midterm 1 Flashcards
Define Ageism
Prejudice/discrimination against people because of real/perceived age
myths/tereotypes about older people
List examples of ageism
too old to learn new technology
millennials/Gen Z are lazy and entitled
lack of older person representation
makeup ads for anti wrinkles
older persons not being hired
consequences of ageism
generational divide
older adults becoming invisible
valuable experiences/opinions are disregarded
What is confusion?
ea disorientation
A decline in cognitive ability, cannot think
symptom of an underlying medical condition
Name s/s of confusion
Anxiety
Behaviour Changes (anger, restlessness, depression, irritability)
Tremors
Delusions
Disorganized thinking/speech
What causes confusion?
UTI
intoxication
Low blood sugar
Concussion
Fever
Medications
Certain mental health illnesses
What is the relationship between confusion and delirium?
delirium is when confusion occurs suddenly without warning, its an advanced version. while they are similar, delirium poses a greater risk to a persons health.
Define delirium?
sudden and unwarned confusion that can be hypoactive, hyperactive, or mixed. it develops quickly and can take long periods to recover from.
What causes delirium
infection
Dehydration
Multiple medications
withdrawal
High/low blood sugars
Constipation
Pain
Recent fall
Recent move/relocation
What is an HCA’s responsibility with regards to managing and
supporting someone with delirium?
know signs of delirium
Provide safe environment
Support basic needs
Create calm environment
Communicate
Monitor/Report
Collaborate with Care Team
What is Dementia?
progressive degenerative disorder
umbrella term for decline in intellectual/social abilities affecting daily functioning
Name main parts of the human brain
Cerebrum (right and left hemispheres)
Cerebellum
Brain Stem
frontal lobe
top front
manages:
personality
social skills
judgement
reasoning
emotion regulation
movement
speech
temporal lobe
bottom
manages:
memory
recogition
art/music
understanding language
speech
hearing
parietal lobe
top back
manages:
depth perception
spatial orientation
sensory input
language processing
writing/reading
calculation
spatial attention
occipital lobe
bottom back
manages:
sight
processing visual information
cerebellum
balance
learning
emotion regulation
coordinate movement
attention
brainstem
breathing
heartrate
alertness
sleeping patterns
Name 5 controllable risk factors of Dementia
Smoking
Diabetes
Obesity
Alcohol
Depression
Hearing loss
Social isolation
reversible forms of Dementia
depression
infection
medication
tumour
vitamin deficiency
irreversible forms of Dementia
alzheimers dementia
vascular dementia
lewy body dementia
frontotemporal dementia
huntingtons disease
alzheimers dementia
Most common (60-80%)
Progressive degenerative disease of brain which causes thinking/memory to be seriously impaired
Characterized by amyloid plaques and neurofibrillary tangles
alzheimers s/s
Memory loss
Difficulty performing familiar tasks
Difficulties with language
Disorientation to time and space
Impaired judgement
Misplacing things
Changes in mood and behaviour
causes/risk factors of alzheimers
family history
age (65+)
depression
smoking
diabetes
vascular dementia
2nd leading cause (10-20%)
White matter changes in the brain
from ischemic or hemorrhagic cerebrovascular lesions, often from series of small strokes (clots or bleeds)
vascular s/s
Changes in ability to make decisions, plan or organize
Difficulties with movement (ea slow gait and poor balance)
causes/risk factors of vascular
Hypertension
Atrial fibrillation
High cholesterol
Smoking
Diabetes
Frontotemporal Dementia
3rd most common (10%)
Dementias that primarily affect the frontal and temporal lobes
Frontotemporal s/s
Behavioural::
inability to restrain actions
Loss of interest in personal hygiene
Easily distracted
Overeating
Inappropriate social actions
Blunted emotions
Speech::
lessened or loss of speech.
Difficulty finding words
Repeating others’ words
Stuttering
causes/risk factors of frontotemporal
family history
head injuries
Lewy Body Dementia
4th most common (5-10%)
from abnormal deposits of protein alpha-synuclein in brain cells named Lewy bodies
mostly affects cognitive processes, movement and motor control
Lewy Body s/s
Difficulty w short-term memory, word-finding, and focus
Depression and anxiety
Disrupted sleep patterns
Visual hallucinations
Muscle stiffness
tremors
slow, shuffling movements
causes/risk factors of Lewy Body
male
family history
age
Describe some protective factors in reducing risk of Dementia
Keep brain active
Protect hearing
Do not smoke
healthy BMI
Reduce alcohol
Avoid pollution
social connections
Lower bad cholesterol
early stage of dementia
usually still at home.
help w organization, problem solving, and remembering (ea appointments and medications)
need support and supervision
Some can stay involved in activities and some may need cues or encouragement
middle stage of dementia
forget personal history and no longer recognize family/friends
restless or pacing (may need a medical alert or wonder guard)
assistance w ADLs
late stage of dementia
unable to remember, communicate or perform self-care
requires 24hr care
S/s:
bedridden
difficulty eating/swallowing
losing control of bodily functions
Death as a result of secondary complications
Describe person-centred care model
Focuses on individual over condition
Focuses on person’s strengths and abilities over losses.
