About
A chronic, progressive decline in memory and ability to do activities of daily living, with onset of dementia and personality changing symptoms.
Assess
Rule out other illnesses, cognitive changes, memory, attention, judgment, communication changes, self care deficit, dementia, sundowning, incontinence, personality changes
Complications
End stage disease; wandering; injury; seizures; death; ineffective coping
Diagnosis
- Chronic confusion related to dementia
- Self care deficit related to physiological or psychological impairment
- Fear related to chronic progressive illness
- Risk for injury related to confusion
Goals
The client will remain free from injury.
Interventions
- Monitor orientation, mobility status, alertness, communication.
- Monitor swallowing, continence status.
- Re-orient to person, place, and time.
- Maintain a safe environment ( call light within reach, room close to nurses station, bed alert sensors, etc.).
- Maintain mobility, use active and passive range of motion exercises.
- Maintain quiet, familiar environments as much as possible.
- Provide structure and routine.
- Assist with ADL's, provide frequent toileting opportunities.
- Encourage active participation with activities of daily living.
- Administer medications ( cholinesterase inhibitors, Namenda, etc.) as ordered.
- Encourage positive reinforcement, validation therapies, and redirection as needed.
- Teach the client and family members about the disease, progression, and goals of therapy.
- Teach the family how to care for client in latter stages of disease, including 24 hour supervision and maintaining a safe environment.
- Encourage family to verbalize concerns, fears and encourage support programs.
- Encourage arm band identifying client and diagnosis.
- Monitor for signs/ symptoms of complications.
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