Final: Dementia Vs Delirium

delirium

• acute

• physiological cause

• reversible

• fluctuate

• very sudden

dementia

• slow onset

• many causes

• more apparent over time

• big umbrella of progressive cognitive changes

alzheimers

• severe memory loss interferes with ability to function

alzheimers stages

mild: able to function, memory lapses, word + thought loss, poor planning/organization

moderate: mood/personality changes, worse memory loss, disorientation, incontinence, sundowning, wandering

severe: unable to respond to environment, full time care, physical inabilities (passing soon)

cholinesterase inhibitors

• prevent AcH breakdown to temporarily improve sx (in early stage)

• n/v/d, live toxicity

NMDA receptor antagonist

• blocks glutamate receptors

Leceanemab (Leqembi)

• prevents amyloid plaques

• serious SE: brain swelling or bleeding

Donanemab (Kisunia)

• works better but more risks

• also targets amyloid plaques by teaching immune system to remove

• potentially life threatening: brain swelling and bleeding (3 deaths)

therapeutic interventions

• reorientation

• repetition

• maintain safety

• ADL’s

• movement (fall risk)

• patience

• distraction

• personalization

CO end of life options act

• 18

• terminal w/ less than 6 months

• 15 day period between acceptance and prescription ordered (many people die in)