Recognizes personality of person with dementia is not lost
What are the 4 core principles of Person-centred care
- Dignity and Respect
- Information Sharing
- Participation
- Collaboration
Eden Philosophy
transforming care facilities into life-affirming environments
Develops elder-centered communities to address loneliness, helplessness, and boredom
principals:
Encourages reciprocal companionship among residents, staff, and the community
Promotes meaningful care through interactions with plants, animals, and children
Creates a community worth living in
Best Friends Approach
Building Trust
Encouraging Communication
Focus on Strengths
Meeting Friendship Needs
Addressing Emotional Needs
The Knock
Empathy and Respect
Use common sense, patience, and understanding in all interactions
What is stigma?
a negative perception or discrimination against a person or group based on characteristics (ea health, identity, or belief)
includes social, self, and structural
social stigma
when society or general public shares negative thoughts or beliefs about a person or group of people
self stigma
negative attitudes, including internalized shame, that people may have about their own self or condition
structural stigma
when laws, policies, and practices result in the unfair treatment of people
What are effective strategies to combat the impact of stigma on dementia?
Learn about Dementia
Don’t make assumptions
Hear from people who experience stigma
Encourage early diagnosis
Support the caregiver
Remember the person inside
What communication challenges do individuals with dementia face?
Reduced vocabulary
Word-finding difficulty
Repetition of thoughts
Losing track of topic
Difficulty adhering to social norms
decline in reading and writing
PCC Approach to Communication
Believe communication is possible.
Focus on the person’s abilities
Provide re-assurance
treat them w respect and dignity
Meet the person where they are and accept their reality
validation
recognizing their beliefs and accepting their reality instead of judging.
Try to understand meaning and emotions behind their messages
Prioritize connection over correction
Respond with patience
redirection
shifting focus to something else instead of correcting or reprimanding
includes validating, joining, and distracting
How to communicate with a client who has dementia?
Use simple, short sentences
Give one direction or information at a time
Use a friendly and relaxed approach
Address them by preferred name
Be patient and listen without interrupting
Foster two-way communication
Encourage humor and laughter
How not to communicate with a client who has dementia?
controlling or authoritative tone
arguing
abstract language
modern slang
“love” “dearie”
Define reminiscing
The act of recalling our past
Engages long term memory
Elicits varying degrees of emotional responses (happy or unhappy)
benefits of reminiscing
increased sense of well-being
Resolves past conflicts
Increased sense of identity
Decreased disorientation
Improved social interaction
How important is it to be accurate with we are reminiscing?
it isn’t, the accuracy is how they felt or feel about those memories now
List ways in which HCA’s can provide memory friendly environments
Location with minimum distractions
no glaring lighting
Ensure physical and emotional comfort
Group compatible; not too large
Should be able to see and hear all
What can HCA’s do if the client experiences a painful memory?
Listen carefully and allow pauses
Use touch as needed
use empathy
ask open ended questions
What is BPSD
Behavioural and Psychological symptoms of
Dementia, or Responsive Behaviour
When ppl with dementia cant express physical and emotional needs or make sense of their environment
reactive vs proactive
being proactive, or stopping things before they start, so response behaviours don’t occur
Name 10 different responsive behaviours
Aggression
Restlessness
Hoarding
Yelling
Depression
Delusions
random noises
Becoming withdrawn
Sexual Behaviour
Sundowning
Wondering
What factors precipitate responsive behaviours
Physical
Intellectual
Emotional
Capabilities
Environment
Social
Actions of Others
strategies preventing and responding to PBSD
Respond supportively and reassure
Reduce noise
toileting schedule
Maintain a consistent routine
Distract with something familiar or comforting.
Approach slowly from the front and at eye level
leave room to de-escalate.
sundowning
pattern of behavior in late afternoon or evening in ppl w dementia
may experience increased confusion, agitation, or restlessness
can last into the night and can disrupt sleep.
Describe how to safely de-escalate
Stay calm
Assess environment for danger
no sudden movements
Provide space
Avoid confrontation or arguing
Offer reassurance
Seek help
Leave the area
know where your exit is
What are the basic needs according to Maslow?
Physiological
Safety/security
Love and belonging
Self-esteem
Self fulfillment
List the guidelines for helping with ADL’s
Treat with respect
Pay attention to reactions
Maintain dignity
Encourage independence
Simplify and clarify
Keep regular routine
Be flexible and patient
Good communication techniques
What are the 4 techniques for helping with ADL’s
Break the tasks into steps
Demonstrate
Help begin action
Be patient
How would an HCA respond to resistance
Pay attention to cues
Respond to emotional messages
Redirect to something pleasant
Try again later
List and describe the causes of resistance
Physiological: pain, vision, constipation, lack of sleep
Environmental Causes: new environment, distractions, boredom, bad smells
Other: decreasing coordination, unclear instructions, rushed by caregiver, tension
Describe the distract and act method
Two person approach
First person distracts (speaks to client, Keeps eye contact, Touches to reassure)
Second person:
Uses no verbal communication, Completes the care (quickly, quietly and gently)
How can caregivers promote self-esteem for their clients
Assurance of personal worth
Grooming and dressing important
Praise
Choose appropriate clothes, not too warm/cold, sometimes undress themselves
Who is the caregiver
anyone who provides care and support to someone who is unable to take care of themselves
2 types: family and professional
Who is generally referred to as the sandwich generation
people who have parents to take care of on top of their own children
How can we support the family caregivers
Acknowledge challenges and emotional toll of caregiving
Encourage self-care
Emphasize it’s okay to take breaks
empathy and understanding
Define compassion fatigue
emotional strain or distress that results from caring for others who are suffering
how to prevent and manage compassion fatigue
Practice self-care
seek emotional support.
Engage in therapy or debriefing sessions
Set emotional boundaries in caregiving roles
Define burnout
Depleted ability to cope with work demands
Sense of powerlessness to achieve goals
alter our view of workplace
how to prevent and manage burnout
Prioritize workload management (say no
when needed).
Take regular breaks and vacations
Advocate for systemic changes to reduce stress
