Part 3 Dementia Nursing Care • Communication • Wandering • Sundowning • Agitation • Dementia Medications

What is the highest nursing priority when caring for a patient with dementia?

Maintain the patient's highest possible level of functioning.

What should nursing care focus on rather than tasks?

The person.

What should nurses adjust during dementia care?

Communication, responses to behaviors, and the patient's environment.

Who should receive dementia education?

Both the patient and family.

How should nurses communicate with patients who have dementia?

Use short, simple, direct statements.

What type of questions should be asked to patients with dementia?

Short, straightforward questions.

How should nonverbal communication be used?

To reinforce verbal messages.

How should instructions be given?

Clearly, specifically, and one step at a time.

Why should choices be limited?

Too many choices increase confusion.

How can nurses help reduce disorientation?

Frequent reorientation and environmental cues.

What environmental cues help orient patients?

Large clocks, calendars, signs, the patient's name, today's date, and daily schedules.

What should families be taught regarding disorientation?

How to use reorientation techniques at home.

Why is wandering dangerous in dementia?

It increases the risk of injury, theft, exposure, and death.

How should wandering be managed?

Provide safe, supervised areas where patients can move freely.

What is sundowning?

Increased confusion, agitation, and restlessness during the late afternoon or evening.

What contributes to sundowning?

Disrupted circadian rhythm, fatigue, and decreased stimulation.

How can daytime habits reduce sundowning?

Regular sunlight exposure, limiting naps, and encouraging physical activity.

What evening activities may reduce sundowning?

Calm social interaction, quiet television, or shared meals.

How should bedtime be approached for patients with sundowning?

Provide a consistent transition to sleep.

Who should be consulted if medications worsen sundowning?

The provider and pharmacist.

What is often the best initial response to agitation?

Wait a few minutes, then calmly try again.

What unmet needs should be assessed when a patient becomes agitated?

Hunger, fatigue, sleep deprivation, fear, or hallucinations.

How should nurses respond after identifying the cause of agitation?

Address the unmet need.

Why are clear boundaries important?

They reinforce appropriate behaviors and expectations.

Is there a cure for dementia?

No.

What medications may temporarily improve cognition in dementia?

Cholinesterase inhibitors.

What is the primary effect of cholinesterase inhibitors?

Temporarily improve cognitive symptoms or slow decline.

What medication may slow progression of Lewy Body dementia?

Memantine.

What are the highest-yield concepts from this lecture?

Delirium vs. dementia, dementia stages, sundowning, aphasia/apraxia/agnosia, confabulation, communication techniques, restraint avoidance, and anticholinergic medications.

How does delirium differ from dementia?

Delirium has a sudden onset, fluctuates, is usually reversible, and is a medical emergency; dementia develops gradually, progresses over time, and is usually irreversible.

What type of consciousness change occurs in delirium?

Fluctuating level of consciousness.

What type of consciousness change occurs in dementia?

Usually remains clear until later stages.

Which condition is usually reversible?

Delirium.

Which condition is progressive?

Dementia.

What is the priority treatment for delirium?

Identify and treat the underlying medical cause.

What is the priority treatment for dementia?

Maximize remaining function and ensure patient safety.