Agitation: May be verbal, physical in nature; generally brought about by confusion, fear, or many times a self-defense mechanism.
Aggression: Actions that are harmful or threatening, may be verbal or physical in nature.
Agnosia: Inability to correctly interpret signals from the 5 senses (unable to recognize people or objects, or unable to perceive Òchest painÓ or a Òfull bladderÓ).
Alzheimer’s Disease: A progressive, neurodegenerative disease characterized by loss of function and death of nerve cells in several areas of the brain, leading to loss of mental functions such as memory and learning. Most common cause of dementia.
Amnesia: Loss of memory, the inability to remember facts or events.
Anxiety: General sense of apprehension or fear and may result in agitation. Worry about loved ones, responsibilities or circumstances.
Apathy: Loss of interest in activities that used to be enjoyed or loss of motivation.
Aphasia: unable to communicate effectively
Apraxia: Inability to complete pre-programmed motor tasks, or to complete ADLÕs. Motor skills learned during development are forgotten (in the later stages of Alzheimer’s), this includes chewing, swallowing, and walking.
Brainstem: The stemlike portion of the brain connecting the cerebral hemispheres with the spinal cord. Responsible for neurological functions necessary for survival.
Cerebrum: Largest part of the brain that has left and right hemisphere. The cerebrum controls remembering, problem-solving, thinking and feeling.
Cerebellum: Area of the hindbrain that controls motor movement coordination, balance, equilibrium and muscle tone.
Capgras syndrome: A recurrent and transient belief that a person (usually someone closely related) has been replaced by an imposter.
Cerebral Vascular Accident (CVA): Sudden death of brain cells in a localized area because of inadequate blood flow.
Cognitive Abilities: Mental abilities such as judgment, memory, learning, comprehension, and reasoning.
Confusion: Unsure of present time, place, person, or situation that affects the ability to make decisions.
Delusions: A fixed, false belief- like believing that someone is stealing from you or believing someone is going to harm you.
Dementia: The loss of intellectual functions (such as thinking, remembering, and reasoning) of sufficient severity to interfere with a person’s daily functions. It is a progressive state of mental decline associated with memory, function, or judgment that may include disorientation and disintegration of personality.
Depression: Mood disorder causing sadness, increased frustration, fatigue, loss of interest in activities, and changes in appetite and sleep.
Expressive Aphasia: Loss of ability to speak and write.
Hallucinations: Seeing, hearing, or smelling things that are not there.
Illusions: Distorted perceptions- like seeing a rope and thinking it was a snake.
Receptive Aphasia: Unable to understand spoken or written words; may read but not understand what is read.
Redirect: To change the direction or course of a patient with Alzheimer’s train of thought with a different situation. For example- a patient says I want to go home, redirect them from the problem with yes, and let’s stop and look at the birds on the way.
Repetition: Questions, behaviors, or mannerisms that a person frequently repeats. Unable to remember what was just said or done because of brain cells that have been destroyed.
Respite: A short break or time away.
Sundowning: Behavior (reaction) that increases in the afternoon, evening or night hours. May observe an increase in confusion and agitation.
Trans-Ischemic Attacks (TIA’s): When blood flow to a part of the brain stops for a short period of time, then breaks up quickly and dissolves.
Validation: Addresses the feelings of a person, rather than focusing on the accuracy or content of the conversation.
Wandering: Related to searching for the familiar (early stages), while in the later stages may be from simple motor agitation.
Vascular Dementia is small strokes or TIA’s (Trans-ischemic attacks) that result in temporary loss of blood supply, and brief interruptions of sight or consciousness.
Signs and Symptoms:
- Numbness or paralysis (one side of the face or body)
- Memory Loss- Depends on which part of the brain is affected and where the reduced blood flow occurred
Following a major stroke or CVA (Cerebral vascular accident), major challenges in areas of the brain affected may show
- Increased confusion and disorientation
- Difficulty with speaking or understanding speech
- Changes in vision; loss of vision
If many small strokes or TIA’s occur over time, changes may include:
- Impairment of judgment and planning
- Uncontrolled laughing or crying
- Changes in attention span
- Problems with social function; situations
- Problems with finding or expressing the right words
Who is at risk? People with:
- High Blood Pressure
- High Cholesterol levels
- Hera or blood vessel disease
- History of, or previous TIA’s
- Advancing age in general
Ways to Decrease Risk:
- Do not smoke
- Keep Blood Pressure, Cholesterol, and Blood Sugar within doctor-recommended guidelines.
- Eat a healthy, balanced diet
- Exercise on a routine basis
- Maintain a healthy weight
- Limit alcohol intake
Dementia with Lewy Bodies (DLB)
Dementia with Lewy Bodies is a Dementia type that is closely related to Parkinson’s Disease. This disease is progressive and incurable and affects thinking, movement, behavior, and sleep.
Signs and Symptoms:
- Changes in Reasoning and thinking
- Alertness and confusion vary on a day-to-day basis
- Hunched back
- Rigid Muscles
- Visual Hallucinations
- Memory Loss
- Involuntary Movement (Dyskinesia)
- Balance problems
- Sleep disorders
- Slow movement (BradyKinesia)
- Difficulty interpreting visual information
- May act out dreams during REM sleep
- Autonomic Nervous System shows malfunctions
The Difference Between Alzheimer’s and DLB
- Memory loss- early in disease
- Movement- seen in moderate and severe stages
- Hallucinations- less frequent
- REM Sleep Disorder- less common
- Autonomic Nervous System- Symptoms less common
- Memory loss: Advanced disease process
- Movement- more likely cause of disability
- Hallucinations- more frequent
- REM Sleep disorder- more common
- Autonomic Nervous System
- Blood pressure drops when standing
- Increased risk of falls
- Urinary incontinence
How to Diagnose:
- Detailed medical history
- Physical exam
- Neurological exam
- Blood tests
- Brain scans
- Verify all physical ailments are ruled out that may cause behavior disturbances (pain, UTI, fecal impaction)
- Utilize physical therapy, occupational therapy, counseling, or speech therapy to maintain physical and mental abilities until life quality shows no benefit of therapies.
- Avoid Antipsychotics (very sensitive to medications)
- Medication prescribed for specific symptoms (hallucinations, delusions, uncontrolled movement, depression) with close monitoring
- Caregiver needs and wants also need to be considered in the treatment of LBD
- Disease of years, not months
- Rate of survival depends on:
- General wellness
- Other medical conditions
- Aggressive and appropriate treatment
- Average life expectancy is 5-7 years after diagnosis
- Caregiver burden may be higher than in
- Alzheimer’s diagnosis
- More impaired functionally
- More impaired in self-care skills, motor skills, and have more neuropsychiatric symptoms especially hallucinations
An Inherited disease (affects Chromosome 4) that causes certain nerve cells in the brain to waste away. If one of the parents has HD, the child has a 50% chance of inheriting the gene and therefore passing it onto their children.
Forms of Huntington’s Disease:
- Adult-Onset- The most common, symptoms develop in the mid 30’s-40’s
- Early Onset- Includes a small number of cases, symptoms begin in childhood and adolescence
Signs and Symptoms:
Behavior changes may occur before mobility problems
- Behavior disturbances
- Depression and/or irritability
- Restlessness or fidgeting