Depression Symptoms Assessment Quiz

Dementia mainly affects memory and is typically caused by anatomic changes in the brain, with a slower onset and generally irreversible, while delirium mainly affects attention and is typically caused by acute illness or drug toxicity, with a more rapid onset and often reversible.

Any change in mental status in an older adult requires a comprehensive geriatric assessment with a strong focus on cognitive function, as changes in cognitive function in older adults are often seen as normal and therefore not investigated.

The passage mentions that dementias can be classified as Alzheimer or non-Alzheimer type, cortical or subcortical, irreversible or potentially reversible, and common or rare.

In contrast to delirium, major and mild neurocognitive disorders (dementias) typically have a gradual onset and a slow, steady pattern of decline without alterations in consciousness.

The passage states that delirium is typically caused by acute illness or drug toxicity, which can sometimes be life-threatening.

Five common care concerns are communication, behavior concerns, ADL care, wandering, and nutrition.

Caregivers should collaborate in problem solving, resource access, long-range planning, emotional support, and respite.

Advance care planning ensures that the individual's preferences for care are known and respected.

Caregivers should provide support in problem solving, resource access, long-range planning, emotional support, and respite.

Characteristics of the social and physical environment can cause distress or exacerbate behavior and psychological symptoms.

Older men

Serotonin

Exercise, eat well, manage stress, smile and do nice things for yourself.

Fear, doubt, unsure, self-isolation, disassociation from the world, defeated, not human, guilt, unfocused, hallucinations, disoriented, visual impairment, powerless, loneliness, bothered by a persistent spy.

Family, friends and professional support staff.

Flat

Recent, may relate to life change; can be chronic

In depression, symptoms are fairly stable and may be worse in the morning. In dementia, symptoms are fairly stable but may change with stress, worsen at night (sundowning), or change suddenly with vascular events.

In depression, speech may be slow, while in dementia there may be difficulty finding words or perseveration.

In depression, orientation is usually normal though the individual may answer 'I don't know' or not try to answer. In dementia, orientation is often impaired and the individual may make up answers, answer close to correctly, or confabulate but still try to answer.

Behavior carries a message of need that can be addressed if factors are carefully evaluated.

Background factors and proximal factors.

By manipulating proximal factors and maximizing strengths while minimizing limitations of background factors.

If the person is not getting adequate sleep at night.

Modifying factors interfering with sleep, such as noise and frequent awakenings.

The NDB model is the Need-Driven Dementia-Compromised Behavior Model, and its purpose is to study and understand behavioral symptoms in individuals with dementia.

Caregivers should interpret behaviors as a form of communication, especially as verbal communication becomes limited.

Maximize functional abilities, establish a caring relationship, identify triggers, modify the environment, provide control, keep the environment stable, provide ongoing education and support.

Caregivers should use these behaviors to determine appropriate limits of activity and stimuli.

To adjust the plan of care accordingly based on the individual's responses and needs.

By providing as much control as possible, offering choices, explaining actions, and not pushing or forcing the person to do something.

Identifying triggers helps in understanding factors in the environment and caregiver communication that may contribute to behavioral symptoms.

Modifying the environment can support losses, promote safe function, and enhance the individual's overall well-being.

To equip caregivers with the necessary knowledge and skills to provide effective care and address challenges that may arise.

The NDB model emphasizes that all behaviors have meaning and are a form of communication, especially in individuals with limited verbal communication.

Irreversible cognitive impairments, such as dementias like Alzheimer's Disease, Lewy Body Dementia, and Dementia caused by AIDS/HIV, are progressive and degenerative disorders that gradually reduce a person's ability to function in everyday life. A person with an irreversible dementia cannot regain their previous level of functioning, even though some symptoms may be managed through treatment. On the other hand, reversible cognitive disorders, such as pseudodementia and delirium, can have their progression halted by identifying the cause of the symptoms and properly treating the underlying disorder. With appropriate treatment, a person's previous level of functioning can be restored in cases of reversible cognitive disorders.

The causes of delirium are potentially reversible; therefore, early accurate assessment and early identification are critical. By identifying the underlying cause of the symptoms early and providing appropriate treatment, the progression of delirium can be halted, and the person's previous level of functioning can be restored.

Dementia, which primarily affects older people, accounts for more than half of nursing home admissions. This highlights the significant impact that irreversible cognitive impairments like dementia can have on the living arrangements and care needs of older individuals, often necessitating admission to long-term care facilities.

Mental health professionals classify cognitive disorders into two broad categories: those that are irreversible (i.e., not curable) and those that are reversible (i.e., curable). This classification is based on the potential for restoration of previous functioning and the ability to halt the progression of the cognitive impairment through appropriate treatment.

Delirium is given many labels: acute confusional state, acute brain syndrome, confusion, reversible dementia, metabolic encephalopathy, and toxic psychosis. These different terms highlight the varying presentations and underlying causes of delirium, which is a reversible cognitive disorder.