Dementia & Patients

Explanation
Reference:
Alzheimer's Australia (2005d) Diagnosing dementia (Available at www.alzheimers.org.au/upload.HS1.2.pdf

Explanation
The statement is false.It is important to recognise that not all types of dementia are progressive and incurable.For example,although dementia that results from conditions such as Alzheimer's disease and Lewy body disease is progressive and incurable-certain medical conditions which may manifest in dementia like symptoms,such as Vitamin B12 deficiency and hypothyroidism.are amenable to treatment.

Adapted
Brain & Nerve Information at iVillage (2000-2008) Alzheimer's $dementia quiz Available at http://neuro.health.ivillage.com/quizzes/q next.cfm?qid=66

Explanation
NO. Use of these imaging tests may identify causative factors for dementia. However,they are not able to identify the specific neurological characteristics of some forms of dementia such as: (a) Lewy Bodies (found in Lewy Body dementia): and (b) neurofibrillary tangles (found in fronto-temporal dementia and Alzheimer's disease). These signs can only be definitively determined after death when an autopsy is performed.

Adapted
Brain & Nerve Information at iVillage (2000-2008) Alzheimer's $dementia quiz Available at http://neuro.health.ivillage.com/quizzes/q next.cfm?qid=66

Explanation
Lewy Body dementia involes insidious impairment of executive fuction with Parkinsonism,visual hallucinations,fluctuating cognitive abilities,and increased risk of falls or autonomic failure.
Multi-infarct dementia involves a stepwise deterioration in executive function with or without language and motor dysfunction.Patients usually have risk factors for atherosclerosis (such as diabetes, hypertension, and smoking). It tends to have a more sudden onset and stepwise progression than Alzheimer's disease.

Alzheimers's disease is characterised by an insidious onset and slow deterioration.

Reference:
McKeith, I.; Galasko, D.,Kosaka,K.,Perry,E.,Dickson,D.,er al.(1996)
Consenus guidelines for the clinical and pathological diagnosis of dementia with Lewy Body (DLB): Report of the consortium on DLB Internatioal Workshop Neuroology 47:113-1124 (abstract only)
Available at http://www.neurology.org/cgi/content/abstract/47/5/113

Explanation
Delirium, a state of confusion and disorientation, can be caused by various factors including pain, dehydration, and urinary tract infections. These conditions can disrupt normal brain function and lead to symptoms such as confusion, agitation, and altered mental status. Therefore, the correct answer includes options a, b, and c, as all of them can contribute to the development of delirium.

Explanation
Having a companion animal in the ward, multi-sensory rooms, and simulated presence therapy can all help reduce agitation. Companion animals provide companionship and comfort, which can help calm and distract individuals who may be agitated. Multi-sensory rooms offer a soothing and stimulating environment that can help individuals relax and reduce agitation. Simulated presence therapy involves using audio or visual recordings of familiar voices or faces to create a sense of presence and familiarity, which can help reduce anxiety and agitation. Therefore, all of these interventions can contribute to reducing agitation.

Explanation
The most accurate way to assess if a resident has pain is to ask the resident if he/she has any pain. This approach allows the resident to directly communicate their experience and provides the most reliable information about their pain. Observing the resident together or monitoring vital signs may provide additional information, but these methods are not as accurate as directly asking the resident. Similarly, relying on the intuitive skills of the usual care staff may lead to subjective judgments and may not accurately capture the resident's pain experience.

Explanation
Agitation can be triggered by various factors. Not getting enough exercise can lead to pent-up energy and restlessness, which can contribute to agitation. Similarly, not receiving enough mental stimulation can result in boredom and frustration, leading to agitation. Tiredness can also play a role as it can make individuals more irritable and less able to cope with stressors, increasing the likelihood of agitation. Therefore, all of the mentioned factors can potentially trigger agitation.

Explanation
Impaired vision can lead to frustration and difficulty in perceiving and understanding one's surroundings. This can result in increased reliance on verbal communication to gather information and express oneself, leading to a higher likelihood of verbal agitation.

Explanation
Anticonvulsant medication can indeed improve agitation. Agitation is a symptom that can occur in various conditions, including seizure disorders, bipolar disorder, and dementia. Anticonvulsant medications are commonly used to treat seizures, but they can also have a calming effect on the brain, which can help reduce agitation. These medications work by stabilizing electrical activity in the brain and reducing the risk of abnormal and excessive neuronal firing. Therefore, it is true that anticonvulsant medication may improve agitation.

Explanation
The given statement is false because a behavioural pain assessment tool may not always accurately determine the intensity of pain experienced by a resident. Pain is a subjective experience, and relying solely on behavioural indicators may not provide a complete picture of the individual's pain level. Other factors such as verbal communication, self-reporting, and physiological measures should also be considered for a comprehensive pain assessment.

Explanation
The statement suggests that a resident who is agitated by lunchtime needs to balance their arousal by resting quietly all afternoon. However, the correct answer is false because there is no one-size-fits-all solution to balancing arousal levels. Different individuals may have different ways of managing their agitation, and resting quietly all afternoon may not be the most effective or appropriate approach for everyone.

Explanation
The statement is true because infections can cause delirium in individuals with dementia. Delirium is a sudden change in mental state characterized by confusion, disorientation, and difficulties with attention and memory. Infections, such as urinary tract infections or respiratory infections, can trigger delirium in people with dementia. This is because the infection can lead to inflammation and release of certain chemicals that affect brain function. Therefore, if a resident with dementia is less active than usual, it could be an indication of an underlying infection causing delirium.

Explanation
Training aged care facility staff about problem behaviors can reduce restraint use because it equips them with the knowledge and skills to effectively manage and address these behaviors. By understanding the underlying causes of problem behaviors and implementing appropriate strategies, staff can prevent situations that may lead to the use of restraints. This can result in a decrease in the overall need for restraints, even if there is an increase in the number of problem behaviors initially. Therefore, the statement is true.

Explanation
The statement suggests that positive comfort measures should be tried before finding the cause of agitation in residents. However, this is incorrect. It is important to identify the cause of agitation in order to address it effectively. Simply using comfort measures without addressing the underlying cause may provide temporary relief but will not solve the problem in the long term. Therefore, the correct answer is false.

Explanation
This statement suggests that the agitation of residents may be influenced by the mood of their caregiver. It implies that if the caregiver is agitated, it can affect the emotional state of the residents, causing them to also become agitated. This highlights the importance of caregivers maintaining a calm and positive demeanor in order to create a peaceful and comfortable environment for the residents.

Explanation
Residents with severe dementia are actually at high risk for delirium. Delirium is a common condition characterized by sudden confusion, disorientation, and changes in mental function. It can be triggered by various factors such as infections, medications, or changes in the environment. Individuals with severe dementia already have impaired cognitive function, making them more susceptible to delirium. Therefore, the statement that residents with severe dementia are at low risk for delirium is incorrect.

Explanation
Using restraints such as physical restraints or chemical restraints can indeed increase agitation in residents with dementia. Restraining a person with dementia can cause feelings of frustration, fear, and confusion, leading to increased agitation and potentially aggressive behavior. It is important to find alternative approaches to manage challenging behaviors in individuals with dementia, such as using person-centered care, providing a calm and supportive environment, and using non-pharmacological interventions.

Explanation
Aromatherapy is a form of alternative medicine that uses essential oils to promote relaxation and improve overall well-being. Many essential oils have calming properties and can help reduce agitation and stress. Therefore, it is true that aromatherapy can be a pharmacological treatment that can reduce agitation.