1. The caregiver can define dementia and delirium.
   1. Dementia is any condition that creates a decline in memory and other mental functions that is severe enough to affect the daily life.
   2. Dementia shows as a gradual, irreversible loss of intellectual abilities.
   3. Delirium has similar symptoms but
      • Has sudden onset
      • Is temporary
      • Is curable after specific cause is treated
   4. Various conditions are characterized by dementia, such as
      • Alzheimer’s disease
      • Parkinson’s disease
      • Cerebrovascular disorders
   5. Delirium can be caused by
      • Drugs or alcohol abuse
      • Infection (usually urinary or respiratory infections)
      • Medication changes or new combina- tions
      • Sleep deprivation
      • Electrolyte imbalances (such as severe dehydration)
      • Cardiac or respiratory problems
      • Urinary of fecal problems
      • Complications of medical illness, recovery, or surgery
2. The caregiver can list signs and symptoms of dementia.
   1. Loss of memory
   2. Loss of intellect
   3. Loss of judgment
   4. Disorientation
   5. Anger, agitation, anxiety, and depression
   6. Sundowning syndrome (confusion increases at night)
   7. Decreased attention span
   8. Limited speech
3. The caregiver can list measures to decrease confusion.
   1. Follow a routine.
   2. Do not rearrange furniture.
   3. Label objects.
   4. Clarify misperceptions.
   5. Reorient as needed.
   6. Use clocks, calendars, etc.
   7. Remind client to wear glasses/hearing aids.
   8. Write reminder notes.
   9. Provide adequate lighting.
4. The caregiver can list measures to decrease verbal and physical aggression.
   1. Reduce sensory stimulation.
   2. Redirect to another room or activity.
   3. Praise good behavior.
   4. Encourage timeout.
   5. Reduce stimuli (lights, noise, etc.).
5. The caregiver can state measures to increase independence in activities of daily living.
   1. Keep choices of clothing to a minimum.
   2. Give verbal cues as needed.
   3. Give finger foods.
   4. Give one bowl at a time at mealtime.
   5. Give assistance only as needed.
   6. Use clothing that has elastic waists or Velcro for closures.
6. The caregiver can state measures to promote safety.
   1. Precautions while eating
      1. Use unbreakable dishes.
   2. Poison prevention
      1. Keep medications out of reach.
      2. Do not keep poisonous plants in the house.
      3. Keep poison control number within reach.
   3. Prevention of burns
      1. Keep water temperature 120°F or less to prevent burns.
      2. Watch closely with hot beverages—may use thermal cup with a lid.
      3. Watch closely if smoking.
   4. Prevention of falls
      1. Avoid throw rugs.
      2. Assist with walking as needed.
      3. Place gate in front of stairs.
      4. Use low-heeled, nonskid shoes.
   5. Prevention of cuts or injuries
      1. Keep sharp objects out of reach.
   6. Prevention of client getting lost
      1. Use alarms on doors.
      2. Use identification bracelet.
      3. Place pictures on doors of each room to identify.
   7. Prevention of medication errors
      1. Use pill box for early stages.
      2. Keep medications in locked cupboard.

Resources

National Association of Adult Day Care
www.nadsa.org/adsfacts

National Institute on Aging
www.nia.nih.gov

Alzheimer’s Disease and Related Disorders Association
800-621-0379

References

Ackley, B. J., & Ladwig, G. B. (2006). Nursing diagnosis handbook: A guide to planning care. Philadelphia: Mosby Inc.
Cohen, B. J., & Wood, D. L. (2000). Memmler’s the Human Body in Health and Disease (9th ed.). Philadelphia: Lippincott Williams & Wilkins.
Nutrition made incredibly easy. (2003). Springhouse: Lippincott, Williams & Wilkins.
Portable RN: The all-in-one nursing reference. (2002). Springhouse: Lippincott, Williams & Wilkins.
Taylor, C., Lillis, D., & LeMone, P. (2005). Fundamentals of nursing. Philadelphia: Lippincott Williams & Wilkins. Timby, B. K., & Smith, N. C. (2003). Introductory medical-surgical nursing (8th ed.). Philadelphia: J. B. Lippincott
Williams & Wilkins.

Credits

Client Teaching Guides for Home Health Care, 2nd ed.
© 2008 Jones and Bartlett Publishers, Inc.
www.jbpub.com