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- 5. Normal Aging vs Dementia Characteristics Normal aging Alzheimer ’s/Dementia Memory loss Mild forgetfulness (able to use reminders) Progressive memory loss (gradually unable to use reminders, eventually no ability to learn or recall information) Thinking (cognitive impairment) None Progressive loss in thinking skills (the ability to make decisions, to judge, to follow directions) Paranoia, hallucinations Some paranoia related to vision & hearing loss (may think others are talking about them) Function of the illness although symptoms will vary among individuals. Paranoia and hallucinations are more prevalent, especially in the middle stage. Self-care capacity Usually able to perform all self-care tasks Progressively unable to care for themselves (eventually requires total assistance)
- 17. Diffuse Lewy Body Disease Dementia Early problems with attention, executive function, and visuospacial abilities even preceding memory impairment Fluctuating cognitive ability (day to day changes) Visual (93%) and auditory (50%) hallucinations are common and not always troubling to patients Early Parkinson-like motor abnormalities and falls
- 18. Diffuse Lewy Body Disease Dementia At risk for exaggerated Parkinsonian drug side effects from haloperidol and risperidone psychosis with dopaminergic drugs
- 19. Vascular Dementia Dementia related to strokes Variety of presenting signs with attention disturbances, memory loss and changes in social behavior being common Course is progressive, commonly with a step-wise decline being related to each new stroke Focal neurologic signs are often present Patients have other vascular diseases such as DM, HTN, High Cholesterol and a history of smoking Commonly occurs with Alzheimer ’s Disease (10-15%)
- 20. Frontotemporal Dementia & Pick ’s Disease Early Behavioral changes: lack of social skills, poor hygiene, sexual disinhibition, constant touching and rearranging objects, putting objects in mouth Age of onset earlier than Alzheimer ’s Calculation and visuospacial skills intact until late in illness Slow and steady progression
- 21. Parkinson ’s Dementia Dementia occurs late in the history of Parkinson ’s Disease (different pattern than DLBD) Steadily progressive
- 22. Characteristics of Common Dementias Memory problems Attention Cognition Hallucinations Distress Behavior Motor Problems AD Early Hallmark Early Intact attention Late or never Late occurring DLBD Not first symptoms Early Fluctuating cognition Early and Common Parkinson-like Early VAS Early attention problems Common Early PD Precedes dementia by years
Notes de l'éditeur
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page Safety== home safety, driving, compliance Families often blame themselves or blame patient for behavior they cannot control. Caregivers need to get into education of what to expect. They need to have time to grieve and accept this sudden change in normalcy. Advance planning of wills, proxies appointed, advance directives of care—living wills etc. Patient ’s family has the right to know what is happening and what to expect. The burden of care directly and indirectly will fall on them. New medications do allow for care.
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page Comfortt measure: Companionship, light, reassurance, warmth, and reorientation.
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page Suicide::80% visited their physician within a month of the act.
- UNIVERSITY OF MIAMI School of Nursing NUR 624: Lecture Oct. 17, 2003 Dementia and Cognition Page Suicide::80% visited their physician within a month of the act.