Chronic & Progressive Lab: FND & Dementia Assessment/ treatment

What type of learning is essential for treatment of Alzheimers disease ?

errorless

what type of memory does errorless learning rely on when treating Alzheimer's disease ?

implicit memory

Describe repetition and variability for errorless learning

high repetition, low variability

What is important to consider when practicing errorless learning ?

current emotional status of patient and frustration tolerance

True or false: for errorless learning it is best to be in an open environment

false - closed environment

What are some errorless learning treatment strategies ?

feedforward instruction, physical assistance, modify task variables, cues, spaced retrieval

cues provided before patient performs task

feedforward instruction

Pt demonstrates tasks; sequential tasks are modeled and mastered one step at a time a time, building on the last mastered step

stepwise approach modeling

hand over hand or tactile cues for correct completion

physical assistance

repeat questioning requiring immediate recall with incremental increase in time between question and response

spaced retrieval

what types of cues can be used during errorless learning?

verbal, visual, vanishing

cues are gradually reduced after successful recall trails until patient correctly responds without cues to implement in setting of spaced retrieval

vanishing cues

how should a verbal cue be expressed

consistently; short/simple

explain how external cueing may progress as the disease progresses

start using checklists or words, as disease progresses (worsens) which to using more picture cues

a term used to describe an observed increase in confusion that may occur from dusk to dawn

sundowning

signs of sundowning

difficulty sleeping, anxiety, agitation, hallucinations, pacing, disorientation

What are contributing factors for sundowning ?

mental/phsycial exhaustion, new/confusing environment, day/night confusion, hallucinations

How to approach a patient with dementia who is agitated?

approach calmly, find if there is something they need, avoid arguing, reassurance, avoid restraint, gently provide reminders

Some guidelines when treating a patient with FND

build trust before challenging them, project confidence about FND diagnosis, expectation of improvement, involve family, LIMIT hands on facilitation, goal directed

Clinical tips for treating somebody with FND

BE ENCOURAGING, dont over-focus on abnormal movements, reinforce positive gains, emphasis on relaxation animator imagery, validate patient feelings