Nursing Care of Clients with Dementia 2025.pdf

Dementia for nursing students

2. Confused patient? Differentiate first!
Data collection findings
•A+O?
•GCS?

Confused patients are not
oriented. But, before we know
if they have an ongoing
condition or if this is new, we
need to differentiate between
delirium OR dementia

3. Delirium and Dementia
•Delirium is a SUDDEN transient state
of confusion
•Causes
•Fever
•Head trauma
•Infection
•Drug intoxication
•Dementia is a gradual decline in
memory & thinking
•Potential Causes
•Stroke
•Parkinson's Disease
•Abnormal gene mutations
These can look similar during data
collection!

4. Question #1
Is the following
statement true or
false?
Mentation
changes only occur
in advanced age.

5. Answer to Question #1
False
Rationale: Mentation changes can occur anytime in
the life cycle. Depression and other medical
disorders can manifest as cognitive dysfunction.

6. Delirium and Dementia
•Delirium is a sudden and transient
state of confusion
•Symptoms: difficulty processing information,
disorientation, impaired judgment, poor
intellectual capacity, suspicious, frightened,
inappropriate behavior
•Cause: high fever/infection, head trauma, brain
tumor, drug intoxication or withdrawal, metabolic
disorders, poor oxygenation, inflammatory
disorders of the CNS
•Treatment: correct the underlying medical
condition!

7. Delirium and Dementia
•Dementia
•More commonly affects older adults
•Gradual, irreversible decline in memory, other
mental functions; affects individual’s daily life
•Disorders characterized by dementia:
Alzheimer disease, cerebrovascular disorders,
Parkinson disease
•See Table 72-1

8. Alzheimer Disease
•Pathophysiology and Etiology:
•Two types: early onset; late onset
•Etiologic factors
•Environment and lifestyle
•Increased risk: first-degree relative with
Alzheimer disease; inherited genetic
abnormalities
•Four pathologic changes in brain
•Decreased cortex size; deficient
acetylcholine
•Neuritic plaques; neurofibrillary
tangles

10. Question #2
Is the following statement true or
false?

Alzheimer disease presents in two
forms.

11. Answer to Question #2
True
Rationale: Alzheimer disease presents in two forms. Early onset
presents before 60 years of age; late onset after 60 years of age.
Late onset is more common, with nearly 30% of all adults older
than 85 years of age will manifest Alzheimer disease.

12. Alzheimer
Disease
•Assessment Findings:
•Three distinct stages
•Preclinical
•Mild cognitive impairment
•Alzheimer’s dementia
•Classic symptom: memory loss; insidious onset;
impaired long-term memory, ability to make
appropriate judgments, problem-solving ability;
behavior disturbances, personality changes;
depression
•Advanced: deterioration in memory, cognition,
awareness, self-care; wandering; periodic violent
behavior
•Aphasia, alexia, agraphia, acalculia, agnosia,
ataxia, and tremors; apraxia

13. Alzheimer
Disease
•Diagnostic Findings: electroencephalography,
CT, PET, MRI; new diagnostic: biomarkers
•Medical Management: no cure; supportive
treatment
•Drug therapy; folic acid supplements;
antidepressants; tranquilizers) (Drug Therapy Table
72-1)
•Nursing Management (Client and Family
Teaching 72-1)
•Maintaining client’s independence in home
environment for as long as possible; refer to ECF
if/when appropriate
•Assess: client safety; caregiver burden

14. Question #3
Is the following statement
true or false?
The goal of Alzheimer
disease treatment is to
place the client in an
extended care facility as
soon as possible to
maintain his or her safety.

15. Answer to Question #3
False
Rationale: The goal of Alzheimer
disease treatment is to maintain
client’s independence as long as
possible in familiar surroundings
(depends on available caregivers
and finances). Careful assessment is
continuing for client safety and
caregiver burden.

16. Living with Alzheimer's – the White family
https://www.youtube.com/watch?v=PZu51MnqfF4