Quiz 3

Question 0

What is Alzheimer’s disease

Answer 0

Progressive, degenerative, and fatal disease of brain tissue leads to memory loss problems with thinking and daily life activities

Question 1

Alzheimer’s accounts for what percentage of the cases of dementia

Answer 1

50 to 70%

Question 2

How long can Alzheimer’s disease last

Answer 2

Can last from 3 to 20 years with most people dying after 8 years

Question 3

What causes Alzheimer’s disease

Answer 3

Caused by formation of plaques and tangles – protein fragments that buildup between nerve cells and form inside dying brain cells

Question 4

Name the four stages of Alzheimer’s disease

Answer 4

Early/mild impairment stage
Mid/moderate impairment stage
Late/severe impairment stage
Terminal stage

Question 5

Describe the early/mild impairment stage of Alzheimer’s

Answer 5

Average 1-3 years, possibly longer
Memory loss, especially with recent events
Difficulty with complex cognitive tasks
Difficulty with decision-making planning
Decreased attention span concentration
Impaired word finding skills
Preference for familiar settings

Question 6

Describe the mid/moderate impairment stage of Alzheimer’s disease

Answer 6

Average 5 to 7 years, possibly longer
Chronic recent memory loss
Difficulty with written and spoken language
Tendency to ask questions constantly
Tendency to experience visual – spatial perceptual problems
Assistance with ADL functions necessary
Tendency to wander, pace, and Rummage

Question 7

Describe the late/severe impairment stage of Alzheimer’s disease

Answer 7

Average 2 to 3 years
Dependence on others for ADL functions
Decreased interest in food
Difficulty with chewing and swallowing
Incontinence
Decreased vocabulary
Misidentification of familiar objects, persons
Impaired ambulation/gait, increase falls

Question 8

Describe the terminal stage of Alzheimer’s disease

Answer 8

Average 3 months to 1 year
Usually in bed or wheelchair
Limited ability to track visually
Mute or few incoherent words
Little spontaneous movement
Loss of appetite, severe weight loss
Difficulty in swallowing
Total dependence on others for care

Question 9

What is one thing that those with Alzheimer’s have a difficulty recalling in early stages

Answer 9

Nouns

Question 10

Why do we want to refrain from confronting those with Alzheimer’s

Answer 10

They will have increased agitation

Question 11

Given example of therapeutic fibs

Answer 11

Jim states, my wife is taking me home in five minutes. In reality intervention session has an additional 30 minutes remaining. Sue, The COTA agrees with him stating that he and his wife will soon be together and that he has a wonderful, caring wife. She realizes that a discussion of the amount of remaining time would increase Jim’s agitation

Question 12

As a therapist, what is something that you should be on the lookout for

Answer 12

Beware of nonverbal messages; acting rushed, looking at clock, raising one’s voice, agitation

Question 13

What are ways that we can improve communication with those with Alzheimer’s

Answer 13

Talk it eye level
Use short and simple sentences
Always be willing to repeat if needed
Do not appear rush
When asking a question, offer two choices
Ignore the need to be right
State requests with positive words
Realize some with AD are tactile defensive

Question 14

What are some behavior and psychosocial aspects of someone with Alzheimer’s

Suggestions on helping with these

Answer 14

Should have opportunities for proud and meaningful involvement.
A life story book to connect with elders
Behavior such as wondering, pacing, rummaging – use a busy box
Sun – Downing: mid-to-late afternoon due to exhaustion, dehydration. Agitation

Question 15

How is treatment intervention designed for someone with Alzheimer’s

Answer 15

Activities of daily living: understand task breakdown, task simplification.
Focus on abilities by encouraging active involvement.
Consider timing when working on ADL function.

