Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Chapter 21

Cognitive Disorders

Chapter 21

Cognitive Disorders

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Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Mental health continuum for cognitive disordersMental health continuum for cognitive disorders

21-221-2 (Fig. 21-1)(Fig. 21-1)

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Copyright © 2002 by W. B. Saunders Company. All rights reserved.

Eliminate causative factors

Monitor vital and neurological signs

Call client by name and identify self

Use face-to-face contact

Use short, simple, concrete phrases

Explain what’s to be done

Keep room well lit

Keep head of bed elevated

Provide clocks, calendars

Eliminate causative factors

Monitor vital and neurological signs

Call client by name and identify self

Use face-to-face contact

Use short, simple, concrete phrases

Explain what’s to be done

Keep room well lit

Keep head of bed elevated

Provide clocks, calendars

Interventions: Delirious ClientInterventions: Delirious Client

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Have client wear glasses, hearing aids

Provide continuity of personnel

Clarify reality if hallucinations/illusions persist

Ignore insults

Set limits on physically abusive behavior

Have client wear glasses, hearing aids

Provide continuity of personnel

Clarify reality if hallucinations/illusions persist

Ignore insults

Set limits on physically abusive behavior

Interventions: Delirious Client, cont.Interventions: Delirious Client, cont.

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Stage 1 (Mild): Forgetfulness

- Usually not diagnosable

Stage 2 (Moderate): Confusion

- Short term memory impairment

- ADLs decline

- In-home assistance needed

Stage 1 (Mild): Forgetfulness

- Usually not diagnosable

Stage 2 (Moderate): Confusion

- Short term memory impairment

- ADLs decline

- In-home assistance needed

Stages of Alzheimer’s DiseaseStages of Alzheimer’s Disease

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Stage 3 (Severe): Ambulatory Dementia

- ADL losses

- Reasoning and verbal communication poor

Stage 4 (Late): End Stage

- No recognition of family/self

- Nonambulatory

- Forgets how to eat/incontinent

- Institutionalized

Stage 3 (Severe): Ambulatory Dementia

- ADL losses

- Reasoning and verbal communication poor

Stage 4 (Late): End Stage

- No recognition of family/self

- Nonambulatory

- Forgets how to eat/incontinent

- Institutionalized

Stages of Alzheimer’s Disease, cont.Stages of Alzheimer’s Disease, cont.

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Memory impairment Disorientation, mistaken beliefs Needs physical help Risk for injury Apathy Poor Communication Repetitiveness Uncontrolled emotion, behavior Incontinence Poor decision making Burden on family

Memory impairment Disorientation, mistaken beliefs Needs physical help Risk for injury Apathy Poor Communication Repetitiveness Uncontrolled emotion, behavior Incontinence Poor decision making Burden on family

Problems in DementiaProblems in Dementia

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