Alzheimer's and Dementia Training
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45 Terms
What does “senile” mean?
“senile” means…
showing signs of mental or physical decline, especially due to old age
⮕ often used (sometimes insensitively) to describe older adults with memory loss or confusion, often related to conditions like dementia
What does “OBS” mean?
“OBS” means…
Organic Brain Syndrome
⮕ A general term used to describe decreased mental function due to a medical (organic) cause, rather than a psychiatric one
Is dementia a normal part of aging?
No
⮕ It can be seen in ppl over the age of 65, but losing large past memories is not normal
What’s the percentage of elders (ages 65-85) who would have dementia?
6%
What’s the percentage of older elders (ages 85-over) who would have dementia?
75%
What group of people raises the percentage of “Frontal Temperal Lobe” memory loss overall in the U.S?
NFL players
What are the four types of memory?
The four types of memory are…
short-term memory
long-term memory
procedural memory (eg. playing the piano, singing a song, making oatmeal [under long-term])
working memory (eg. learning something new that will have to become a new daily ritual [under short-term])
Should you deny a dementia patient’s reality when their current memory is of something from the far past?
No
➜ This is tricky you see, as Elaine Marieb trains their nursing students to not lie to dementia patients
How should you view dementia patient’s concerns that come along w/ their past memories?
You should treat them as…
an unmet need
➜ “Be their voice”
What are the 7 symptoms of dementia?
The 7 symptoms of dementia are…
Memory
Concentration
Orientation
Language
Judgment
Visuospatial Skills
Sequencing
Memory
↳ only long-term memory from past
Concentration
↳ lasts for only 15-20 minutes
Orientation
↳ …?
Language
↳ will have longer time finding words
Judgment
↳ may not make the best choices (eg. may touch the stove w/o thinking)
Visuospatial Skills
↳ may see dark carpets on floors as holes
Sequencing
↳ would seem out of it and not notice the incorrect order of steps (eg. forgetting to take off the shoe when trying to put on socks)
What is “dementia”?
“dementia” is…
a group of symptoms that affects cognitive, physical, and social aspects of a person
Can you give me a list of irreversible dementias?
Alzheimer’s
Vascular
Lewy Body
Mixed (alzheimer’s + vascular)
Parkinson’s
Frontotemporal
Huntington
Wernicke-Korsakoff Syndrome
Creutzfeldt-Jakob Disease
AIDS-related
Alzheimer’s (“attack on brain”)
Vascular (d/t injury; no blood circulation to brain)
Lewy Body (d/t protein plaques in brain—creates hallucinations)
Mixed (alzheimer’s + vascular)
Parkinson’s (nervous system)
Frontotemporal (often have negative personality changes)
Huntington (mental deterioration)
Wernicke-Korsakoff Syndrome
Creutzfeldt-Jakob Disease
AIDS-related
What is the expected lifespan of a person w/ dementia?
The expected lifespan of a person w/ dementia is…
8-20 years
What is the likelihood of a dementia patient dying d/t the use of anti-psychotics? Give a ratio.
The likelihood of a dementia patient dying from anti-psychotics is 1 in 12 (1:12)
What is a "lewy body"?
A “lewy body” is…
an abnormal clump of protein (specifically alpha-synuclein) that forms inside nerve cells in the brain
What is "flat affect" in some irreversible dementias?
“flat affect” is…
a lack of emotional expression—a person shows little or no facial expression, voice tone changes, or body language, even in situations where you’d expect emotion
What is "Sinemet" (usually given to Parkinson's patients)?
“Sinemet” is…
Carbidopa-Levodopa
⮕ Levodopa turns into dopamine in the brain, which helps improve movement.
⮕ Carbidopa helps prevent levodopa from breaking down too early before it reaches the brain and reduces side effects like nausea.
What medication WOULD YOU NOT GIVE to someone who has Lewy Body to prevent quick decline? (according to a lady in a video)
The medication nurses WOULD NOT GIVE is…
Levodopa
(or Sinemet)
⮕ It will cause gradual decline
What are "Acetylcholinesterase Inhibitors”?
