1. MNA Mosby’s Long Term Care Assistant Chapter 44 Confusion and Dementia

2. Cognitive Memory Thinking Reasoning Ability to understand Judgment
Behavior

3. Confusion Many causes Person may be Angry Drugs Restless Disease
Depressed
Irritable
Many causes
Drugs
Disease
Infection
Injury

4. Caring for persons with Confusion
Follow care plan Provide safety Face person, speak clearly Explain procedures Maintain day/night cycle Be consistent Orient often Provide calm setting
Use clear, simple, easy to understand instructions
Give time to respond
Give clear simple directions and answers

5. Dementia
Loss of cognitive functions
Interferes with daily activities

6. Dementia Not normal part of aging May be due to variety of diseases
Possible Causes:
Alcohol
Alzheimer's
Brain tumors
CVA
Multiple Sclerosis
Huntington’s Chorea
Parkinson's
Syphilis
Head Injury
Not normal part of aging
May be due to variety of diseases

7. Dementia S&S Memory Loss Problems with language, common tasks
Poor judgment
Getting lost in familiar places

8. Delirium Possible causes: Infection Poor nutrition Hormone disorders
Alcohol, drugs
Sudden severe confusion, rapid brain changes.
Occurs with physical or mental illness
Usually temporary and reversible

9. Alzheimer's Disease Effects: Memory Thinking, Reasoning Judgment
Brain disease
Nerve cells are damaged and die
Effects:
Memory
Thinking, Reasoning
Judgment
Language
Behavior, Mood
Personality

10. Alzheimer's Disease Gradual onset Gets worse and worse
S&S
Gradual loss of short term memory
Asking same question over and over.
Repeating the same story
Forgetting how to do everyday activities
Forgetting names, recent events, directions
Gets lost in familiar setting
Gradual onset
Gets worse and worse
Usually live years after onset
Cause is unknown

11. Alzheimer's Disease Progresses from memory loss to
being totally dependent on others to coma to death

12. Alzheimer's Disease Wandering Disoriented, poor judgment.
Causes:
May have no cause
May be looking for something or someone
Drugs
Stress, restlessness
anxiety
Disoriented, poor judgment.
Allow to wander in safe areas.

13. Alzheimer's Disease
Sundowning
S&S increase during hours of darkness.

14. Alzheimer's Disease Approach in calm, quite manner Make eye contact
Use calm gently voice
Use simple easy to understand instructions
Use gestures and body language
Speak slowly
Do not use baby talk
Do not rush
Do not criticize

15. Alzheimer's Disease
Do not try to reason with resident or ask why they are upset: they cannot understand you.
Follow set routine
Ensure safety
Encourage activities early in the day

16. X Alzheimer's Disease Do not restrain
Aggression may be due to physical discomfort (elimination?)
Sexual gestures may be due to physical discomfort (wet depends?) X

17. Alzheimer's Disease Remember, the resident with Alzheimer's Disease:
Did not choose to have this disorder
Deserves to be treated with respect
Has same rights as all other residents

18. Alzheimer's Disease Family Need support and encouragement
Often feel helpless and hopeless
Respite Care