Chapter 47 and 53: Confusion & Dementia and Mental Health Disorders

What is cognition?

The ability to reason and think logically
Cognitive impair=confusion
- This is due to brain cells degenerating
Test: Ask the person about place, time, or person

What is confusion

It is temporary or permanent,
Cause: Poor blood flow, hypoglycemia (low blood sugar), memory loss, brain injury, etc
Result: Anger, depression, etc
Test: Ask the person about place, time, or person

Delirium

Only temporary state of confusion (Different from confusion)
- Cause: condition, mediction, or unfamiliarity
- Cause: Alcohol, condition, medicaiton, side effects, surgery, etc
Effects: Days to 1 week

Dementia

Loss of cognitive function
(Not reversible and NOT NORMAL part of aging)
- Some forms of dementia are reversable, such as hsort term memory loss
- May claim missing personal belongings
Initial Period: forgetting things—> not caring for themselves

Hallucinaiton

Seeing, hearing, and smelling things that do not exist.
CNA responsibility: Do not agree or deny hallucination. Redirect them to other task

Paranoia

Disorder of mind, false belief, and belief that someone is trying to hurt them.
- They’ll act very aggressive

Sun Downing

Behavior change after the sun goes down.
- Sudden aggression
- Adjust schedule (showering, brushing teeth, etc)+ notify nurse

Perseveration

Person repeating the same question.
- CNA: Always respond with the same answer

Alzheimer’s Disease (AD)

Brain cells are dying = brain shrinks
- Protein builds up in the brain leading to slow brain function
Risk: Genetics, age, etc.
- Person has short term memory loss not long term

What are the stages of Alzheimer’s Disease?

Mild: Forgetful (forgetting to eat, memoring names, etc)
Moderate: Don’t know where they are and not going to the bathroom
Severe: 100% dependent of assistants. Can do nothing for themselves (usually end in death)

What are behavior changes in Alzheimer’s?

Wandering/engaging in dangeorus behavior
- Can’t tell what time of day it is
- CNA: keep them up and occupid or set bed time routine + stay constant
Don’t give them more than 2 choices
- Maintain patient atonomy and independence
Trouble feeding b/c patterns confuse them
- Keep things simple + white

Reminence Theory

Allow person to talk about their past.
- Type of therapy

Validation Therapy

Allow them to talk about their feelings

Elopement

Leaving agency without staff knowing
- Bracelet on ankle to allow free movement or else all doors are locked

Types of reaction

Catastrophic reactions:extreme to much stimuli. (person is agitated and combative)
Agitation/ Aggression: Restless, worry, pace

How often do elderly patients have to bathe/shower?

twice a week
- Follow rountine

Dementia Care Communication

• Remain calm

• Treat w/ respect

• Identify yourself

• *Explain procedure/care

• *Break down tasks + simple direction and pacing

Repetitive Behavior/ Perservation

Person is repeating words, questions, etc
- Encourage pleasant activities
- Check expiration labels but need permission to throw away

General Anxiety Disorder (GAD)

Worry for anything

Anxiety

Feeling of worry, nervousness, or fear
- Becomes a disorder when it interferes w/ ADL

Mental Health in elderly

Depression is common in elderly people (withdraw)
ex. sleeping too much, low energy, feeling hopeless, smoking, harmful thoughts, etc

Levels of anixety

General: Person has extreme anxiety, hear, worry, concerns about things
- Painic attacks: feeling of dread
- Phobias: Intense fear of situation
- Obsessive Compulsive Disorder: Repetitive act that is uncontrollable b/c of insecurity

Delusion of grandeur

exaggerated belief about someone

Flat affect

no facial expression

Psychotic Disorder: Schizophrenia

Cause: Psychosis
- Mind that is out of touch to reality

Mood disorders: Bipolar disorder

Severe extreme changes in their mood
- Runs in family and act impulsive
- Develops during late teens or early childhood
- They can be suicidal

What should a CNA do if their patient is suicidal?

Ask if they have a plan then report to the nurse

Depression

Clinical DepressionL Prolonge. intense sadness (needs to be hospitalized)
- Not normal part of aging

Personality Disorders

- Starts at birth
- Very manipulative
-They have social problems
- Set fires, stabbing, throwing acid, etc

Borderline Personality Disorder

Long- term unstable mood behvaior

Eccymosis

Bluish discoloration of the skin
- Signs of overdose

Eating Disorder: Anorexia Disorder

Intense fear of gaining weight.
- they vomit or use laxatives

Eating Disorder: Bulimia Nervosa

Binge eating large amount of food then forced vomit or intense exercise

Eating Disorder: Binge eating disorder

Eating large amout of food and not thirowing up or exercising.