Dementia counselling + hx

Question 1

brief intro

Answer 1

gradual loss of mental ability // personality changes // decline self-care

1 in 20 >65

Question 2

differential to rule out in hx

Answer 2

depression
anxiety
hypothyroidism
delirium

Question 3

brief (i mean brief) types of dementia

Answer 3

alzheimer’s - most common // brain gets smaller & plaques // not inherited

lewy body - protein deposits

frontotemporal - young & personality changes

vascular - stepwise deterioration // CVD risk

Question 4

symptoms of dementia

Answer 4

memory loss - forget recent events first // misplace objects

living in past - forget age // disorientated // lose track of time // poor concentration // cannot grasp ideas

personality changes - irritable // moody // disinhibited // poor self-care

weight loss; falls; loss speech; immobility; incontinence

Question 5

summary dementia tx

Answer 5

cholinesterase inhibitors (donepezil) - slow progression in 50%. SEs feel sick, cramps, diarrhoea

memantine - reduce calcium in brain

tranquillisers & antidepressants where needed

Question 6

practical measurements to help

Answer 6

reality orientation - board w/ details of day/date/season etc

cognitive stimulants - recreational activities // problem-solving activities // talking // physical activity

Question 7

caring for dementia px

Answer 7

carer (often fam member)

social services

daycare centres // sitting services // voluntary organisations // residential/nursing homes