1. Copyright © 2002 by W. B. Saunders Company. All rights reserved. Chapter 21 Cognitive Disorders Menu F

2. Slide Copyright © 2002 by W. B. Saunders Company. All rights reserved. Mental health continuum for cognitive disorders 21-2 (Fig. 21-1) Menu FB

3. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Eliminate causative factors l Monitor vital and neurological signs l Call client by name and identify self l Use face-to-face contact l Use short, simple, concrete phrases l Explain what’s to be done l Keep room well lit l Keep head of bed elevated l Provide clocks, calendars l Eliminate causative factors l Monitor vital and neurological signs l Call client by name and identify self l Use face-to-face contact l Use short, simple, concrete phrases l Explain what’s to be done l Keep room well lit l Keep head of bed elevated l Provide clocks, calendars Interventions: Delirious Client Menu FB

4. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Have client wear glasses, hearing aids l Provide continuity of personnel l Clarify reality if hallucinations/illusions persist l Ignore insults l Set limits on physically abusive behavior l Have client wear glasses, hearing aids l Provide continuity of personnel l Clarify reality if hallucinations/illusions persist l Ignore insults l Set limits on physically abusive behavior Interventions: Delirious Client, cont. Menu FB

5. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Stage 1 (Mild): Forgetfulness - Usually not diagnosable l Stage 2 (Moderate): Confusion - Short term memory impairment - ADLs decline - In-home assistance needed l Stage 1 (Mild): Forgetfulness - Usually not diagnosable l Stage 2 (Moderate): Confusion - Short term memory impairment - ADLs decline - In-home assistance needed Stages of Alzheimer’s Disease Menu FB

6. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Stage 3 (Severe): Ambulatory Dementia - ADL losses - Reasoning and verbal communication poor l Stage 4 (Late): End Stage - No recognition of family/self - Nonambulatory - Forgets how to eat/incontinent - Institutionalized l Stage 3 (Severe): Ambulatory Dementia - ADL losses - Reasoning and verbal communication poor l Stage 4 (Late): End Stage - No recognition of family/self - Nonambulatory - Forgets how to eat/incontinent - Institutionalized Stages of Alzheimer’s Disease, cont. Menu FB

7. Copyright © 2002 by W. B. Saunders Company. All rights reserved. l Memory impairment l Disorientation, mistaken beliefs l Needs physical help l Risk for injury l Apathy l Poor Communication l Repetitiveness l Uncontrolled emotion, behavior l Incontinence l Poor decision making l Burden on family l Memory impairment l Disorientation, mistaken beliefs l Needs physical help l Risk for injury l Apathy l Poor Communication l Repetitiveness l Uncontrolled emotion, behavior l Incontinence l Poor decision making l Burden on family Problems in Dementia Menu B