Dementia

Nursing Aide

What is Dementia?
• Dementia is a broad category of brain diseases that cause a long term and often gradual
decrease in the ability to think and remember such that a person's daily functioning is affected.
• Dementia isn't a specific disease
• dementia describes a group of symptoms affecting memory, thinking and social abilities severely
enough to interfere with daily functioning.
• Dementia indicates problems with at least two brain functions, such as memory loss and
impaired judgment or language, and the inability to perform some daily activities such as paying
bills or becoming lost while driving.
• Though memory loss generally occurs in dementia, memory loss alone doesn't mean you have
dementia. There is a certain extent of memory loss that is a normal part of aging.
Progressive dementias
Types of dementias that are not reversible and worsen over time include:
• Alzheimer's disease.
• Vascular dementia.
• Lewy body dementia. 
• Frontotemporal dementia
Other disorders linked to dementia
• Huntington's disease
• Traumatic brain injury
• Creutzfeldt-Jakob disease
• Parkinson's disease
Sign & Symptoms
Dementia symptoms vary depending on the cause, but common signs and symptoms include:
 Cognitive changes
• Memory loss
• Difficulty communicating or finding words
• Difficulty with complex tasks
• Difficulty with planning and organizing
• Difficulty with coordination and motor functions
• Problems with disorientation, such as getting lost
 Psychological changes
• Personality changes
• Inability to reason
• Inappropriate behaviour
• Agitation
• Hallucinations
Causes
• Dementia involves damage of nerve cells in the brain, which may occur in several areas of the
brain.
• Dementia may affect people differently, depending on the area of the brain affected.
• Dementias can be classified in a variety of ways and are often grouped by what they have in
common, such as what part of the brain is affected, or whether they worsen over time
(progressive dementias).
Risk factors

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Many factors can eventually lead to dementia. Some factors, such as age, can't be changed. Others can
be addressed to reduce your risk.

Risk factors that can't be changed: Risk factors that can't be changed:

• Age • Heavy alcohol use

• Family history • Atherosclerosis
• Down syndrome • Blood pressure
• Cholesterol
• Depression
• Diabetes
• Homocysteine blood levels
• Obesity
• Smoking

Tests and Diagnosis

To diagnose your condition, your doctor will review your medical history and symptoms and conduct a
physical examination. Doctors may order a number of tests to diagnose dementia and rule out other
conditions.
• Cognitive and neuropsychological tests
• Neurological evaluation
• Brain scans
• Laboratory tests
• Psychiatric evaluation
Prevention
There's no sure way to prevent dementia, but there are steps you can take that might help. More
research is needed, but it may be beneficial to do the following:
• Keep your mind active
• Be physically and socially active
• Quit smoking
• Lower your blood pressure
• Pursue education
• Maintain a healthy diet
Treatments and drugs
 Drugs & Therapies
• Cholinesterase inhibitors
• Memantine
• Occupational therapy
• Modifying the environment
• Modifying your responses
• Modifying tasks
 Lifestyle and home remedies
• Enhance communication
• Encourage exercise
• Encourage participation in games and thinking activities

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 • Establish a night-time ritual
• Encourage keeping a calendar
• Plan for the future
Nursing Management
Improving communication
• Speak slowly and use short, simple words and phrases.
• Consistently identify yourself, and address the person by name at each meeting.
• Focus on one piece of information at a time. Review what has been discussed with patient.
• If patient has vision or hearing disturbances, have him wear prescription eye glasses and/or
hearing device.
• Keep environment well lit.
• Use clocks, calendars, and familiar personal effects in the patient’s view.
• If patient becomes aggressive, shift the topic for a safer, more familiar one.
Promoting Independence in Self-care
• Assess and monitor patient’s ability to perform activities of daily living.
• Encourage decision making regarding activities of daily living as much as possible.
• Monitor food and fluid intake.
• Weigh patient weekly.
• Provide food that patient can eat while moving.
• Sit with the patient during meals and assist by cueing.
Ensuring Safety
• Discuss restriction of driving when recommended.
• Assess patient’s home for safety; remove throw rugs, label rooms, and keep the house well lit.
• Assess community for safety.
• Alert neighbors about the patient’s wandering behavior.
• Alert police and have current picture taken
• Install safety bars in the bathroom.
• Encourage physical activity during day time
Preventing Violence and Aggression
• Respond calmly and do not raise your voice.
• Remove objects that might be used to harm self or others.
• Identify stressors that increase agitation.
• Distract patient when an upsetting situation develops.

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