Dementia and Sleep Disturbances

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Questions and Answers

What percentage of people with severe dementia may be affected by sleep disturbance?

  • 25%
  • 50% (correct)
  • 75%
  • 90%

Why is Lewy body dementia unlikely to be the cause of Lauren's symptoms?

  • She has sudden behavioral changes
  • She is experiencing hallucinations
  • She is experiencing Parkinsonism
  • She is not experiencing hallucinations (correct)

What is the importance of 'watchful waiting' in NCSD treatment?

  • Most NCSDs resolve themselves within a 4-week period (correct)
  • It is a non-pharmacological intervention
  • It is a pharmacological approach
  • It is a direct intervention

Why are pharmacological approaches to NCSD treatment limited?

<p>They have limited effectiveness and can have harmful side-effects (C)</p> Signup and view all the answers

What is the goal of direct interventions in NCSD treatment?

<p>To promote well-being, improve quality of life, and improve mood and behavior (D)</p> Signup and view all the answers

What type of interventions involve caregiver training and modifying environmental factors?

<p>Indirect interventions (D)</p> Signup and view all the answers

What is the goal of Cognitive Stimulation Therapy (CST)?

<p>To improve quality of life and maximize available cognition (B)</p> Signup and view all the answers

What is the core principle of person-centered care (PCC)?

<p>Treating the whole person, not just the disease (D)</p> Signup and view all the answers

What is a key benefit of person-centered care training for staff?

<p>Improving agitation and quality of life for people with dementia (A)</p> Signup and view all the answers

Why is it important to offer training sessions to family carers?

<p>To support carers in developing their skills and addressing their emotional and practical needs (A)</p> Signup and view all the answers

What is a key communication technique for people with dementia?

<p>Reducing noise levels and creating a calm environment (A)</p> Signup and view all the answers

Why is it important to respect the person with dementia's reality?

<p>To improve person-centered care and build trust (D)</p> Signup and view all the answers

What is a key aspect of the bio-psycho-social-physical perspective?

<p>Recognizing the interplay between biological, psychological, social, and physical factors (C)</p> Signup and view all the answers

What is a key recommendation for supporting family carers?

<p>Advising carers on their rights and the services available to them (D)</p> Signup and view all the answers

What is a key goal of non-pharmacological interventions in dementia care?

<p>To reduce the need for antipsychotic and other medications (A)</p> Signup and view all the answers

What is a key principle of good communication with people with dementia?

<p>Approaching the person with a calm and friendly demeanor (B)</p> Signup and view all the answers

What is the primary impact of a smaller, less crowded environment on people with dementia?

<p>Reduced NCSD (B)</p> Signup and view all the answers

What is the benefit of using a well-thought-out wayfinding system in a person-centered care approach?

<p>Helping people navigate and reducing stress and anxiety (C)</p> Signup and view all the answers

What is the primary goal of a comprehensive assessment before considering psychotropic medication in a person with dementia?

<p>To rule out underlying causes of late-onset psychosis (D)</p> Signup and view all the answers

What is the effect of increased lighting on people with dementia?

<p>Improved orientation and reduced behavioral disturbance (B)</p> Signup and view all the answers

What is the primary consideration when providing pharmacological intervention for non-cognitive symptoms of dementia?

<p>The severity of distress or risk of harm to the person and/or others (C)</p> Signup and view all the answers

What is the characteristic of 60% of late-onset psychosis?

<p>It is secondary and has an underlying cause (D)</p> Signup and view all the answers

What is the primary goal of a person-centered approach in caring for people with dementia?

<p>To understand the human value of people living with dementia and their individuality (C)</p> Signup and view all the answers

What is the recommended way to communicate with a person with dementia?

<p>Talking clearly and speaking in short, simple sentences (B)</p> Signup and view all the answers

What is the primary indication for antipsychotic medication in people with dementia?

<p>Agitation, psychosis, and aggression (A)</p> Signup and view all the answers

What is the benefit of using single rooms that are homelike and personalized in a person-centered care approach?

<p>Reducing psychiatric symptoms (A)</p> Signup and view all the answers

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Study Notes

Sleep Disturbance in Dementia

  • Up to 25% of people with mild to moderate dementia and 50% of people with severe dementia experience sleep disturbances.
  • Lauren, a person with dementia, exhibits agitated behavior during the day and wanders around the house at night, but does not show signs of hallucinations or Parkinsonism.

NCSD (Non-Cognitive Symptoms of Dementia)

  • NCSDs affect people with dementia and include agitation, aggression, disinhibition, delusions, hallucinations, anxiety, apathy, wandering, and repetitive actions.
  • Most NCSDs will resolve themselves within a 4-week period, so "watchful waiting" is recommended.
  • Pharmacological approaches have limited effectiveness and can have harmful side-effects, so non-pharmacological interventions should be prioritized.

Interventions for NCSD

  • Indirect interventions target caregivers and the environment, including caregiver training, multidisciplinary team approaches, individualized treatment plans, and modifying environmental factors.
  • Direct interventions target individuals with dementia, such as art, music, physical exercise, meaningful activities, life story discussion groups, and Cognitive Stimulation Therapy (CST).
  • CST is a talking therapy that improves quality of life and maximizes available cognition in people with mild to moderate dementia.

Bio-Psycho-Social-Physical Perspective

  • An integrated approach considers biological, psychological, social, physical, and environmental factors for effective management of NCSD.

Person-Centered Care

  • Focus on the whole person, not just the disease.
  • Get to know the person with dementia, recognize and accept their reality, and support ongoing opportunities for meaningful engagement.
  • Build and nurture authentic, caring relationships and create a supportive community.

Caregiver Support

  • Family carers play a central role in caring for people with dementia and need support to develop their skills and address their own emotional and practical needs.
  • Recommendations include dementia-specific training, carer support, and address the risk of depression among carers.

Communication

  • Good communication skills are essential in supporting people with dementia.
  • Techniques include creating a calm environment, speaking clearly, and respecting the person's perspective.

Environmental Design

  • A well-designed environment can reduce NCSD, improve orientation, and reduce behavioral disturbance.
  • Key principles include reducing crowding and noise, using clear signage, and providing easy-to-use toilets.

Pharmacological Intervention

  • Prior to considering psychotropic medication, a comprehensive assessment must be performed.
  • Antipsychotics may be indicated for agitation, psychosis, and aggression, but risks and benefits must be fully explained to the patient and/or caregivers.

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