Transcript Activities for Mid Stage Alzheimer`s

Webinar
Why Do They Do That?
Presented by:
Jennifer A. Scott, B.S.R.A., C.A.L.M.
VP Facility Development and Operations
Tree of Life Care Group
Management Company
For Arveda Alzheimer’s Assisted Living Residences
512-828-8151 Office
[email protected]
www.arvedacare.com and www.tlcaregroup.com
Presentation Goals
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The participants will be able to identify the different
types of the most common forms of dementia
The participants will be able to identify how the different
dementia disease processes impact the patient
The participants will be able to identify the medications
available to treat Alzheimer’s disease and how they
benefit the patient.
The participants will be able to identify the leading
problem behaviors associated with Alzheimer’s disease.
Disease Diagnoses
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Alzheimer’s Disease
Vascular Dementia – Multi Infarct Dementia
Parkinson’s Dementia
Lewy Body Dementia
Pick’s Disease
Alcohol Dementia-Wernicke-Korsakoff Syndrome
Creutzfeldt Jakob Disease
How do you know the difference?
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Alzheimer’s Dementia
Slow progression
Short Term Memory
Loss first
Loss of executive
functioning Skills
Long Term Memory
Loss
Loss of motor skills
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Vascular Dementia
Stair Step Decline
Incontinent of bladder
sooner than Alz.
Loss of language
sooner than Alz.
Loss of ambulation
sooner than Alz.
How do you know the difference?
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Parkinson’s Dementia
Irregular Body
Movements
Stiffness in joints and
limbs
Loss of motor skills
40%-50% also get
Alzheimer’s
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Lewy Body Dementia
Hallucinations
Loss of motor skills
Pseudo-Parkinson’s
symptoms
Rapid cognitive changes
Syncope Episodes
Intolerance of
psychotropic medications
How do you know the difference?
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Pick’s Disease
Frontal Temporal Involvement
Only 1-5% of people
diagnosed with this
Diagnosis early in life – 40’s
and 50’s
Extreme hyperactivity or very
lethargic
Short Term Memory Stays
intact longer
May put everything in mouth
Gluttonous eating
Extreme loss of language in
late stages
Hyperactivity turns into nonresponsiveness in late stage
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Wernicke-Korsakoff Syndrome
Thiamine deficiency; Vitamin
B1 deficiency
Most often caused by
excessive alcohol consumption
Confabulation
Psychosis
Motor Skill Losses
Neuropathy of extremities
Muscle Wasting
Brain damage affecting
language and thinking
Heart Failure is common
Behaviorally very difficult to
care for
How do you know the difference?
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Creutzfeldt Jakob Disease
Two different types “classic” and “variant” forms
Variant seems to be linked to “mad cow disease”
but not always and it’s very rare
Classic is not linked to “mad cow”
Both forms have long gestation periods but once
diagnosed the person deteriorates very rapidly,
a few months to a year
Signs and symptoms in both forms are similar –
personality changes, loss of thinking ability,
behavioral symptoms, loss of motor control
What Happens in the Brain?
Hypothalamus (Hippocampus)
Alzheimer's begins in the part of the brain that is called
the Hypothalamus. (Hippocampus) This part of the brain
contains our short-term memory center.
This is the first part of the brain to be affected by
Alzheimer's. However the disease is not localized here. It
will travel to all parts of the brain.
That is what makes Alzheimer's disease different from
other diseases.
What Happens in the Brain?
Hypothalamus (Hippocampus)
All information has to travel through our Hypothalamus
before it can reach the part of our brain where
information is stored.
This part of our brain is called the Cerebral Cortex. It is
responsible for long-term memories and conscious
thought.
The Cerebral Cortex is one of the last parts of the brain to
be affected by Alzheimer's disease.
What Happens in the Brain?
Hypothalamus (Hippocampus)
Alzheimer's disease causes all new information to no
longer be able to pass through the Hypothalamus. You
can think of it as if a "Dam" is being built in that part of
the brain.
Therefore, the person can no longer tell you the
conversations they just had with someone, or tell you
what they had for lunch, or if they took their medicines.
They lose the ability to tell you what happened moments
before in time, or what happened last week, two weeks
ago, etc.
Frontal Lobe – What does this do?
Abstract Concepts
Rationalizing/Reasoning
Clothing – clean/dirty
Natural Consequences
Television
Left from Right
Safety Issues
Using good judgment
Knowing if something is true
or untrue
Seeing someone else’s point
of view
Not arguing with reality
Multi-Step Tasks
Personality
Tooth brushing
Eating
Bathing
Dressing
Emotional Control
Happy/Sad/Anger
Dealing with Changes
Personality Changes
Frontal Lobe – What does this do?
Impulse Control
Empathy
Yelling
Aggressive type behaviors
Saying the first thing on
their minds
Eating off some else’s plate
Taking/Borrowing Items
Understanding how their
actions affect others
To put themselves in
someone else’s shoes
Knowing what others are
doing for them
Initiation
Attention To Task
Starting Tasks
Changing clothes when dirty
Fixing something to eat
Participating in activities
To finish tasks and stay
seated
To watch whole movies
To participate in long
activities
Understanding Disease Related Behaviors
Behavioral issues are hard to manage. They upset
the resident, they upset the other people living in
the community, they upset the staff, and they
upset the families.
In other words, behavioral issues really upset the
apple cart and decrease customer satisfaction all
the way around. Therefore, the following
information lists the things that might cause
behavioral issues to occur.
Types of Disease Behaviors
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Looking for a deceased
relative
Borrowing items from
others (some people call
this stealing, which is
incorrect)
Yelling
Striking out at others
Refusals to bathe and
non-compliant with ADL’s
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Disrobing in public
Medication Refusals
Pushing/pulling furniture
Wandering
High Anxiety
Hoarding
Rummaging
Catastrophic Reactions
Causes for Behavioral
Disruptions
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Changes in the brain
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Health and Medical Problems
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Environmental Factors
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Problems with Communication
Alzheimer’s Medications
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Aricept®(donepezil)
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Exelon® (Rivastigmine)
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Razadyne ® (galantamine)
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Namenda ®(Memantine)
The Tragic Difference
We need to
Love them and
be Patient at all
times.
Thank You
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I want to thank the Star Chapter of the
Alzheimer’s Association’s Regional Office in
San Antonio for the wealth of information
and resources that helped in formulation
of this program.
Late Stage Dementia Care – book
resource available through the Alzheimer’s
Association networks.