week 5 promoting wellness cognitive and psychosocial

cognition is influenced by

biology, environment, behavior, older adults show variability (decine + preservation + growth), not a uniform process

key concepts of cognition and aging

fluid intelligence, crystalized intelligence, memory (working, short term, long term may take longer to achieve but may still have it), neuroplasticity, congnitive reserve

fluid intellignece

individuals ability to deal with something new, solving new problem, declines some what as we age not fully, navigate and figure put something new

crystalized intelligence

remain stable and increase with age, something you have known throughout your life

neuroplasticity

brain can continuing forming and reorganizing later in life, they are still learning as they get older

cognitive reserve

brains resiliency against cognitive decline

factors that affect cognitive wellness (modifiable)

sociocultural influences (education, isolation, ageism), lifestyle factors (sleep, activity, nutrition), vision and hearing impairments), medication effects (polypharmacy, anticholinergics)

high risk cognitive threats

sensory loss (untreated hearing/ vision impairment), meds (anticholinergics, benzos, sedatives, opiods) sleep disruption + fatigue, depression and loneliness (sometimes looks like cognitive decline), dehydration, infection, hypoxia

mild cognitice impairment

still can preform normal activities of daily living (independence maintains), cognitive function impaired beyond normal aging, may be amnesic or non amnesic, important evaluate early, nursing role (screening + safety + referral),

nursing assessment of cognitive function

baseline cognitive status + changes over time, brief screening tools, psychosocial assessment (mood, stress, support), formal neuropsychological testing (provider-led)

common cognitive screening tools

mini cog (mini cognation quick screen 3 word recall and clock drawing test) MoCA (more sensitive for mild impairment, montrial cognitive assessment), MMSE (widely used, less sensitive for early changes, mini mental state examiniation influenced by education levels), CAM (confusion assessment method for delirium)

alzheimer dementia

msot common, progressive memory loss, gradual onset

vascular dementia

related to strokes/ vascular damage, stepwise decline, executive dysfunction common

lewy body dementia

hallucinations, parkinsons sysmptoms, fluctuating cognition

frontotemportal dementia

personality/ behavior changes, language impairment, earlier onset possible

delirium

sudden/ acute, hours to days, fluctuates, impaired, altered, often reversible, infection, dehydration, hypoxia, medications, hallucination common, identify cause immediately

dementia

gradual/ progressive, months to years, progressive decline, usually intact early, usually normal, usually irreversible, neurodegenerative disease, hallucinations possible in later stages, promotes safety/ function

delirium = medical emergency priority nursing assessments

acute change from baseline, attention/ concentration, oxygenation, hydration, infection, medication review, pain assessment

priority nursing interventions delirium

treating underlying cause, reorient frequently, reduce overstimulation, promote sleep, ensure sensory aids available, maintain safety/ fall precautions

cascade iatrogenesis (chain of complications of unintended consequence of medical treatment)

functional decline related to hospitalization, secondary diagnosos, increased risk for harm, changes in mental status, injuries, increased mortality, increased healthcare costs

nursing interventions to promote cognitive wellness

health education about brain health, improve attention/ concentration, encourage mentally stimulating activities, promote physical activity, medication safety + polypharmacy reduction

transition from cognitive psychsocial wellness

cognition and psychosocial health are linked, isolation worsens cognition, depression can minic cognitive impairment, wellness requires whole person assessment

psychosocial wellness age related life events

retirement, relocation, death of friends/ family, widowhood, driving cessation, chronic illness and functional impairment

stressors

illness, caregiving, loss, finances, role changes

symptoms of stress and coping

sleep issues, appetite, change, irritability, fatigue

coping skills

problem solving, social support, spirituality

resources

family, community, counseling, respite, services

factors influencing psychosocial function

religion and spirituality, generativity and meaning, cultural considerations, social roles and identity

depression/ pseudodementia

often sudden, prominent memory complaints, Idk responses, often impaired, depressed/anxious, often improves with treatment

functional consequences of psychosocial challenges

loneliness and social isolation, decreased resilience, alcohol use disorder risk, worsened chronic disease outcomes

interventions that promote autonomy

offer choices, explain procedures and ask permission, involve the patient in care planning, support self care and independence, avoid doing tasks that patient can do safely

infantillization

treating older adults like children

elderspeak

baby talk tone or simplified speech