Dementia, Depression, and Delerium Flashcards
Define “depression” in the context of aging
A change in mood which lasts at least 2 weeks and includes sadness, negativity, loss of interest, pleasure and/or decline in functioning.
Define “dementia” and name the most common cause
Progressive loss of brain cells resulting in decline of day-to-day cognition and functioning. A terminal condition.
Most common cause is Alzheimer’s Disease
Define “delirium,” and what are the 2 most common causes?
Delirium: an acute or sudden onset of mental confusion as a result of a medical, social, and/ or environmental condition.
Most common causes are Urinary Tract Infections (UTI) and/or severe dehydration
What does Dementia affect?
Dementia usually affects cognitive impairment, resulting in affected memory and orientation as well as abstract thinking, judgment and problem solving skills, language, ability to recognize objects/people, or personality
What clues will tell you your patient has depression, not dementia?
Signs of depression are commonly seen in the patient’s affect, and the way they answer questions. Patients may respond with “I don’t know” or “I’m not sure” because they are too depressed to give a “real” answer
Describe someone with Delirium
They may be perplexed, disoriented, fearful, and/or forgetful. They may suddenly be less alert than normal or sleepy. Sometime, they can be hyper-alert, agitated, or suspicious
Name some other causes of Delirium and Reversible Dementia, and (potentially) how they can be reversed
Alcohol or drugs: symptoms resolve when pt is taken off the med, or is no longer going through widthdrawal
Fecal Impaction
Distended Bladder (due to prostate enlargement, dehydration or malnutrition)
CerebroVascular Accident : usually treatable
Name some other causes of Irreversible Dementia
Parkinson’s, Huntington’s, MS, Alcoholic dementia, head trauma, Mass lesions (cancer), TB, AIDS, CVA, Anoxia
Describe the psychiatric symptoms of Irreversible Dementia
Usually expressed as behavioral changes: becoming combative or impulsive
Name some key strategies for working with Dementia patients
1) get on their level
2) don’t yell like they can’t hear you
3) use a name they’re familiar with
4) avoid triggers for anger, frustration, or confusion
5) focus on the present
6) Redirect
Explain 3 different redirection techniques
Therapeutic Lying: “they’ll be back shortly” -just make sure they can’t catch you in a lie
Validation: get them to recall happy memories, ask them questions about it
Aikido: side-stepping confrontation, don’t lie –find the deeper meaning, connect with them on an emotional level
**use a combination of all three in practice
What’s the difference between Palliative care and Hospice?
Palliative care focuses on providing physical, emotional, and spiritual comfort to those with chronic, debilitating disease
Hospice provides palliative care to those facing the end of their lives: usually lasts about 6 months
What is a Living Will?
specifies which medical treatments can be performed, “do not resuscitate” orders, the power of attorney, etc.
