1. Dementia, Abuse and Neglect, Medical Radiation Safety, and End of Life
Additional Patient Information for Orientation

2. Dementia
Dementia is a set of signs and symptoms. It is a non-specific syndrome in which affected areas of brain function may be affected.
Dementia, unlike Alzheimer’s, is not a disease in itself.
It is a general term used to indicate that a person has developed difficulties with reasoning, judgment, and memory.

3. Dementia Causes
Diseases that cause degeneration or loss of nerve cells in the brain such as Alzheimer Disease
Diseases that affect blood vessels such as stroke
Infections
Parkinson dementia
Nutritional deficiencies
Head injuries

4. Dementia Symptoms
Memory loss, confusion
Moodiness: anger, hostility, anxiety, passiveness
Communication difficulties including talking, reading, writing
Agitation; restlessness; pacing & sleeping problems
Wandering; getting lost
Difficulty concentrating
Hoarding
As dementia progresses, the individual’s ability to carry out everyday tasks may diminish and he/she may not be able to provide self-care.

5. Dementia - Strategies to Consider
Create an individualized plan for care and intervention.
Minimize environmental change; make sure it is safe
Do not rush the individual
If aggressive or upset, try to shift the focus to another activity
Limit excessive visual or auditory stimulation
Provide reassurance; do not get upset yourself; remain calm
Limit the number of caregivers, if possible
Talk slowly
Provide simple instructions; break tasks into small parts
Involve the individual in activities
Check for your facility’s specific guidelines.

6. Dementia - Compassionate Care
It is important to ensure that all patients with dementia receive individualized, compassionate care that supports their respect, dignity, and safety at all times.
Collaboration with the entire healthcare team, along with the individual’s family members, assists in the creation and implementation of a plan of care that is optimally effective.

7. Abuse & Neglect
Every patient has the right to receive care in a safe setting that is free of all forms of abuse, neglect, or exploitation.
Definition of Abuse
An intentional act that results in maltreatment of an individual that may cause physical or psychological injury. The abuse may be physical, mental, sexual, or verbal.

8. Abuse & Neglect (continued)
Definition of Neglect
A careless or negligent act that results in the absence of services or resources to meet basic needs.
Definition of Exploitation/ Misappropriation
An intentional act that is meant to take advantage of an individual (financially or otherwise) or to deprive that person of property.

9. Abuse & Neglect - Reporting
Staff must report:
All falls and injuries of unknown origin (witnessed or un-witnessed). They may be considered possible neglect and should be reported immediately
Observations that may be related to an injury of unknown origin
A patient’s report of missing personal items
A patient’s report of misused personal information
Any observation of a person, or persons, that you suspect may contribute to patient harm including injury verbally, physically, mentally, or sexually.
It is VITAL to report IMMEDIATELY – see hospital specific information

10. Abuse & Neglect – Reporting (continued)
Staff must report all observations that may be related to injury of unknown origin such as:
Bruises or scrapes
Red sores or wounds
Fractures
Welts or bite marks
Pain during movement or restricted movement
Negative verbal or physical interactions between patients
All patient or family complaints about care
Cares not provided according to orders, the care plan, and/or policy-procedure

11. Medical Radiation Safety
Radiation is used for medical testing.
Although it is very effective, it can change the integrity of living cells in the body.
That is why it is important for medical workers to take precautions to limit and monitor exposure.

12. Medical Radiation Safety (continued)
Pregnancy: Radiation can affect the health of a fetus. Pregnant workers can voluntarily report their pregnancy in writing to the manager for potential additional monitoring.
Staff should not enter a room with the Radiation Danger sign unless authorized.

13. Medical Radiation Safety (continued)
Magnetic Resonance Imaging (MRI)
MRIs do not use radiation, but the intense magnetic energy that attracts objects to the center of the machine may cause projectile injuries.
The magnetic field is in operation at all times
Magnetic objects near the MRI are prohibited
Never attempt a resuscitation effort in the MRI magnet room itself
If you will be working in the Radiology Department at your facility,
check for additional policies and procedures to be followed to
ensure medical radiation safety.

14. End of Life MAJOR CONCEPTS
When “cure” is not possible and death is imminent, it is important to provide compassionate care.
MAJOR CONCEPTS
Death is a natural process.
We should not be afraid to encounter this process with the patient and family. Instead, we need to provide emotional and physical support, along with resources.
Comfort, compassion, education, and well planned care throughout the dying process can help to create the best possible transitional experience for both the patient and the family.

15. End of Life (continued)
Advance Directives provide pre-planned instructions composed by the patient that are important to end of life care and decision making.
A patient has the right to request assistance with end of life care planning.
Refer to hospital specific resources if a patient or family is requesting information.