Dimentia Flashcards
Very mild to Mild cognitive decline (pre-dementia)
“Is there a problem?”
- ADLs and IADLs are intact
- Mild memory problems
- perceived loss of control
- Anxious and fearful
- Socially and physically intact
- Use calendar, checklists
- Exercise/well-being
Interventions for very mild to mild cognitive deficits (pre-dementia)
- New tasks are possible: grade for success!
- Calendar, checklists
- Exercise, destress
Mild dementia/Early stage
“I just want to be alone”
- ADLs mostly intact, mild deficits
- IADLs mod A
- Moderate memory loss
- Denial, moody, paranoia
- Difficulty learning new tasks
- Lose valued objects
- Affects orientation to place, which affects community mobility
- Become disoriented while traveling away from home
- Financial management, shopping, meal prep
- Driving should be reevaluated
- Communication impaired
- Clings to old habits and repetitive routines or neglects old habits and routines
- Participation declines
Interventions for mild dementia
- Use SIMPLE instructions (no new tasks)
- Family is important
- Exercise
- Community resources e.g., volunteers, daycare, community dinners
moderate/middle dementia
“Go Away! Who are you?”
- Impairments in all areas of occupation
- Can’t live alone
- Eating problems and weight loss
- Dependent for community mobility, finances, shopping
- Safety is a huge concern…wandering, letting stranger in home, causing fire
- Limited leisure
- Some cleaning and cooking with supervision
- No ADLs or IADLs intact
- Disoriented to time/place
- Sleep disturbances/repetitive behavior
- Wandering
- Impaired visual and spacial orientation
- Delusions/paranoid
- Emotional changes
- Maybe incontenance
- Limited social participation to caregivers
At what stage of dementia does wandering occur?
Moderate
Safety first!
Interventions for Moderate dementia/middle
- Overlearned tasks with less than 2-3 steps
- Caregiver instruction
- Cuing
- Adapt environment
- Safety first! They’re wandering around! e.g., i.d. tags, footwear
Late dementia
“Err no her”
- No ADLs or IADLs
- All areas of occupation lost
- Dependent on all ADLS
- Can’t ambulate safely
- No understanding of cultural, social, or spiritual contexts
- Generalized motor slowing –> bedridden
- Incontinent
- Unable to communicate –> one word
Interventions for severe cognitive and physical decline (moderately severe/severe dementia)
Maintain proper positioning
- family support
- nature/nice, comforting environment
Level of dementia when person may begin to notice and complain of memory problems, have forgetfulness, trouble finding familiar objects, but no deficits in social life and employment. Fam and friends may not notice
Very mild cognitive deficit (pre-dementia)
Stage of dementia when others begin to notice deficits. Have increased forgetfulness and begin to see decreased performance in work and social environment
Mild Cognitive decline (pre-dementia) (Miri’s mom cut dog’s hair!)
Stage of dementia when it’s first possible to get a dx
Mild dementia/early
Stage of dementia when you are still oriented to time and place and can recognize familiar faces; difficulty will IADLs e.g., finances, shopping, ordering food; decreased sequencing and planning; denial as defense mechanism; can still live at home with support
Mild dementia/early stage
Stage of dementia in which client can’t live alone anymore–can’t function independently and requires cues and assistance for ADLs and IADLs
Moderate dementia/middle stage
Stage of dementia in which client can’t recall major life events, phone numbers and addresses; disoriented to time and place; can’t drive safely; distraught and confused
Moderate dementia/middle stage
Stage of dementia when person forming incomplete sentences, can’t follow 2 step tasks, personality and emotional changes; frustration, agitated, anxious, obsessive, delusional behavior; dependent for all ADLs and IADLs; incontinent
Moderately severe dementia (middle-late)
Stage of dementia when person is bedbound; unintelligible utterences; may be in vegetative state; total A
Severe/late dementia. Aware of secondary complications e.g., disease, infection, fall, pneumonia
Standardized function based cognitive screening instruments for dementia
- Allen Cognitive Level screen
- AMPS
- Cognitive Performance Test
- Executive Function Performance Test
- Independent Living Scales
- Kitchen Task Assessment
- Arnadottir OT-ADL Neurobehavioral Eval
Standardized cognitive screening instruments for Dementia
- Blessed Dementia Scale
- Cognitive Competency Test
- Lowestein OT Cognitive assessment
- Middlesex Elderly Assessment of Mental State
- Mini-Mental State Examination and Modified
- Neurobehavioral Cognitive Status Screening Examination
- Repeatable Battery for the assessment of Neuropsychological Status
The Allen’s Cognitive Disability Theory is often used with what condition
Dementia
Strategies for sundowning behaviors with dementia pt
- Adequate lighting
- Provide safe area of physical activity
- provide reassurance in a calm and caring manner
- Provide client with fluids during day
- Reduce noise and clutter
- Avoid using restraints
Cognitive functioning approaches for Dementia
- Psychoeducation during early stages for family and caregivers
- Cognitive facilitation and stimulation e.g., reminiscing groups
- Relaxation techniques e.g., rocking chairs, soothing music
- Structured communicative approaches
- Environmental structuring to compensate for functional deficits e.g., visual aids, home setup
- Sensorimotor therapy
