Module 3 - Dementia

Question 1

What is Dementia?

Answer 1

A progressive neurodegenerative disease, which results in an irreversible loss of cognitive function for a person. Dementia is a terminal disease and there is no cure. Umbrella term for about 100 conditions or disorders that cause symptoms of dementia.

Question 2

Is dementia a normal part of ageing?

Answer 2

NO - Dementia is not a normal part of ageing.

Question 3

What is Young onset dementia?

Answer 3

Used to describe any form of dementia diagnosed in people under the aged of 65.

Question 4

How many new cases of Dementia are estimated to be diagnosed each week?

Answer 4

1,800

Question 5

What percentage of ALL deaths is contributed to Dementia?

Answer 5

15.8%

Question 6

What percentage of deaths of people living in residential aged care is Dementia contributed to?

Answer 6

52%

Question 7

What are the most common conditions cause (forms) of Dementia?

Answer 7

• Alzheimer’s Disease
• Vascular Dementia
• Frontal Lobe Dementia
• Dementia with Lewy Bodies

Question 8

50-75% of dementia in Australia is caused by:

Answer 8

Alzheimer’s Disease

Question 9

Alzheimer’s Disease is caused by:

Answer 9

Caused by tangles building up and disrupting messages in the brain; resulting in impaired thinking, memory and behaviour. A person may live from 3 to 20 years with Alzheimer’s disease, average being 7 to 10 years.

Question 10

Symptoms of Alzheimer’s Disease include but are not limited to:

Answer 10

• Short term memory loss
• Difficulty finding the right words for everyday objects.

Later symptoms include:

• impaired judgement,
• disorientation,
• confusion,
• behaviour changes
• difficulty swallowing, speaking and walking.

Question 11

20-30% of dementia in Australia is caused by:

Answer 11

Vascular Dementia.

Question 12

Two types of Vascular Dementia are:

Answer 12

Multi-infarct dementia and Binswanger’s disease.

Question 13

What causes Vascular Dementia?

Answer 13

It is caused by problems with circulation of blood to the brain.

Question 14

The onset of Vascular Dementia is:

Answer 14

Sudden and less predictable.

Question 15

Risks factors for the development of Vascular Dementia are:

Answer 15

• Untreated high blood pressure
• Irregular heart rhythms.

Question 16

What are the symptoms of Vascular Dementia?

Answer 16

• Impaired judgement or inability to plans steps needed to complete a task.
• Depression Mood swings
• Epilepsy

Question 17

5 -10% of dementia in Australia is caused by:

Answer 17

FRONTAL LOBE DEMENTIA.

Question 18

What causes Frontal Lobe Dementia?

Answer 18

Caused by a degeneration in one or both frontal lobes of the brain.

Question 19

What are the frontal lobes of the brain responsible for?

Answer 19

• Mood
• Social behaviour
• Attention
• Judgement
• Planning
• Self-control

Question 20

What are the symptoms of Frontal Lobe Dementia?

Answer 20

• 1. Changes in personality, reasoning, mood and language. Loss of emotional responses
• 2.Changes in normal inhibitions, talking to strangers or exhibiting behaviour they might otherwise find embarrassing.
• 3. Decline in attentiveness to personal hygiene is also seen.

Question 21

5% of dementia in Australia is caused by:

Answer 21

Dementia with Lewy Body Disease

Question 22

What causes Dementia with Lewy Bodies?

Answer 22

Lewy body disease is caused by the degeneration and death of nerve cells in the brain. The name comes from the presence of abnormal spherical structures, called Lewy bodies, which develop inside nerve cells. It is thought that these may contribute to the death of the brain cells.

Question 23

Have any know causes, risk factors or hereditary factors for Dementia with Lewy Bodies been established?

Answer 23

NO. Although it is more common in men and progresses rapidly.

Question 24

What are the symptoms of Dementia with Lewy Bodies?

Answer 24

• Fluctuating cognition
• Visual hallucinations
• Tremor and Rigidity in limbs (similar to that seen in Parkinson’s Disease).
• There also might be some difficulty in concentration, confusion and depth or distance perception (which can result in falls).

Question 25

What percentage of people with Parkinson's Disease is estimated to develop dementia?

