elderly neuro disorders

neurocog disorders

decline from a previously attained level of cog fxning

1. delirium

2. mild neuro

3. major neuro

neurodegenerative disease

results of impaired mobility, coordination, strength, sensation and cognition

delirium

acute and reversible cognitive disturbance characterized as a syndrome

cause is always physiological

delirium risk factors

old age, polypharmacy, ICU or surgery, comorbidities (multi conditions along with the primary disease), infection, aphasia, fractures, stroke, restraint use, and sensory impairment. 

delirium nursing concerns

safety needs, risk for injury, hallucinations and illusions, disruption in sleeping, impaired verbal communication, fear, and self care deficits. 

delirium outcomes

remain safe and free from injury and reality orientation

dementia

progressive deterioration of cog fxn and global impairment of intellect

alzheimers disease

• agnosia

• agraphia

• amnesia

• aphasia

• apraxia

• confabulation

• perseveration

• sundowning

• hyperorality

• hypermetamorphosis

agnosia

inability to recognize or identify things

agraphia

loss/impairment to write

amnesia

loss of memory

aphasia

impaired language ability

apraxia

inability to perform purposeful, learned movements despite having the physical ability

confabulation

make up stories to preseve self esteem

perseveration

repetition of a word or phrase

sundowning

tendency for mood to deteriorate/agitation to inc late in the day

hyperorality

tendency to taste, chew, or put everything in their mouth

hypermetamorphosis

urge to touch everything

delirium interventions

treat the underlying cause, safety, reality orientation, quiet and well lit environment, and avoid restraints

dementia/alz interventions

step by step instructions, simple communication, decrease in stimulation, routine and structured schedules, limit their choices, validate their feelings, and provide resting periods.

caregiver/family teaching

ways to ensure client safety, how to maintain reality orientation, provide assistance with activities of daily living, nutritional information, difficult behaviors, medication administration, and matters related to hygiene and toileting.

community support

transportation services, supervision and care when the primary caregiver is out of the home, referrals to day care centers, information on support groups in the community, Meals on Wheels, information on respite and residential services, telephone numbers for help lines, and home health services.

cholinesterase inhibitors

1. Donepezil (aricept), Rivastigmine (exelon), Galantamine (Razadyne). 

   1. Used for Alzheimer’s 

      1. Can cause a slow cognitive decline 

NMDA receptor ant

memantine