Question 16

What are some difficulties with ADLs associated with dementia or AD

Answer 16

Decreased attention span
Limited ability to follow directions
Increased length of time to complete tasks
Problems with sequencing
Problems with perception
Problems with body awareness

Question 17

What are some ADL techniques that are used for someone with Alzheimer’s disease

Answer 17

Hand over hand
Chaining: Ford or backward chaining
Bridging: having them hold an electric razor while you shave them with another electric razor.
Avoid use of adaptive equipment that does not look familiar
Adapt the environment

Question 18

How did therapist work with pacing, wandering, or both

Answer 18

Figure out what wondering is telling you: hunger, needs to avoid, feels uncomfortable, or is really lost.
Use distraction techniques to break up the pace and pattern.
When attempting to redirect, music, approach with eye contact
Identify positive aspects of pacing or wandering

Question 19

What are some activities for someone that is pacing or wandering

Answer 19

Support physical exercise to promote overall wellness.
Offer to walk with the elder.
Offer expressive arts that includes large muscle groups and movements or dancing activities.
Present familiar routines or normalized activities

Question 20

What are some ways that a therapists can assist an Elder with Alzheimer’s in bathing.

Answer 20

No whether client prefers a bath or shower.
Elder may wash one part of the body per day until able to accept total bathing.
Create a warm at home like bathing environment.
Consider safety by using adaptations.
Consider alternatives such as having a family member present to assist with bathing.

Question 21

What are some ways that a therapist can assist someone with Alzheimer’s in shaving

Answer 21

Use a mirror unless the elder cannot recognize themselves.

Using bridging technique: have them hold an electric razor while you shave them using another electric shaver

Question 22

What are some ways a therapist can assist an elder with Alzheimer’s in oral care

Answer 22

Use a child size toothbrush.
Pretend to brush your own teeth and encouraged them to mirror you.
Use bridging technique for removing dentures.
Set up simulated dental chair.

Question 23

What are some ways a therapist can assist an elder with Alzheimer’s in dressing

Answer 23

Suggest clothing one size larger.
Is verbal and visual cues to simplify each step
If they become anxious, ask them to show you how the clothing items to put on.
If possible, use washable shoes with Velcro closures.
Ask the elders sit with dressing.

Question 24

What are some ways a therapist can assist in elder in toileting

Answer 24

Use pictures of toilets with the word toilets on the bathroom doors.
Be sure the toilet seat color contrast with the floor.
Offer the elder something to hold all toilet such as a magazine.
Never referred to pads for incontinence is diapers.

Question 25

What are some ways that a therapist can assist an elder in eating

Answer 25

Absurd eating for safety problems such as overstuffing the mouth.
Offer the meal in a quiet area without distractions.
Avoid plastic utensils.
Use finger foods
Simplify the meal by serving one item and one utensil out of time

Question 26

What are the Medicare cognative levels of assistance

Answer 26

Total assistance
Maximal assistance
Minimal assistance
Standby assist
Independent status

Question 27

What is diversity

Answer 27

Uniqueness of a person’s culture, values, and beliefs

Question 28

This culture learned through socialization or is it carried through person’s genetic makeup

Answer 28

It is through socialization

It is learned over the course of a lifetime

Question 29

What are the levels of culture

Answer 29

Individual level: rational 1 to 1 interactions through which people learn and express their unique representations of culture. Own space

Family level: Beliefs and values that are shared within a primary social group

Question 30

What is ethnicity

Answer 30

Part of one’s identity that is derived from membership in a racial, religious, national, and linguistic group

Question 31

What is ethnocentricity

Answer 31

Belief held by members of a particular ethnic group that their expression of values and beliefs are superior to that of others and that all other groups should also take on the same values and beliefs

Question 32

What percentage of elders age 45 and older of both sexes consider sexual relationships as contributing to their quality of life

Answer 32

56%

Question 33

What percentage of new diagnosis of HIV/AIDS and 2005 were among individuals 50 or older

Answer 33

15%

Question 34

What can COTAS do to help elders sexual functioning

Answer 34

They can recommend lubricants and Kegel exercises for elders, importance of safe sex