complexity 4 dementia and delirium in older adults

geriatric syndromes

common conditions involved in ____ include falls, frailty, incontinence, pressure injuries and immobility

true

cognitions impact: learning ability, following instructions, planning and sequencing, recognizing hazards and active rehab participation

t or f

false

cognitions impact: learning ability, following instructions, planning and sequencing, healing infections and active rehab participation

t or f

dementia

a significant decline in thinking abilities beyond normal aging affecting memory, attention, language, problem solving and judgement interfering with independent daily fxn

alzheimer’s disease

type of dementia which is a gradual progressive memory loss and the difficulty of learning new information

alzheimer’s disease movement features

movement often being preserved early but eventual slowing gait and balance declines w disease progression

alzheimer’s disease treatment

benefit from repeated instructions, routine, visual representations and practicing in the same environment

vascular dementia

type of dementia resulting from stroke or small vessel disease leading to executive dysfunction and slower thinking

vascular dementia movement features

movement with early gait impairment, poor balance, slower walking, weakness or asymmetry after strokes

vascular dementia treatment

benefit from plenty of breaks in sessions, and breaking down tasks during sessions into parts

lewy body dementia

a type of dementia which has fluctuating cognition, visual hallucinations, and parkinsonism

lewy body dementia movement features

movement with parkinsonian gait, freezing, rigidity, and postural instability that can vary day to day

lewy body demential treatment

benefits from external cueing, shorter sessions and constant check ins

frontotemporal dementia

type of dementia which is earlier in onset, behaviour or language changes precede memory loss with poor judgement, impulsivity or apathy occurs

frontotemporal dementia movement features

movement is often preserved initially but impulsivity and poor insight raise safety and fall risk

frontotemporal dementia treatment

benefits from managing behaviour w structured sessions, and clear instructions, strategies in place to ensure safety, supervision and clear boundaries

mixed dementia

type of dementia which has 2 or more pathologies together and common in older adults

true

the most common type of mixed dementia is alzheimers and vascular dementia

t or f

false

the most common type of mixed dementia is alzheimers and lewy body dementia

t or f

mixed dementia movement features

movement is a blend of features addressing both cognitive and physical impairments

true

communication strategies include: gaining attention, simple instructions, demonstrating task, give time for processing and use encouragement and familiar routines

t or f

false

communication strategies include: gaining attention, detailed instructions, demonstrating task, give time for processing and use encouragement and familiar routines

t or f

delirium

a sudden change in cognitive functioning with alterations in lvl of consciousness, and acute fluctuations

true

causes of delirium includes: pain, hypoxia, hypotension, medications, constipation, urinary retention, sleep deprivation, fear, depression and fractures

t or f

false

causes of delirium includes: pain, hypoxia, hypertension, medications, constipation, urinary retention, sleep deprivation, fear, depression and dementia

t or f

true

during delirium it starts with a vulnerable person with a sudden stressor causing the brain to be overwhelmed/delirium

t or f

false

during delirium it starts with a healthy person with a sudden stressor leading to inc vulnerability causing the brain to be overwhelmed/delirium

t or f

true

those w delirium can have it reversed when the underlying cause is treated

t or f

false

those w delirium will always have it even when the cause is treated

t or f

hyperactive delirium

delirium which predominantly shows restlessness and agitation, inc motor activity, loss of control, and wandering

hypoactive delirium

delirium which predominantly shows predominant drowsiness and inactivity, dec action speed, speech speed, amount of speech, awareness of surroundings, listlessness and withdrawal

true

delirium is considered a medical emergency and is something which should be notified

t or f

false

delirium is not considered a medical emergency and is something which can be ignored for treatment

t or f

confusion assessment method

used to help assess for delirium looking for: acute onset/fluctuating course, inattention, disorganized thinking and altered level of consciousness

true

based on the CAM pt require an acute onset/fluctuating course, inattention and either altered consciousness or disorganized thinking

t or f

false

based on the CAM pt require an acute onset/fluctuating course, altered consciousness and inattention or disorganized thinking

t or f

4AT

used to assess for delirium using alertness, attention, remembers age DOB place and current year, and an acute change or fluctuating course

true

in the 4AT an acute change/fluctuating course itself or more factors show +ve delirium/cognitive impairment

t or f

false

in the 4AT an alertness itself or more factors show +ve delirium/cognitive impairment

t or f

true

delirium can be prevented by ensuring eating well, hydration, seeing and hearing, mind stimulation, constant movement and sleeping well

t or f

true

if a pt has suspected delirium treatment should stop and be escalated to the team to treat the underlying cause in addition to reorintation and mobilizing gently

t or f

false

if a pt has suspected delirium treatment should stop and be escalated to the team to treat the underlying cause and discontinuing treatment for now

t or f