Dementia is characterized by a loss of cognitive, executive, and memory function, even when fully alert. Insidiously, the condition gradually develops into a chronic, progressive and irreversible condition. The longer life expectancy of the global population has increased the number of dementia cases.
How does dementia develop?
Various factors contribute to dementia. However, the following are major types of dementia etiologies:
- Dementia of the Alzheimer’s type: The exact cause of Alzheimer’s disease is unknown, but various theories have been proposed, including acetylcholine depletion, plaque formation, tangles, head trauma, and genetic factors.
- HIV-related dementia: HIV-related immune dysfunction can lead to brain infections caused by other organisms. The virus seems to be directly responsible for dementia.
- Dementia caused by Parkinson’s disease: Parkinson’s disease is characterized by the loss of nerve cells in the substantia nigra of the basal ganglia. Therefore, the symptoms of dementia caused by Parkinson’s disease are similar to those of AD
- Vascular dementia is caused by extensive cerebrovascular disease. The patient has the equivalent of a small stroke caused by hypertension or emboli or thrombi in the brain that eats away at several areas of the brain. This type of dementia begins more abruptly than AD.
- A traumatic head injury may result in the development of dementia–related signs and symptoms.
- The Creutzfeldt-Jacob disease is a form of dementia caused by a slow virus or prion. In a typical dementia presentation, the disease progresses rapidly, with deterioration and death occurring within a year after onset.
- Huntington’s Disease dementia: The damage occurs in the areas of the brain’s basal ganglia and cerebral cortex due to a Mendelian dominant gene.
- Dementia caused by Lewy Body Disease: Lewy Body disease has a lot in common with Alzheimer’s. However, the progression is much more rapid, and visual hallucinations and parkinsonian symptoms appear earlier. It is characterized by the presence of Lewy bodies, which are eosinophilic inclusion bodies found in the cerebral cortex and brain stem.
- Chronic Dementia Due to Substance Abuse: This form of dementia is caused by the continued use of substances such as alcohol, sedatives, inhalants, anxiolytics, hypnotics, and various medications.
- Dementia’s clinical manifestations
Here are some examples of clinical manifestations related to dementia:
- An inability to think abstractly, to judge, and to control impulses
- Impaired memory with an inability to learn new information or to recall previously learned information
- A person’s personality changes
- In some cases, the patient might not be able to name objects because of language impairment
- Disorientation of the mind leads to wandering
- Disorientation. There may be disorientation regarding time, names of close family members, or current location.
- Persecutory delusions in particular
- Despite intact motor abilities, impaired ability to perform motor activities
Nursing Assessments of Dementia
To assess a dementia patient, the nurse will need to consider the following:
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Psychiatric interview
As part of the psychiatric interview, the nurse must describe in detail the patient’s mental condition, including behavioural characteristics, the flow of thinking and speaking, mental content and thought processes, cognitive status, sensorium, insight, intellectual resources, and judgment.
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Serial assessment
Serial assessments of the psychiatric status should be performed by the nurse. In this way, we can determine if a mental condition has fluctuated and if there have been acute changes. In the case of infants and young children with cognitive impairments, an interview with the parents is crucial to the treatment.
Nursing Diagnosis
- Alteration of the structure or function of brain tissue that causes a chronic mix-up
- Trauma risk associated with disorientation or confusion
- Impairment of self-care associated with cognitive disorders
- Deficiency in cognitive functioning is associated with a higher risk of falling
- Based on delusional thinking, there is a risk of self-directed or other-directed violence
The Nursing Care Plan and Goals
There are two major nursing care planning and goal for dementia, which are:
- Patients will accept explanations of inaccurate interpretation within the environment
- The patient will be able to interrupt non-reality-based thinking with the help of the nurse or caregiver.
Interventions in nursing
The following nursing interventions are recommended for patients with dementia. These include:
- The patient should be regularly orientated to reality and the present situation. To aid in maintaining reality orientation, let the patient become familiar with the objects around them, such as a calendar, clock, and watch.
- Encourage prospective caregivers to reorient the patient as needed by providing instructions about how to do so based on time, place, person, and circumstance. After the patient is discharged from the hospital, the caregiver is responsible for his or her safety.
- Dispute suspicious behaviour from others: Express reasonable doubt if the patient expresses suspicious beliefs in response to delusional thoughts. Consider the possibility that frequent suspicion of others might negatively affect the patient.
- Provide positive feedback whenever a patient’s behaviour or thought is appropriate or when the patient expresses unfounded ideas. The feedback that is positive increases self-esteem and the desire to repeat appropriate behaviour.
- Engaging the patient in conversation or communicating face-to-face rather than shouting into his or her ear is the most effective way to communicate with them. A dementia patient with hearing loss can be successfully communicated with when they speak slowly and in a face-to-face manner.
- Keep a close eye on the patient: Observe the patient’s behaviour to discover if delusional thinking reveals violent intentions. Your priority is to ensure the patient’s safety.
- False ideas must not be encouraged: Don’t allow your patient to ruminate on false concepts, and once observed, talk to them about their real lives.
Assessment of nursing.
An individual with dementia should meet the following nursing outcome criteria:
- The patient can distinguish between reality-based and non-reality-based thinking with the help of a caregiver.
- Patients may be oriented to reality in specific ways by potential caregivers.
To write an excellent dementia nursing care plan, you need to be familiar with the best assessment, diagnosis, planning, objectives, and intervention strategies. We can provide you with nursing care plans for dementia writing help so you can focus on choosing the most appropriate management techniques for dementia.
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