September 2014
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Did You Know?

Caring for Patients with Dementia

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Top 10 tips for communicating with a patient with dementia

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Dementia Trivia – How much do you know?


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  • #67314 / #313914 Frontotemporal Dementia/Delirium in the Geriatric Patient

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Did You Know?

Caring for Patients with Dementia

Did you know that there are approximately 5.2 million Americans living with Alzheimer’s disease, and experts predict that number will reach 16 million by the year 2050?

As the population ages, so does the number of people living with dementia. About two thirds of all general acute care patients are over the age of 65, and the prevalence of dementia in this population is approximately 30 percent. Research shows that when these patients are hospitalized, they experience worse clinical outcomes, longer lengths of stay, a greater number of falls, and higher readmission and mortality rates than those without dementia.

Dementia is a general term that describes a number of diseases and conditions that develop when nerve cells in the brain are damaged, die, or no longer function properly. This process causes a progressive decline in memory, behavior, and the ability to communicate, interact socially, and think clearly. These changes evolve slowly, becoming more evident over months and years.

The most common type of dementia is Alzheimer’s disease, which accounts for 60 to 80 percent of all dementia cases. Vascular dementia is caused by brain injury affecting circulation of blood to the brain. It makes up about 10% of dementia cases. The term, early onset dementia, describes dementia in a person under the age of 65. Over 200,000 people in the U.S. have early onset dementia. Other types of dementia can occur with progression of Parkinson’s Disease, Pick’s Disease, Creutzfeldt-Jakob Disease, Hydrocephalus, and Huntington’s Disease.

Delirium is a medical condition marked by abrupt confusion that emerges over days or weeks and represents a sudden change from a person’s previous course of dementia. Confusion related to delirium often fluctuates within hours and sometimes becomes dramatic. When patients with known dementia are admitted to the hospital in a confused state, staff should consult family members or caregivers to establish baseline information about the patient’s usual state. If confusion seems greater than usual, other issues, such as infection, medications, injury, or illness could be the underlying cause.

When patients with dementia are hospitalized, a variety of factors, such as the strange new environment, disrupted daily routine, medications, and other underlying medical conditions, often increase confusion and anxiety. There are a number of things healthcare providers can do to help reduce confusion and ensure optimal outcomes of care.

  • Remain calm avoid multi-tasking or appearing rushed while with the patient
  • Follow the patient’s usual routine as closely as possible
  • Encourage the use of items that are comforting and remind the patient of home, such as, a favorite pillow or blanket
  • Provide care by the same nurses and nursing assistants as much as possible
  • To the extent possible, minimize startling noises from alarms, call lights, intercoms, or TVs
  • Carefully evaluate the patient for pain and discomfort. Often times, patients with dementia do not verbally complain even though they may be experiencing pain
  • Provide uninterrupted rest periods throughout the day
  • Limit visitors to one or two at a time
  • Use room darkening and quieting to cue the patient for sleep, while ensuring enough lighting and a clear pathway to the bathroom to prevent falls
  • Keep the bed in a low position
  • Offer fluids frequently throughout the day. Ask caregivers what drinks the patient prefers
  • Always tell the patient what you are going to do, one step at a time

References:

Acute Hospitalization and Alzheimer's Disease: A Special Kind of Care. (2014, August 11). Retrieved August 16, 2014, from National Institute on Aging: www.nia.nih.gov

Alzheimer's Facts and Figures. (2014). Retrieved August 16, 2014, from Alzheimer's Association: www.alz.org


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Top 10 tips for communicating with a patient with dementia:

  1. Always identify yourself and call the patient by name
  2. Use short, simple sentences
  3. Speak slowly and use a pleasant tone
  4. Maintain good eye contact
  5. Keep facial expressions and body language warm and friendly
  6. Use non-verbal and verbal reassurances that the environment is safe, people are available to help, and that they care about the patient’s well-being
  7. Ask one question at a time and allow the patient plenty of time to respond (20 seconds)
  8. When you need to repeat a question, always restate it exactly the same way
  9. Give directions simply and one at a time
  10. Listen for “hidden” feelings or emotions behind what a patient tells you. It may reveal the root of a patient’s anxiety, agitation, or fear.

Now Trending

Dementia Trivia – How much do you know?

Which type of memory loss is most likely to occur first in the early stages of dementia?

Which of these famous people were diagnosed with Alzheimer’s Disease?

Below are two lists with normal, age-related memory changes on one side and signs of Alzheimer’s disease on the other. Which one is which, do you know the difference?

List A List B
Dramatic changes in mood and personality Becoming slightly irritable when a routine is a disrupted
Forgets entire experiences Forgets part of an experience
Rarely remembers later Usually remembers later
Poor judgment and decision-making Occasionally makes a bad decision
Inability to manage a budget Misses a monthly payment
Difficulty having a conversation Occasionally forgets which word to use
Puts things in unusual places and can’t find them later Misplaces things in reasonable places from time to time

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Short-term memory

Patients with early onset dementia tend to struggle with short-term memory. They may have trouble remembering what they had for breakfast a couple of hours ago, but may still be able to recall events in detail that happened years ago.

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All of these people were diagnosed with Alzheimer’s disease.

Others include Glenn Campbell, Pat Summit, Perry Como, Rita Hayworth, Sugar Ray Robinson, Estelle Getty, and Peter Falk.

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List A is Signs of Alzheimer’s Disease and List B is Normal Age-Related Memory Changes.

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