1. Gwendolyn de Geest, RN, BSN, MA Managing Responsive Behaviors In Care

3. Alterations in Cognition Delirium Dementia Depression

4. Maria Martin, VCC BSN student, 2011

5. Delirium Acute Reversible Physiological, psychosocial, environmental factors

6. Dementia Chronic, progressive Symptoms - loss of memory - poor judgment - mood swings - disorientation

7. Alzheimer’s Disease Dr. Alois Alzheimer 1906 – Auguste D. Frankfurt, Germany Plaques and Tangles

8. Aaron Copland 90 yrs Rita Hayworth 68 yrs Aaron Copland 90 yrs Sugar Ray Robinson 67 yrs Burgess Meredith 89 yrs Barry Goldwater 89 yrs E.B. White 86 yrs

9. Alzheimer Disease Normal Brain TIME July 17, 2000 Language Memory Language Memory

10. GREEN RED GREEN BLUE RED BLUE RED BLUE GREEN RED Attention / Frontal Lobe Skills

11. The Thief of Memory

12. The person remains The person’s humanity remains Communicates with feelings, not words Impact on Communication

13. Depression Chronic Reversible Often mistaken for dementia

15. Reason for every behavior Check out approach Apraxia, Agnosia, Aphasia Responsive Behaviors

16. Maria Martin, VCC BSN student, 2011

17. Apraxia Loss of ability to take purposeful action even when muscles, senses, and vocabulary seem intact.

18. Agnosia Inability to recognize objects by use of the senses.

19. Aphasia Inability to use or understand language (spoken or written). 1.expressive aphasia 2.receptive aphasia

21. Intervention Strategies (1) Calm approach Explore cause of behavior Understanding Education and support for family

22. Intervention Strategies (2) Apraxia - loss of independence Agnosia - environment Aphasia - frustration

23. Communication Strategies Reminiscence Simple repetition Appropriate touch Distraction - catastrophic reaction

25. Nursing Process Application Situation  86yr-old woman exhibits disturbed attention and confusion Nursing diagnosis  ineffective coping related to organic memory loss

26. Nursing Process Application Nursing goal  minimize factors that contribute to inattention Nursing approach  supportive, calm

27. Nursing Process Application Nursing intervention Direct eye contact Use of appropriate touch Clear, simple direction Repeat messages slowly Modify environmental stimuli Assist family to understand

28. Evaluation of Successful Outcomes Does not occur through words Behavior Co-operation Positive response

29. References Arnold & Boggs, Interpersonal Relationships De Geest, G., Living Dementia Case-Study Approach Potter & Perry, Canadian Fundamentals of Nursing