psych mental health issues in the aging adult

neurocognitive disorders

• neurocognitive disorders involve a celine in one or more areas of cognition, such as eecutive function, learning and memory, judgement or social cognition that represents a significant changes from an individual’s previous level of functioning

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what is delirium

• acute onset

• fluctuating course

• impaired attention

• altered level of consciousness

• usually reversible

• medical emergency

what is dementia

• insidious onset

• progressive decline

• memory impairment

• LOC not altered

• usually irreversible

• chronic condition

types of dementia

neurocognitive disorders - pharmacologic treatment

• cholinesterase inhibitors: donepeil (aricept), rivastigmine (eelon), and galantamine (razadyne)

  • side f include: N/V, anoreia and weight loss

• NMDA receptor antagonist - Memantine (Namenda)

  • side f include: dizziness, headache, constipation

• antipsychotics may be considers

• antidepressants when depression and aniety are present

• For othery types of dementia (other than Alzheimers disease)

  • target cause or symptoms

    • Antidepressants, antipsychotics (lewy body)

    • statins, anticoagulants, aspirin (vascular disorders)

Alzheimers: stage 1: no cognitive impairment

• no mmory problems or cognitive deficits, independet in all activities

Alzheimers: stage 2: very mild cognitive decline

• ocasionally forgets names. words, or where items are places, independent in daily activities

Alzheimers: stage 3: mild cognitive decline

• difficulty finding words, remembering names, concentrating; may struggle with comple tasks such as finances or work responsibilities

Alzheimers: stage 4: moerate cognitive decline

• forgets recent events, reduces short term memory, difficutly with calculationsl needs help with emdication management and meal planning

Alzheimers: stage 5: moderately severe cognitive decline

• significant memory loss and confusion about time and place; requires asssitance with choosing clothing anf some daily activities

Alzheimers: stage 6: severe cognitive decline

• difficulty recognizing familiar people, incr. confusion, behavioral symptoms may occur; req. assistance with dressing, bathing, toileting, eating

Alzheimers: stage 7: very severe cognitive decline

• limited or absent verbal communications, inability to recognize lovved ones dependants for all ADLs, may lose ability to walk, sit, or swallow

nusing care for clients with dementia

• use a pt. centered approach

• maintain a structured and predictable approach

• prioritize safety

• communicate using simple lanugae and one-step instructions

• encourage independence while providing necessary assitance

• involve family in planning care

• ALWAYS treat pt with dignity and respect

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neurocogntive disroders - family education

• progression of the illness and what to epect

• way s to ensure patient safety (fall prevention, elopement risk, medication safety, kitchen, stove, water, and household hazards)

• strategies for aiding with ADLs

• nutritional information

• managing difficult behaviors

• support services (home health care, respite care, etc)

• encourage caregiver support groups