Flashcards in Test 2 Deck (58):
How many American have some type of dementia?
how many nursing homes serve ppl w/dementia?
who are the majority of ppl w/dementia cared for?
untrained family or workers
how many ppl r newly diagnosed each year?
more than 1mil
dementia occurs from how many causes?
more than 70
name four benefits of evidence-based approaches to healthcare
1. improve quality of care
2. improve standards of practice and fewer variations
3. provide cost savings bc the interventions are supported by evidence
4. Improves outcomes
why was the NEST approach designed?
to decrease dependence of psycho-pharmaceutical means of behavior control among ppl w dementia
define each part of the NEST approach
N - "needs" of the person with memory loss
E - "environment" of the person in distress
S - "stimulation," for appropriate levels of stimulation and rest
T - "techniques" and approaches used by caregivers
what are the two sets of symptoms with dementia
clarify each set of symptoms regarding dementia
cognitive - memory impairment, diff w prob solving and decision making, language probs, confusion, etc.
behavioral - apathetic, psychiatric, physical nonaggressive, physical aggressive, verbal nonaggressive, verbal aggressive, etc.
evidence shows that ppl w dementia will have what at some point?
what is likely to happen if behavioral problems occur with ppl with dementia?
long term care and drug intervention increases
what can placement result in for ppl w dementia?
what can that result in?
what can that result in?
social isolation and long periods of doing nothing
boredom behavior problems
increased drug intervention
how effective is pharmacological treatments for ppl w dementia?
very limited effectiveness
What are behaviors?
expressions of unmet needs
What programs should nursing homes target for clients w dementia?
psychosocial and recreational programs based on their lvl of need
What opportunities should be offered to ppl w dementia in nursing homes?
meaningful involvement in their environments
What should be altered in nursing homes?
their focus from one of nursing home needs and conditions to one of lifestyle and living conditions of the clients
What is the most common form of dementia?
how many ppl in the USA have Alzheimer's?
how many are newly diagnosed each yr?
250K each yr
what are seven types of dementia?
3. dementia w Lewy bodies
4. picks disease
5. Parkinson's disease
6. alcohol related
7. wernicke-korsakoff syndrome
Alzheimer's is progressive
what five areas doe Alzheimer's affect?
1. intellectual functioning
5. ability to perform ADLs
what r the three stages of Alzheimer's?
describe each stage of Alzheimer's
early - memory loss, language and mood probs
intermediate - more memory loss, additional language probs, may b physically aggressive
later - severe deterioration of physical/intellectual functions, loss of language, loss of bowel/bladder control, inability to walk, or complete ADLs
which form of dementia is caused by cerebrovascular disease? (which results from insufficient O2 to the brain)
describe the five diff onsets of vascular dementia, depending on the cause
may b abrupt, insidious, static, remitting, or progressive
what is a often occurs prior to ppl with vascular dementia?
TIAs (mini strokes)
how do symptoms of vascular dementia appear following a major stroke?
if not vascular dementia is not caused by a major stroke, describe the usual onset
what does vascular dementia usually affect?
confusion, recent memory, wandering, incontinence, emotnal probs (affect)
which type of dementia affects more males than females?
dementia w Lewy bodies
what is the typical age of onset for dementia w Lewy bodies?
bw 50-80 yrs old
Alzheimer's usually progresses faster than Lewy bodies
dementia w Lewy bodies usually has a faster progression
what percentage of the pop has dementia w Lewy bodies?
about 10-20 percent
about how many ppl with Alzheimer's also has DBL?
what r four clinical features of DBL?
1. acute episodes of confusion which vary hr to hr
2. hallucinations which can worsen during acute confusion
3. Parkinsonism w mild gait impairment
4. abnormally sensitive to neuroleptic therapy
describe the acute episodes of confusion with DBL
excessive daytime drowsiness, staring into space, disorganized speech, short-term memory and word finding diff
which hallucinations are most common with DBL
describe the Parkinsonism clinical feature of DBL
bradykinesia (slow movement,) rigidity, stooped posture, shuffling gait, diff initiating movement
what makes ppl with DBL ideal candidates for TR.
sensitivity to neuroleptic medications
picks disease is nonprogressive
it is progressive
what is affected with picks disease?
slow deterioration of social skills, changes in personality, impaired intellect, memory and language
picks disease has a cure
how long is the course of picks disease?
only about 5 yrs
what is the typical onset of picks disease?
how early and how late has it been seen?
bw 40-60 yrs old
early as 20 and as late as 80
why is picks disease sometime diagnosed as mental illness?
personality changes, insensitivity, lack of restraint, obsessive thinking, lack of insight, decreased language
ppl with picks disease usually become non verbal
what is picks disease also known as?
Kluver Bucy Syndrome
Parkinson's is a non progressive disease of the CNS.
it is progressive
what is Parkinson's characterized by?
tremors, stiffness of limbs and joints, speech impediments, diff initiating movements
what are two other names for alcohol related dementia?
what causes wet brain/pickled brain?
excessive drinking over period of years
what problems occur with alcohol related dementia?
memory, learning, cognitive skills, poor judgment, diff making decisions, lack of insight, personality changes
what is alcohol related dementia often accompanied by?
what is another form of alcohol related dementia?
whats the diff bw wernickes n korsakoff?
wernickes - due to malnutrition and results in CNS nerve damage as well as peripheral nerve damage in the rest of the body
korsakoff - characterized by impaired memory and intellect, most distinguishing feature is confabulation (fabrication) or lying