1. Master’s Advanced Curriculum (MAC) Teaching Module: Advanced Practice in Mental Health Settings
Acknowledgement: The development of this PowerPoint was made possible through a Gero Innovations Grant from the CSWE Gero- Ed Center’s Master’s Advanced Curriculum (MAC) Project and the John A. Hartford Foundation.

2. Dementia
DEFINITION:
Group of symptoms that can be caused by many disorders.
Syndrome which refers to progressive decline in intellectual functioning severe enough to interfere with person’s normal daily activities and social relationships. (National Institute on Aging, 1995 No )

3. Dementia Progressive and irreversible declines in memory
visual-spatial relationships
performance of routine tasks
language and communication skills
abstract thinking
Mathematical ability

4. Dementia
Two Types:
Reversible
Irreversible

5. Dementia Reversible: D= Drugs, Delirium
E= Emotions (such as depression) and Endocrine Disorders
M= Metabolic Disturbances
E= Eye and Ear Impairments
N= Nutritional Disorders
T= Tumors, Toxicity, Trauma to Head
I= Infectious Disorders
A Alcohol, Arteriosclerosis
(Dick-Mulheke- Overview of Alzheimer's Disease)

6. Dementia Irreversible: Alzheimer’s Lewy Body Dementia
Pick’s Disease (Frontotemperal Dementia)
Parkinson’s
Heady Injury
Huntington’s Disease
Jacob-Cruzefeldt Disease

7. Dementia Irreversible:
Alzheimer's most common type of irreversible dementia
Multi-Infarct dementia second most common type of irreversible dementia
Death of cerebral cells
Blockages of larger cerebral vessels, arteries
Abrupt in onset
Associated with previous strokes, hypertension
Can be determined through diagnostic procedures

8. Changes Caused by Alzheimer's
Diminished blood flow
Neurofibrillary Tangles
Neuritic Plaques
Degeneration of hippocampus, cerebral cortex, hypothalamus, and brain stem

9. Theories Regarding Causes of Alzheimer's
Changes in Protein Synthesis
Changes in Neurotransmitters
Genetic Theories

10. Theories Regarding Causes of Alzheimer's
Genetic Theories
Metabolic Theories
Calcium Theories

11. Theories Regarding Causes of Alzheimer's
Environmental
Aluminum--Traces of metal found in brain.
Zinc--found in brains on autopsies.
Food borne poisons--amino acids found in legumes in Africa and India my cause neurological damage.
Viral
May be hidden in body and attack brain cells years later. (NIH-1995)

12. Theories Regarding Causes of Alzheimer's
Head Trauma
Head trauma increase the concentration of B-amyloid protein
Low Level of Education
Individuals with low level of education less able to compensate for cognitive deficits
Estrogen Deficiency

13. Diagnosis of Dementia Due to Alzheimer’s
Memory Impairment
Multiple cognitive deficits with at least one disturbance in the following areas:
Aphasia—loss of the ability to use symbols to communicate orally or in writing
Apraxia—inability to initiate complex learned motor movement or unable to perform activity on command
Agnosia---inability to recognize familiar objects by sight, touch, taste, smell or sound

14. Diagnostic Tests Neurological Exam
Brain Imaging—shrinkage, atrophy of brain (CT or MRI)
Blood Work

15. Stages of Alzheimer’s Disease
Mild Stage
Memory Loss
Symptoms:
Confusion
Loss of Spontaneity
Loss of Initiative
Mood/Personality Changes
Poor Judgment
Takes Longer to Perform Routine chores

16. Stages of Alzheimer’s Disease
Moderate Stage
Impairments in:
language
motor ability
recognition of objects
increasing memory loss and confusion

17. Stages of Alzheimer’s Disease
Moderate Stage
Symptoms:
Problems recognizing family members, close friends.
Repetitive statements and/or movements.
Restless, especially in late afternoon and at night..
Problems organizing thoughts, thinking logically.
Can’t find right words; confabulation.
Reading and writing difficulties
May be suspicious, irritable, fidgety, teary or silly.

18. Stages of Alzheimer’s Disease
Severe Stage
Symptoms:
Weight loss, even with good diet.
Deterioration in self-care.
Difficulties in verbal - May put everything in mouth or touch everything.
Loss of bladder and/or bowel
May have difficult with seizures, swallowing, skin breakdown, infections.

19. Stages of Alzheimer’s Disease
Terminal Stage
Symptoms:
Loss of ability to ambulate.
Loss of ability to sit.
Loss of ability to smile.
Loss of ability to hold up head.
Loss of ability to swallow.