Welcome to Episode 95
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Tip of the Week– Patient care of Dementia
Link to last week’s podcast episode on Assessment and Nursing Care of Delirium.
Dementia is described as a progressive neurologic disorder. Affected cognitive areas include attention, orientation, judgment, abstract thinking and personality. In 2001, it was cited as the eighth leading cause of death in the United States. As opposed to delirium, symptoms of dementia aren’t usually reversible.
Dementia is rare in under 50 years of age and the incidence increases with age. It afflicts up to 10% of adults ages 65 to 85, 20% of adults ages 75 to 85, and 50% of adults over age 85.
Causes and Risk Factors
65-70% of dementia cases are related to Alzheimer’s disease. Other common causes include Stroke, Pick’s disease, Huntington’s, Downs Syndrome, Creutzfeldt-Jacob, AIDS, alcoholism, Parkinson’s disease and other neurodegenerations, and drug intoxication.
Risk factors of dementia comprise of the following:
- Age – above 50
- Down’s Syndrome
- Head Injury
- Fewer years of education- less brain cell activity
- Gender- higher risk for females
In the early stages of dementia, patients display signs and symptoms like changes in personality, progressive memory loss, difficulty finding the right words, and an inability to perform familiar tasks. As the disorder progresses, other cognitive difficulties may arise, such as aphasia (speech problems), apraxia (motor memory problems), agnosia (sensory recognition problems), and diminished executive functioning (complex behavior sequencing problems).
There is no change in alertness but if asked, the patient might not respond appropriately and does not have the ability to think abstractly, behavior changes are also seen. There is also rapid shift of emotions from anger to laughter to tears. Judgment and impulse control are impaired. Patients with dementia may be unaware of his decline and rarely complain of pain or illness.
Since dementia is irreversible, nursing interventions are focused on preserving the patient’s functional capacity and independence and maintaining the highest quality of life.
> Providing a structured environment reduces confusion. Creating means of remembering like, lists of activities, reminding notes, labels on items, pictures, diagrams etc. will assist the patient to remember. Make sure he wears his eyeglasses and hearing aid. Making activities routine and keeping tasks within the patients capability will optimize functional capacity.
> Providing a safe environment is also very important to avoid accidents. This can be done by removing rugs, extension cords and other things that hast the potential to trip the patient. Ensure that furniture are out of the way and provide adequate lighting especially at night for trips to the bathroom.
>Since caring for a patient with dementia can be straining to family members, they should be educated and increase their understanding that dementia can make a person increasingly dependent. Referral to support groups can also be helpful.
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Other Podcasts from Jamie Davis:
- The MedicCast (for EMTs, Paramedics, EMS field work)
- MedicCast News (Weekly short medical news program)
- MedicCast Live (Monthly live call-in show with a single EMS topic)
Song this week:
Music from The Podsafe Music Network
This week- Matthew Ebel with “Drive Away”
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