N212: Health Differences Across the Life Span 2

Health Differences Across the Lifespan 2 Study Guide Classic signs and symptoms include decreased concentration, depression, inability to retain new memories, inability to recognize family members, decreased response to stimuli, deterioration in motorability, and disorientation to people, places, and time. Nursing interventions include maintaining a safe environment by removing potential hazards and obstacles. Nurses should provide communication that is consistent and structured to prevent added confusion. Encourage the use of community resources for caregivers. With Alzheimer patients, allow wandering in a controlled area, have clocks and calendars in plain view to enhance orientation, and provide familiar objects in and around the room. 2.3 Alzheimer’s Disease The stages of Alzheimer’s disease: • Stage 1: (2-4 years) o Decline in short term memory leads to the patient losing things o Difficulty with completing complex tasks such as selecting appropriate clothing and dressing o Decreased cognitive functions are seen as a decreased ability to make accurate judgments or plan effectively o Impaired driving skills, reduced concentration (with increasing distractibility), and decline in verbal skills and time orientation (memory of people still intact) will also occur o Patient experiences gaps in memory, which leads to confabulation (filling in memory gaps with imaginary information) in an attempt to hide the deficit o Patient compensates by using memory aids, such as developing routines and using lists o Patient is concerned and aware of the problem; may be frightened by confusion o Depression may occur, which worsens symptoms and may increases anxiety, frustration, helplessness, and shame • Stage 2: (several years) o Disorientation occurs in the three spheres of person, place, and time o Patient exhibits lack of spontaneity in verbal and nonverbal communication, which declines over time to aphasia o Patient exhibits poor impulse control with frequent outbursts and tantrums, labile emotions, catastrophic reactions, or overreaction to minor stresses o Patient loses the ability to carry out ADLs in a typical order: bathing, grooming, choosing clothes, dressing, and toileting o Patient may exhibit wandering behavior o Misidentification syndrome occurs; familiar people are seen as unfamiliar, and strangers are seen as people known to the patient ©2017 Achieve Test Prep Page 54 of 140