Cognitive Assessment and Delirium in Older Adults

<p>90% (D)</p> Signup and view all the answers

<p>A rapid onset with fluctuating symptoms (D)</p> Signup and view all the answers

<p>Language barriers (D)</p> Signup and view all the answers

<p>Galantamine (Reminyl) (B), Donepezil (Aricept) (C), Rivastigmine (Exelon) (D)</p> Signup and view all the answers

<p>People from Africa and South Asia (D)</p> Signup and view all the answers

<p>It can include dementia with Lewy bodies and Parkinson’s disease dementia. (B)</p> Signup and view all the answers

<p>Cholinesterase inhibitors (D)</p> Signup and view all the answers

<p>Age 65 years or older (A)</p> Signup and view all the answers

<p>Weekly exercise regime (B)</p> Signup and view all the answers

<p>Hypoactive delirium (C)</p> Signup and view all the answers

<p>Functional decline (C)</p> Signup and view all the answers

<p>Multiple psychoactive medications (D)</p> Signup and view all the answers

<p>Increased postoperative complications (B)</p> Signup and view all the answers

<p>Inadequate education about delirium (C)</p> Signup and view all the answers

<p>Age 65 years or older (A)</p> Signup and view all the answers

<p>Gently touch their arm or shoulder (C)</p> Signup and view all the answers

<p>Belittling their concerns (A)</p> Signup and view all the answers

<p>Continue walking and allow control (B)</p> Signup and view all the answers

<p>They experience higher levels of stress (A)</p> Signup and view all the answers

<p>Special care units in institutional settings (D)</p> Signup and view all the answers

<p>To have a plan in case they become lost (D)</p> Signup and view all the answers

<p>Rapid onset usually over hours or days (D)</p> Signup and view all the answers

<p>They reside in community settings (B)</p> Signup and view all the answers

<p>It has a gradual onset with a steady pattern of cognitive decline. (B)</p> Signup and view all the answers

<p>Fewer distractions to enhance focus (A)</p> Signup and view all the answers

<p>Nursing assessments can be intrusive and intimidating. (D)</p> Signup and view all the answers

<p>A personalized care plan tailored to the cognitive abilities of the patient. (A)</p> Signup and view all the answers

<p>Nurses need to have skills to minimize patient stress during assessment. (D)</p> Signup and view all the answers

<p>Cognitive stimulation and social interaction (A)</p> Signup and view all the answers

<p>Accepting the prognosis (C)</p> Signup and view all the answers

<p>Encouraging self-care and making bathing areas comfortable (A)</p> Signup and view all the answers

<p>Conduct a comprehensive pain assessment (B)</p> Signup and view all the answers

<p>Through careful observation of the person's patterns (D)</p> Signup and view all the answers

<p>Making bathing areas unsafe to promote compliance (B)</p> Signup and view all the answers

<p>Engaging in regular exercise (A)</p> Signup and view all the answers

<p>Explain all actions and respect their choice (A)</p> Signup and view all the answers

A thorough evaluation of an older adult experiencing changes in cognitive function to identify any underlying medical conditions.

Three conditions that often affect older adults: delirium, dementia, and depression. These conditions are not normal parts of aging and can be challenging to diagnose.

A condition characterized by a sudden onset of confusion, disorientation, and changes in mental status. Usually develops quickly, over hours or days.

A progressive decline in cognitive abilities, including memory, thinking, and reasoning. Usually develops gradually over time, with a slow and steady pattern of decline.

A mood disorder that can cause cognitive difficulties, including difficulty concentrating, making decisions, and remembering things.

A set of tests used to evaluate different aspects of a person's thinking ability, including their level of consciousness, orientation (time, place, person), memory, attention, reasoning, and problem-solving skills.

A sudden and fluctuating change in mental state characterized by confusion, attention problems, and changes in thinking. It is often a complication of illness, medication, or surgery.

The cause of delirium is thought to be related to disturbances in brain chemicals that control thinking, behavior, and mood. It can also be caused by low blood flow to the brain.

