Week 3: Care of the Person with a Life Limiting Illness (Dementia) Flashcards
What is dementia?
A variety of conditions with cognitive features caused by damage occurring in different parts of the brain
What are the signs and symptoms of dementia?
Decline in two or more mental abilities including memory, learning, orientation and attention
Deterioration in at least one intellectual skill, including abstraction, judgement, comprehension, language and calculation
Loosening emotional control or personality change
Difficulties in family, social and work functioning
Difficulty in self-care abilities associated with cognitive decline
Apathy or depression
How does dementia affect the frontal lobe?
Difficulties with: Planning Organising Problem solving Personality Regulating social behaviour Starting and stopping actions
How does dementia affect the parietal lobe?
Difficulties with:
Language and reading
Spatial perception (sense of
geography)
Touch and pressure, judgment of weight, texture, size and shape
Misidentification of facial images Not knowing dressing sequence
How does dementia affect the temporal lobe?
Difficulties storing new information, short term memory, long term memory
Distinguishing sounds and smells
How does dementia affect the occipital lobe?
Difficulties with recognition of shapes and colours, visual reception and depth perception
How does dementia affect the limbic system?
Problems with sleep and appetite.
Difficulty linking emotions, memories behaviours
Accentuation of libido; tied up with frontal lobe Aggressive emotional response if cautioned re inappropriate behaviour
What is the difference between dementia, delirium and depression?
Dementia is an umbrella term for chronic and progressive cognitive decline over months to years
Delirium: acute and sudden organic disturbance of higher cerebral functioning associated with environment
Depression: multifaceted syndrome, comprising a constellation of affective, cognitive, somatic and physiological manifestations in varying degrees
What are the causes of dementia?
Neurodegeneration Cerebrovascular causes Infection-related Toxic and metabolic causes Traumatic brain injury Hereditary (uncommon)
What are the neurdegenerative causes of dementia?
Alzheimer’s Disease Dementia with Lewy Bodies Frontotemporal dementias Parkinson’s Disease dementia Huntington’s Disease
What are the cerebrovascular causes of dementia?
Vascular or Multi-Infarct dementia
What are the infection related causes of dementia?
Cruetzfeldt-Jabob disease and other Prion diseases
HIV-AIDS related dementia
What are the toxic and metabolic causes of dementia?
Wernicke-Korsakoff syndrome
Leukodystrophy
What are the hereditary causes of dementia?
One gene (Apolipoprotein E) is associated with an increased risk of Late Onset Alzheimer’s disease. Three genes (Amyloid Precursor Protein, Presenilin 1 and Presenilin 2) are associated with Younger Onset Alzheimer’s disease
How do you assess the presence of dementia?
Medical History Physical Exam Neurological Exams Brain, Spinal cord and Neurons Coordination Reflexes Eye movements Speech Sensations (smell, touch, sound, etc.) Mental Status Exam Brain Imaging/Scans Laboratory Exam Determine blood count Rule out vitamin or nutrient deficiency Evaluate thyroid hormone levels (low levels may cause dementia symptoms) Rule out other diseases such as infections and diabetes
How do you assess the progressive decline in cognitive ability?
Judgement Orientation Emotions Memory Thinking Communication Function in ADLs Sociability
What are the tools used to assess dementia?
Mini Mental State Exam (MMSE) Global Deterioration Scale (GDS) GP –Cog Functional Assessment Staging (FAST) Clinical Dementia Rating (CDR)
What is a stage 1 Functional Assessment Staging?
Normal adult: no functional decline
What is a stage 2 Functional Assessment Staging?
Normal older adult: personal awareness of some functional decline
What is a stage 3 Functional Assessment Staging?
Early Alzheimer’s Disease: noticeable deficits in demanding job situations
What is a stage 4 Functional Assessment Staging?
Mild Alzheimer’s Disease: requires assistance with complicated tasks such as handling finances, planning parties
What is a stage 5 Functional Assessment Staging?
Moderate Alzheimer’s Disease: requires assistance choosing proper clothing
What is a stage 6 Functional Assessment Staging?
Moderately severe Alzheimer’s Disease: requires assistance dressing, bathing, and toileting. Experiences urinary and faecal incontinence
What is a stage 7 Functional Assessment Staging?
Severe Alzheimer’s Disease: speech ability declines to about a half-dozen intelligible words. Progressive loss of abilities to walk, sit up, smile, and hold head up
