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COAD Final > Module 9 - Cognitive Impairment and Neurological Disorders in the Older Adult > Flashcards

Module 9 - Cognitive Impairment and Neurological Disorders in the Older Adult Flashcards

1
Q

What is dementia?

A
  • An irreversible state that progresses over years
  • Causes memory loss
  • Behavior/personality changes
  • Interferes with daily life
  • Disturbances in functioning (planning, organizing, sequencing and abstract thinking)
  • Alzheimer’s disease can cause dementia
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2
Q

What is delirium?

A
  • Confused state of mind due to disturbances of the neurotransmitters in the brain
  • Cognitive decline, behaviour/mood changes, memory loss, delusional thought and sleep disturbance
  • Can be caused due to an infection (UTI)
  • Affects more elderly people and has a rapid onset
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3
Q

What is depression?

A
  • Mood disorder that causes a persistent feeling of sadness and loss of interest
  • Onset is recent and may elate to life change
  • Also known as a flat affect
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4
Q

Risk factors for delirium

A
  • Age
  • Medical illness (stroke, meningitis)
  • Infection - UTI
  • Pain
  • Emotional stress
  • Medication or substance effect
  • Surgical procedures involving general anesthesia
  • Inadequate education about delirium
  • Lack of formal assessment methods
  • Ageist attitudes
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5
Q

What assessments should you provide for delirium?

A
  • Determine cognitive functioning
  • Conduct a formal assessment to identify possible delirium cause - Infection
  • Confusion Assessment Method (CAM)
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6
Q

Intervention and Care plan for delirium

A
  • Intervene the risk factors and the root cause
  • Resources for help - Hospital Elder Life Program (HELP)
  • Pharmacological treatment of delirium is not recommended (unless it is an infection)
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7
Q

What is the Mini-Mental State Examination (MMSE)?

A
  • Screening for cognitive function and Dementia

- Can measure changes in cognitive status that may benefit from intervention

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8
Q

What is the Montreal Cognitive Assessment (MoCA)?

A
  • Rapid screening/in-depth for mild cognitive dysfunction
  • Assesses different cognitive levels such as attention/concentration, functions, memory, language, conceptual thinking and calculation
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9
Q

What is the Cognitive Performance Scale (CPS) by interRAI ?

A

Combines information on memory impairment, LOC and functions

  • Rates scores ranging from 0 (intact) to 6 (very severe impairment)
  • Part of the MDS-RAI
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10
Q

What is the Confusion Assessment Method (CAM)?

A
  • Delirium screening tool
  • Can initiate interventions based on findings
  • Looks at behavior, Inattention, disorganized thinking and altered LOC
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11
Q

What are the 3 types of dementia?

A
  • Primary
  • Secondary
  • Mixed
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12
Q

Primary dementia

A

Dementia is the primary reason for neurological decline

- It is the main disease affected the individual

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13
Q

Secondary dementia

A

Dementia is a result from other conditions such as a pre-existing mental illness or physical condition
- Common development for Parkinson’s Disease

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14
Q

Mixed dementia

A

Combination of primary dementia and secondary causes such as vascular brain changes and pre-existing conditions
- Can be caused due to severe alcoholism

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15
Q

Vascular dementia

A
  • Post- stroke dementia

- Caused by ischemia or hemorrhaging brain damage

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16
Q

Lewy-Body Dementia

A

Mixed dementia with Lewy bodies (DLB), and Parkinson’s disease dementia (PDD)
- Cognitive fluctuations and Hallucinations

17
Q

Frontotemporal Dementia

A
  • Shrinking of the anterior frontal and temporal lobes

- Changes in personality, cognition, memory, language and behaviour

18
Q

Pathophysiology/Etiology - Alzheimer’s Disease

A
  • A cerebral degenerative disorder of unknown origin
  • Destroys proteins of nerve cells in the cerebral cortex causing brain cells to waste away
  • Causes Dementia
19
Q

Signs and Symptoms - Alzeheimers

A
  • Memory loss
  • Difficulty expressing
  • Spatial cognition problems
  • Impaired reasoning and judgement
  • Depression
  • Language issues
  • Difficulty speaking
  • Dysphagia
  • Imbalance when walking
20
Q

Treatment - Alzeheimers

A
  • Depends on type of dementia - No Cure
  • Lifestyle changes
  • Manage Cardiovascular health
  • Exercise
  • Healthy diet
  • Physiotherapy
  • Counselling
  • Medications to slow down progression
21
Q

Pathophysiology/Etiology -Cerebrovascular disease

A
  • Manifested from a stroke or a transient ischemic attack (TIA)
  • Effects blood vessels and blood supply to the brain due to the rupture of blood vessels or vessel permeability
22
Q

Signs and Symptoms Cerebrovascular disease

A
  • Neurological deficits
  • Severe headache
  • Subarachnoid hemorrhages
  • Nausea
  • Vomiting
  • Changes in motor, sensory, and visual function
  • Decrease coordination, cognition and language (depends on the area)
23
Q

Treatments - Cerebrovascular disease

A
  • Prevention to reduce factors
  • Life style changes (no smoking, limit alcohol)
  • Healthy diet
  • Exercise
  • Follow ups with health professionals
  • Medications (Anti-coagulants)
  • Finding the source
24
Q

Management and Assessments - Cerebrovascular disease

A
  • Neurological assessments
  • Nutrition
  • Swallow test
  • Bowel function
  • PT/OT/SLP
  • Ambulation
  • Fall prevention
  • Skin Assessment
  • Compression stockings
25
Q

What is the Progressively Lowered Stress Threshold model?

A
  • Plan and evaluate care for dementia patients
  • Social and physical environment and nursing care are structured to reduce stress
  • Provides the person with a safe and predictable environment
  • Establish a caring relationship with the patient
  • Identify triggers related to discomfort or stress reactions
26
Q

What is the Need-driven dementia-compromised behavior model?

A
  • Maximize strengths and minimize the limitations

- Evaluates physiological needs, mood, physical environment, and social environment

27
Q

What is the Recognition of retained abilities model?

A
  • Focusing on abilities rather than disabilities
  • Assessment and enhancements of the person’s abilities instead of focusing on lost abilities
  • May prevent or reverse excess disability
28
Q

What is the Relating well model?

A
  • Promotion of care provider–resident relationships
  • Focusing the care beyond the task
  • Building relationships on promoting care to Dementia clients
29
Q

Person centered care factors for dementia

A
  • Meaningful relationships
  • Structured activities to enhance abilities
  • Social engagement
  • Freedom of choice
  • Self-expression
  • Spirituality
  • Creativity
  • Supportive care
  • Get to know the person
  • Positive mood
30
Q

What is the Gentle Persuasive Approach?

A
  • Based on the the principles of person centered care and the Needs - Driven Dementia Compromised Model
  • Educates caregivers on skills, knowledge and confidence to deliver person-centered care
  • All behavior has meaning
  • Negative behavioral responses are the result of unmet needs

COAD Final (6 decks)

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