behaviour or restlessness, and take action immediately to help the person feel more calm and reassured.
Try to work out what triggers any aggressive behaviour
how can a nurse reduce a patient with dementia’s stress relating to orientation
show them around the ward, especially toilets, before taking them to their bed
signs with pictures at eye level
someone with dementia may be anxious or confused about new hospital environment- ask family to bring in familiar things e.g. family photos
regular routine can reduce anxiety
how can the nurse promote personal abilities, strengths, and sense of self worth for people with dementia
give them things to do so they have purpose
use “getting to know me” document - individualised person centred care
treat with respect and dignity
promote independence as much as possible e.g. visual reminders, contrasting colours, allow time to do tasks/answer questions
what are early warning signs of dementia
Subtle changes in behaviours & mood
Depression
Visual changes
Difficulty in acquiring, processing and retaining new information
Initial symptoms can be mistakenly associated with stress or age.
describe mild dementia
Cognitive decline evident.
May become more forgetful of recent events or personal details.
Other problems include impaired mathematical ability (for instance, difficulty counting backwards from 100 by 9s),
A diminished ability to carry out complex tasks like throwing a party or managing finances,
Moodiness.
Irritable.
Social withdrawal.
describe moderate dementia
Some assistance with daily tasks is required.
Problems with memory & thinking quite noticeable, inability to recall one’s own contact information or key details about one’s history.
Disorientation to time and/or place.
Decreased judgment and skills in regard to personal care.
Even though symptoms worsening, people in this stage usually; still know their own name & the names of key family members; can eat; use the bathroom without assistance.
describe severe dementia
The most difficult stage for carers as it is characterized by personality & behaviour changes.
Memory continues to decline.
Assistance required for most daily activities.
Reduced awareness of one’s surroundings & recent events
Problems recognizing spouse & other close family members, although faces still distinguished between familiar & unfamiliar
Sundowning :- restlessness & agitation in late afternoon & evening.
Difficulty using the bathroom independently.
Incontinence.
Suspicion.
Repetitive behaviour (verbal and/or nonverbal).
Wandering.
Displaying stress & distressful behaviours.
describe advanced dementia
The person may be –
Unable to respond to the surrounding environment.
Able to speak words or short phrases, but communication is extremely limited.
Basic functions begin to shut down, such as motor coordination and the ability to swallow.
Total care is required around the clock.