Answer 25

30-60%

Question 26

Name three less common types of Dementia?

Answer 26

1. Alcohol-related Dementia (Korsakoff's) 2. Creutzfeldt-Jacob Disease (CJB) 3. HIV Associated Dementia

Question 27

TRUE OR FALSE The prevalence of dementia is 4-5 times high for Aboriginal and Torres Strait people thank the rest of the Australian population.

Answer 27

TRUE

Question 28

Why is the incidence of dementia for Aboriginal and Torres strait people higher?

Answer 28

Increased prevalence of lifestyle related illness.

Question 29

How many older Australians are born overseas?

Answer 29

1 in 5.

Question 30

How many Australians with dementia speak a language other than English?

Answer 30

1 in 8.

Question 31

What language will a person with dementia commonly communicate in?

Answer 31

The language they first learnt in life.

Question 32

THE ROLE OF THE NURSE. What does the Nursing and Midwifery Board of Australia's Code of Conduct state?

Answer 32

"Nurses engage with people as individuals in a culturally safe and respectful way, foster open, honest and compassionate professional relationships, and adhere to their obligations about privacy and confidentiality."

Question 33

What terms and phrases re preferred when talking about dementia?

Answer 33

* Dementia * Alzheimer’s disease and other forms of dementia * A form of dementia * A type of dementia * Symptoms of dementia

Question 34

Make a list of terms that **_should not be used_** when talking about dementia.

Answer 34

* Dementing illness * Demented * Affliction * Senile dementia * Senility * Going on a journey Sufferer * Victim * Demented person * Dementing illness * Dements * Afflicted * Offenders, absconders or perpetrators * He/she’s fading away or disappearing * Empty shell * Not all there * Losing him/her or someone who has lost their mind • * He/she’s an attention seeker • Inmates (referring to people with dementia in care facilities) * An onion with the layers peeling away * Slang expressions that are derogatory, for example, delightfully dotty, away with the fairies, got a kangaroo loose in the back paddock, a couple of cents short * ‘They’ (talking about all people with dementia rather than the individual)

Question 35

When talking about people with dementia, **what phrases are _preferred_**?

Answer 35

* A person/people with dementia * A person/people living with dementia * A person/people with a diagnosis of dementia

Question 36

What is the medical model called that categorises behaviour?

Answer 36

Behavioural and Psychological Symptoms of Dementia (BPSD)

Question 37

What is the DSA?

Answer 37

**Dementia Support Australia (DSA)** is a referral service encompassing the expertise of Hammond Care and the Dementia Behaviour Management Advisory Service (DBMAS) to provide expert assistance to persons living with dementia and their families. *DSA works in collaboration with the person living with dementia and their care network* to understand the causes and/or triggers leading to changes in behaviour.

Question 38

What are some appropriate ways to communicate with a person who is living with dementia?

Answer 38

* Gentle reorientation and cues * Reduce any noise or over stimulation (noises, lighting, room/bed changes). * Involve person and family in all decisions regarding care. * Get to know your patient (fears and frustrations). * Communicate respectfully, sensitively and compassionately. * Active listening * Use simple statements * **Break down tasks into small steps.** * Be conscious of your body language * **_Never argue_** or attempt deep reasoning. * Develop purposeful and meaningful activities. * Picture prompts.

Question 39

What is the most common screening test used for dementia?

Answer 39

Mini-Mental State Examination (MMSE).

Question 40

What methods are used to diagnose Alzheimer's disease?

Answer 40

* A detailed medical history * A thorough physical and neurological examination * A test of intellectual function * Psychiatric assessment * A neuropsychological tests * Blood and urine tests * Lumbar puncture for cerebral spinal fluid tests * Medical imaging (MRI, PET)

Question 41

What is respite care?

Answer 41

**Respite care** is designed to give carers **a break for a limited period of time.** *Someone else provides care* so the carer can go on holiday, attend to everyday activities or just relax. Sometimes a carer might need emergency respite care if, for example, they get sick or need to go to hospital.

Question 42

How do you manage challenging behaviours?

Answer 42

* Know Triggers * Minimise loud noises * Establish routines * Calm approach

Question 43

The onset of dementia is....

Answer 43

Slow and insidious. Deterioration over months and years.