“Acetylcholinesterase Inhibitors” are…
medications that help increase levels of acetylcholine, a chemical messenger in the brain that's important for memory, thinking, and learning. “Acetlcholinesterase inhibitors” help treat dementia and maybe slow the dementia progression, but it doesn’t cure
⮕ Cholinergic = "Cool and Chill" (rest/digest, memory, calm)
↳ mimicks or enhances acetylcholine {—to relax and think in a calm state}
⮕ Adrenergic = "Adrenaline Action" (alert, active, high BP/HR)
↳ releases norepinephrine {—to alert, ready to run, and only think in a “panicked” state}
➜ “-ase” means something that kills acetylcholine {—I think—}, an enzyme. “Acetylcholinesterase” being the enzyme
What is “Exelon”?
“Exelon” is…
Rivastigmine, which is an Acetylcholinesterase Inhibitor
What would "Ativan" do to dementia patients? (They are off-label-use drugs)
“Ativan”…
sedates
What is “Ativan”?
“Ativan” is…
lorazepam
,which is a benzodiazepine medication
What are 7 conditions that may cause dementia-like symptoms?
Seven conditions that may cause dementia-like symptoms are…
B-12 deficiency
medication side effects
depression
thyroid or endocrine problems
infections
electrolyte problems
dehydration
➜ We all know that depression makes it hard for you to think about anything else besides that thing making you feel down
What 5 conditions worsen dementia?
Five conditions that worsen dementia are…
Constipation
Acute or chronic pain
Lack of sleep
Medications
Unmet needs
What is “delirium”?
“Delirium” is…
a sudden and serious change in mental function. It causes a person to become confused, disoriented, and unable to focus or think clearly. It comes on quickly (hours to days), and can get worse or better quickly too
⮕ D/t a sudden change in medical condition or d/t a new medication
➜ I personally think this is what old people feel right before they die
What is a health condition people often associate w/ “delirium”?
A health condition people often associate w/ “delirium” is…
UTI
= Urinary Tract Infection
What is “UA”?
“UA” is…
Urinalysis
There are many indications of what swinging/changing blood sugars can cause, but what is one thing it can cause according to that old lady in the video?
One thing swinging blood sugars can cause is…
mood swings (changing behavior)
What dementia related condition is shown in the photo?
Alzheimer’s
What is “involuntary seclusion”?
“Involuntary seclusion” is…
a type of abuse in nursing,
where a person is involuntarily alone; abandoned, and it’s against their will
confined in room alone
kept away from other residents
What is “misappropriation of resident property”?
“Misappropriation of resident property” is…
Using another resident’s briefs for the resident you’re w/ now
Using their body spray
Stealing jewelry or money
What is “deprivation”?
“Deprivation” is…
depriving or intentionally not providing the services the patient needs for their health.
What is “sodomy”?
“Sodomy” is…
refers to sexual acts that are considered unnatural or non-procreative, depending on the context
oral sex
anal sex
Within how many hours of noticing abuse should you report?
24 hours
If you're reporting a literal crime, within how many hours do you report?
2 hours
If you witness a literal crime, who do you report it to?
You report it to…
both the state agency and local law enforcement
Who should you contact if you're being intimidated by staff in the nursing facility for you reporting abuse?
If I’m being intimidated by staff for reporting abuse, I should contact…
the state agency. There should be a hotline number available (it should also be available to elders)
Do you have to tell people in the nursing facility that you reported abuse?
No
Is interpretation allowed in reports?
No.
➜ Just like the RA job. None of "I think there was a death threat because many of this suspect's friends were bothering him," but maybe you can add that there were past incidents of residents walking into each other's rooms without asking. Maybe…
What 2 descriptive titles must you not use in the reports?
Two descriptive titles you must not use in reports are…
victim
alleged
➜ law enforcement and police only use this
What 2 descriptive titles can you use in a report to refer to your patients and the person who is enacting immoral acts?
Two descriptive titles you can use in a report to refer to your patients and the person who is enacting immoral acts are…
resident
suspected
You are not to simply give labels when reporting. What do you do in place of labeling when reporting?
In place of labeling when reporting, you…
describe in detail. Like, "she hit me," not, "she was aggressive."
How do you report to the administrator when you recognize abuse in a nursing facility?
When you recognize abuse in a nursing facility, you report by either…
ask to enter the administrator’s office
leave a direct physical message for the administrator
write written report and make RN pass to administrator
contact via work cellphone or email
Are CNAs allowed to report instead of CNAs asking RNs to report?
Yes
➜ report directly to your state’s Elder Abuse Hotline, DPPC, Adult Protective Services, or long-term care ombudsman if no action has taken place since your report