Quiz 3 Flashcards
What is Alzheimer’s disease
Progressive, degenerative, and fatal disease of brain tissue leads to memory loss problems with thinking and daily life activities
Alzheimer’s accounts for what percentage of the cases of dementia
50 to 70%
How long can Alzheimer’s disease last
Can last from 3 to 20 years with most people dying after 8 years
What causes Alzheimer’s disease
Caused by formation of plaques and tangles – protein fragments that buildup between nerve cells and form inside dying brain cells
Name the four stages of Alzheimer’s disease
Early/mild impairment stage
Mid/moderate impairment stage
Late/severe impairment stage
Terminal stage
Describe the early/mild impairment stage of Alzheimer’s
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
Describe the mid/moderate impairment stage of Alzheimer’s disease
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
Describe the late/severe impairment stage of Alzheimer’s disease
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
Describe the terminal stage of Alzheimer’s disease
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
What is one thing that those with Alzheimer’s have a difficulty recalling in early stages
Nouns
Why do we want to refrain from confronting those with Alzheimer’s
They will have increased agitation
Given example of therapeutic fibs
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
As a therapist, what is something that you should be on the lookout for
Beware of nonverbal messages; acting rushed, looking at clock, raising one’s voice, agitation
What are ways that we can improve communication with those with Alzheimer’s
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
What are some behavior and psychosocial aspects of someone with Alzheimer’s
Suggestions on helping with these
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
How is treatment intervention designed for someone with Alzheimer’s
Activities of daily living: understand task breakdown, task simplification.
Focus on abilities by encouraging active involvement.
Consider timing when working on ADL function.
What are some difficulties with ADLs associated with dementia or AD
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
What are some ADL techniques that are used for someone with Alzheimer’s disease
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
How did therapist work with pacing, wandering, or both
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
What are some activities for someone that is pacing or wandering
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
What are some ways that a therapists can assist an Elder with Alzheimer’s in bathing.
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.
What are some ways that a therapist can assist someone with Alzheimer’s in shaving
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
What are some ways a therapist can assist an elder with Alzheimer’s in oral care
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.
What are some ways a therapist can assist an elder with Alzheimer’s in dressing
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.
What are some ways a therapist can assist in elder in toileting
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.
What are some ways that a therapist can assist an elder in eating
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
What are the Medicare cognative levels of assistance
Total assistance Maximal assistance Minimal assistance Standby assist Independent status
What is diversity
Uniqueness of a person’s culture, values, and beliefs
This culture learned through socialization or is it carried through person’s genetic makeup
It is through socialization
It is learned over the course of a lifetime
What are the levels of culture
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
What is ethnicity
Part of one’s identity that is derived from membership in a racial, religious, national, and linguistic group
What is ethnocentricity
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
What percentage of elders age 45 and older of both sexes consider sexual relationships as contributing to their quality of life
56%
What percentage of new diagnosis of HIV/AIDS and 2005 were among individuals 50 or older
15%
What can COTAS do to help elders sexual functioning
They can recommend lubricants and Kegel exercises for elders, importance of safe sex
