26 Questions
What percentage of people with severe dementia may be affected by sleep disturbance?
50%
Why is Lewy body dementia unlikely to be the cause of Lauren's symptoms?
She is not experiencing hallucinations
What is the importance of 'watchful waiting' in NCSD treatment?
Most NCSDs resolve themselves within a 4-week period
Why are pharmacological approaches to NCSD treatment limited?
They have limited effectiveness and can have harmful side-effects
What is the goal of direct interventions in NCSD treatment?
To promote well-being, improve quality of life, and improve mood and behavior
What type of interventions involve caregiver training and modifying environmental factors?
Indirect interventions
What is the goal of Cognitive Stimulation Therapy (CST)?
To improve quality of life and maximize available cognition
What is the core principle of person-centered care (PCC)?
Treating the whole person, not just the disease
What is a key benefit of person-centered care training for staff?
Improving agitation and quality of life for people with dementia
Why is it important to offer training sessions to family carers?
To support carers in developing their skills and addressing their emotional and practical needs
What is a key communication technique for people with dementia?
Reducing noise levels and creating a calm environment
Why is it important to respect the person with dementia's reality?
To improve person-centered care and build trust
What is a key aspect of the bio-psycho-social-physical perspective?
Recognizing the interplay between biological, psychological, social, and physical factors
What is a key recommendation for supporting family carers?
Advising carers on their rights and the services available to them
What is a key goal of non-pharmacological interventions in dementia care?
To reduce the need for antipsychotic and other medications
What is a key principle of good communication with people with dementia?
Approaching the person with a calm and friendly demeanor
What is the primary impact of a smaller, less crowded environment on people with dementia?
Reduced NCSD
What is the benefit of using a well-thought-out wayfinding system in a person-centered care approach?
Helping people navigate and reducing stress and anxiety
What is the primary goal of a comprehensive assessment before considering psychotropic medication in a person with dementia?
To rule out underlying causes of late-onset psychosis
What is the effect of increased lighting on people with dementia?
Improved orientation and reduced behavioral disturbance
What is the primary consideration when providing pharmacological intervention for non-cognitive symptoms of dementia?
The severity of distress or risk of harm to the person and/or others
What is the characteristic of 60% of late-onset psychosis?
It is secondary and has an underlying cause
What is the primary goal of a person-centered approach in caring for people with dementia?
To understand the human value of people living with dementia and their individuality
What is the recommended way to communicate with a person with dementia?
Talking clearly and speaking in short, simple sentences
What is the primary indication for antipsychotic medication in people with dementia?
Agitation, psychosis, and aggression
What is the benefit of using single rooms that are homelike and personalized in a person-centered care approach?
Reducing psychiatric symptoms
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.
A quiz about sleep disturbances in people with dementia, particularly in those with mild to moderate and severe dementia. Learn about the common symptoms and possible causes of sleep disturbances in dementia patients.
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