Special Care - Older people: Dementia Flashcards
What is dementia?
A chronic, aggressive and acquired syndrome which deteriorates cognitive function.
What is dementia characterised by? (4)
Amnesia
inability to concentrate
disorientation (time, place, people)
intellectual impairment
What are the types of dementia?
Alzheimers Vascular dementia Dementia with lewy bodies Frontotemporal parkinsons dementia (not parkinsons on its own) HIV related MS Corticobasal degeneration Riemann-Pick disease CJD
What is Alzheimers disease?
a type of dementia that is caused by a reduction of the hippocampus and the cortex
What causes Alzheimers?
Accumulation of plaques between nerve cells from beta-amyloid proteins
What are the features of Alzheimers?
- Short term memory loss
- Aphasia
- Problems with communicating
- Mood swings
- Withdrawn
- Loss of confidence
What are the risk factors of Alzheimers? (5)
- Age
- Sex – woman
- Head injury
- Lifestyle: Smoking, HT, high cholesterol
- Genetics
What causes vascular dementia?
Reduction of blood flow to the brain from, small vessel disease and varying sizes of strokes.
What are the features of vascular dementia?
- Sudden onset memory problems
- Visuospatial difficulties
- Stroke symptoms
- Seizures
What causes dementia with Lewy bodies?
Deposits of abnormal LB proteins inside brain cells in areas responsible for muscle movements and memory
(also found in parkinsons)
What are the features of dementia with LB?
- Short term memory loss
- Cognitive ability fluctuates
- Visuospatial difficulties
- Overlapping motor disorders like speech and swallowing problems
- Sleep disorders
- Delusions
What is the feature of frontotemporal dementia that makes it stand out from the others?
Younger people are commonly affected
What are the features of frontotemporal dementia?
marked changes in personality and social conduct
Uncontrollable repetition of words, others peoples words
Mutism
What are EARLY signs of dementia?
- 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
What are MIDDLE stages symptoms of dementia?
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
What are END stages symptoms of dementia?
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
How is dementia commonly diagnosed? (2)
MMSE - mini mental state exam
Blessed dementia scale
how can we plan treatment for those with early dementia?
plan for the future;
identify key teeth
provide high quality treatment
avoid complex treatment
prevention!!!
what are key teeth?
occluding pairs
anterior teeth
how can we plan treatment for those with mid stage dementia?
home visits
prevention continued
how can we plan treatment for those with advanced dementia?
focus on comfort
ensure treatment in non-invasive
How should we communicate with those who have dementia?
Approach from the front
use simple sentences, words and tasks
use lots of non-verbals: touch, smile
treat in a comfortable environment
What techniques can be used in treating patients with dementia?
distraction
bridging - direct conversation away from triggering topics
hand over hand - provides comfort and guidance
chaining - you start and they end
list ways the dental practice can be made dementia friendly.
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
