1. 1 Alzheimer’s Disease: Delirium and Dementia For use in conjunction with: The Eastern North Carolina Chapter of the Alzheimer’s Association. (2003). Module 1 of Accepting the Challenge: Providing the best care for people with dementia, [Videotape]. Module 14 Geriatric Aide Curriculum NC Division of Health Service Regulation

2. 2 Dementia Objectives 1. Discuss differences between delirium and dementia 2. Define dementia. 3. Discuss Alzheimer’s disease. 4. Discuss vascular dementia. 5. Discuss how changes in the brain affect behavior in dementia.

3. 3 Module 1 of DVD What is Dementia?

4. 4 You have the abilities and strength to prevent or manage problem behavior.

5. 5 Nurse Aides’ Growth Process in Learning To Prevent Or Manage Problem Behaviors Novice nurse aide will: –Fight/resist behaviors; blame residents for behaviors –Think behaviors are on purpose

6. 6 Nurse Aides’ Growth Process in Learning To Prevent Or Manage Problem Behaviors The intermediate nurse aide will: –Tolerate behaviors –Understand difference between behaviors that are risky and those that are not

7. 7 Nurse Aides’ Growth Process in Learning To Prevent Or Manage Problem Behaviors The skilled nurse aide will: –Accept and understand behaviors, intervening quickly and appropriately when necessary and supporting and accepting behaviors that are normal for disease process or coping strategies

8. 8 Delirium A sudden state of severe confusion and rapid changes in brain function.

9. 9 Causes of Delirium Metabolic disorders Infections Medications Dehydration Poor nutrition Congestive Heart Failure Stroke Acute heart attack Acute psychoses Fecal Impaction Urinary retention

10. 10 Symptoms of Delirium Inability to concentrate Disorganized thinking Reduced level of consciousness Hallucinations Disorientation Changes in sensation/perception Altered sleep patterns Short-term memory problems Changes in motor activities

11. 11 Risk Factors for Development of Delirium in Older Adults 65 and older Dementia Hospitalization Acute illness/injury Psychiatric disorder Poor nutrition Acute stress Cancer Impaired ambulation

12. 12 Delirium is a Medical Problem If the resident shows signs of delirium, seek medical assistance immediately!

13. 13 What Staff Can Do Approach the resident from the front in a calm, slow manner Reassure the resident that the condition is temporary Protect the resident and others from harm Report the behavior to a nurse

14. 14 Differences Between Delirium and Dementia Delirium Abrupt onset Acute illness Reversible Disoriented early Varies by moment Dementia Gradual onset Chronic illness Irreversible Disoriented later Generally stable

15. 15 Differences Between Delirium and Dementia - continued Delirium Clouded consciousness Short attention span Sleep-wake cycle varies hour to hour Dementia Consciousness not clouded Attention span may not be reduced Sleep-wake cycle with day/night reversal

16. 16 Comparing Delirium, Depression and Dementia Because delirium and depression are life threatening and reversible, it is important to differentiate between delirium, dementia and depression when working with residents. Report any changes to the nurse.

17. 17 What is Dementia? It is not a normal part of aging. It is more that just forgetfulness, which is a part of normal aging. It makes independent life impossible.

18. 18 What is Dementia? Dementia is an umbrella term that includes many cognitive conditions. General definition: the loss of cognitive function that interferes with routine personal, social and occupational activities. Includes some reversible conditions, so it should be checked out carefully.

19. 19 Alzheimer’s Disease Most common type of dementia in older adults. Caused by damage to nerves in the brain and eventual cell death. Progresses over 8-12 years. Will get worse over time and is terminal Affects structure and chemistry of nerve cells in brain.

20. 20 Effects of Alzheimer’s Disease Changes occur in a predictable pattern People with any dementia are not children in an adult’s body Children learn from simple to complex People with Alzheimer’s disease lose from complex to simple

21. 21 Vascular Dementia Caused by damage to blood supply to nerves in brain. Not predictable. Affects memory, emotions, interests. May not change in severity for long periods, then take a big dip.

22. 22 Other Dementias Includes about 75-80 types. Each is unique in some ways, and similar in others. Might be helped with careful assessment and treatment.

23. 23 Effects of Alzheimer’s and Vascular Dementia Affects person’s entire life; causes the brain to shrink and stop working. It steals memories; the most recent first, and eventually almost all.

24. 24 Effects of Alzheimer’s and Vascular Dementia It steals ability to understand what others mean and say. It steals reasoning and logic. It robs individuals of relationships.

25. 25 Effects of Alzheimer’s and Vascular Dementia It makes even the familiar seem odd and scary. It steals the ability to care for self and to move around safely.

26. 26 Effects of Alzheimer’s and Vascular Dementia It robs individuals of impulse control. It takes away emotional and mood control.

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