Special Care - Older people: Dementia Flashcards

1
Q

What is dementia?

A

A chronic, aggressive and acquired syndrome which deteriorates cognitive function.

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2
Q

What is dementia characterised by? (4)

A

Amnesia
inability to concentrate
disorientation (time, place, people)
intellectual impairment

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3
Q

What are the types of dementia?

A
Alzheimers 
Vascular dementia 
Dementia with lewy bodies
Frontotemporal 
parkinsons dementia (not parkinsons on its own) 
HIV related 
MS
Corticobasal degeneration 
Riemann-Pick disease
CJD
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4
Q

What is Alzheimers disease?

A

a type of dementia that is caused by a reduction of the hippocampus and the cortex

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5
Q

What causes Alzheimers?

A

Accumulation of plaques between nerve cells from beta-amyloid proteins

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6
Q

What are the features of Alzheimers?

A
  • Short term memory loss
  • Aphasia
  • Problems with communicating
  • Mood swings
  • Withdrawn
  • Loss of confidence
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7
Q

What are the risk factors of Alzheimers? (5)

A
  • Age
  • Sex – woman
  • Head injury
  • Lifestyle: Smoking, HT, high cholesterol
  • Genetics
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8
Q

What causes vascular dementia?

A

Reduction of blood flow to the brain from, small vessel disease and varying sizes of strokes.

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9
Q

What are the features of vascular dementia?

A
  • Sudden onset memory problems
  • Visuospatial difficulties
  • Stroke symptoms
  • Seizures
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10
Q

What causes dementia with Lewy bodies?

A

Deposits of abnormal LB proteins inside brain cells in areas responsible for muscle movements and memory
(also found in parkinsons)

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11
Q

What are the features of dementia with LB?

A
  • Short term memory loss
  • Cognitive ability fluctuates
  • Visuospatial difficulties
  • Overlapping motor disorders like speech and swallowing problems
  • Sleep disorders
  • Delusions
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12
Q

What is the feature of frontotemporal dementia that makes it stand out from the others?

A

Younger people are commonly affected

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13
Q

What are the features of frontotemporal dementia?

A

marked changes in personality and social conduct

Uncontrollable repetition of words, others peoples words

Mutism

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14
Q

What are EARLY signs of dementia?

A
  • Loss of short term memory
  • Confusion
  • Poor judgement
  • Anxiety/agitation
  • Unwilling to make decisions
  • Distress over changes
  • Inability to manage everyday tasks - which they were once able to do without any problem
  • Communication problems – problems with talking, reading and writing
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15
Q

What are MIDDLE stages symptoms of dementia?

A

More support required – reminders to eat, wash, dress

Forgetful – especially well. Recognisable people in their life

Mood changes – distress and anger from frustration

Risk of wandering/getting lost, leaving gas on, taps running

Hallucinations – old memories

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16
Q

What are END stages symptoms of dementia?

A

Inability to recognise familiar objects and people – can have moments of recognition

Shuffle walk and unsteady

Problems with eating and swallowing = weight loss

Incontinence

Loss of speech

17
Q

How is dementia commonly diagnosed? (2)

A

MMSE - mini mental state exam

Blessed dementia scale

18
Q

how can we plan treatment for those with early dementia?

A

plan for the future;

identify key teeth
provide high quality treatment
avoid complex treatment
prevention!!!

19
Q

what are key teeth?

A

occluding pairs

anterior teeth

20
Q

how can we plan treatment for those with mid stage dementia?

A

home visits

prevention continued

21
Q

how can we plan treatment for those with advanced dementia?

A

focus on comfort

ensure treatment in non-invasive

22
Q

How should we communicate with those who have dementia?

A

Approach from the front

use simple sentences, words and tasks

use lots of non-verbals: touch, smile

treat in a comfortable environment

23
Q

What techniques can be used in treating patients with dementia?

A

distraction

bridging - direct conversation away from triggering topics

hand over hand - provides comfort and guidance

chaining - you start and they end

24
Q

list ways the dental practice can be made dementia friendly.

A

The reception desk is visible from the entrance

The walls are a different colour form the doors and the skirting/floors
- unaccessible rooms same colour as wall to prevent unwanted attention

signposts

ramps

handrails