Delirium is a common and serious condition, especially in older adults. It affects up to 20% of older adults in the emergency room, over 50% in hospitals, and as much as 90% in intensive care.

Delirium is often missed by healthcare providers. It is crucial to be aware of the signs and symptoms, especially in older adults.

A type of medication used to treat Alzheimer's disease. They work by increasing the levels of acetylcholine, a neurotransmitter important for memory and thinking.

A medication used to treat moderate to severe Alzheimer's disease. It works by blocking a type of receptor in the brain that is involved in learning and memory.

A type of dementia caused by damage to blood vessels in the brain. It can be caused by strokes, mini-strokes, or other vascular problems.

A type of dementia caused by the build-up of protein deposits called Lewy bodies in the brain. It is often associated with Parkinson's disease.

While both involve brain cell damage, Lewy Body Dementia is characterized by physical symptoms like tremor and rigidity, often associated with Parkinson's Disease. Alzheimer's disease primarily affects memory and cognitive function.

Factors that increase an individual's susceptibility to delirium. These factors can be present long before the onset of delirium.

Factors that increase the likelihood of delirium include: advanced age, male sex, dementia, cognitive impairment, history of delirium, depression, dependence, immobility, low activity levels, history of falls, sensory impairment, decreased oral intake, multiple medications, alcohol abuse, and co-existing medical conditions.

Factors that trigger the onset of delirium. These factors can occur suddenly and often in a hospital or other healthcare setting.

Factors that can trigger delirium include: certain medications, neurological diseases, infections, surgery, environmental changes, pain, emotional stress, and sleep deprivation.

Delirium can manifest in different ways based on the person's behavior and symptoms.

A subtype of delirium characterized by agitation, restlessness, and increased alertness. Individuals with hyperactive delirium may be combative, disoriented, and experience hallucinations.

A subtype of delirium characterized by lethargy, slowness, reduced alertness, and decreased activity. Individuals with hypoactive delirium may appear withdrawn, quiet, and unresponsive.

Delirium can have a significant impact on individuals and their families, leading to a range of negative outcomes.

Gently touch the person's arm, shoulder, back, or waist if they don't move away. This can help calm and ground them.

Call the person by their formal name (e.g., Mr. Jones). Using a respectful address can help them feel recognized and valued.

Pay attention to both verbal and nonverbal communication to understand the person's feelings and needs.

Try to understand the reason behind their wandering. What are they trying to accomplish or what are their underlying emotions?

Respond to the person's emotions in a calm and supportive manner. Validate their feelings and acknowledge their concerns.

Repeat specific words or phrases that express their needs or emotions (e.g., "You need to go home; you're worried about your husband.").

If talking doesn't distract them, walk alongside them and continue talking calmly, repeating phrases and acknowledged emotions.

Provide orienting information only if it calms the person. If it increases distress, stop talking about the situation.

Activities that provide mental stimulation and opportunities for social interaction, improving self-worth, belonging, accomplishment, and emotional expression.

Exercise has positive benefits for all older individuals, regardless of their condition or living environment. It improves function, prevents disability, and boosts mood.

All evidence-based recommendations suggest a thorough pain assessment for older adults, yet a significant portion of seniors in long-term care receive antipsychotics, highlighting a gap in care.

Early diagnosis of Mild Cognitive Impairment (MCI) and memory loss allows for earlier interventions, potentially minimizing the impact on patients and families.

Families caring for loved ones with early-stage memory loss often face emotional challenges, including accepting the diagnosis, prognosis, and the changing relationship.

Common concerns for caregivers of individuals with MCI include nutrition, personal care activities (ADLs), maintaining health and function, safety, communication, and the caregiver's own needs.

When assisting with bathing, it's essential to honor the individual's lifelong routines and preferences, respecting refusals and explaining all actions.

Wandering can pose risks, including falls, elopement, disruptions to care routines, and invasion of others' privacy.