Michelle Peck | Legal Nurse Consultant | Adult & Geriatric Nurse Practitioner | Health Care | Consultant | Professional Speaker | Educator | Researcher
Enjoy your journey through this slide deck!
During your journey through Geriatric Dementia, Delirium and Depression, you will experience how to:
• Differentiate delirium, depression & dementia.
• Describe the etiology & signs and symptoms of delirium, depression, and dementia.
• Identify risk factors for delirium, depression, and dementia.
• Identify types of medications that may cause depression.
• Communicate and care for people experiencing delirium.
• Explain non-pharmacologic interventions for treating dementia.
In order to minimize risk and customize interventions, we have to know where and how our clients are living.
The picture on the first slide is from geriatric simulation lab, where nursing students practice administering geriatric assessment scales to identify areas of risk. What risks and hazards can you see in this picture?
What you can't see is that the V8 Splash bottle is actually whiskey, medications and incontinence briefs are scattered all over the floor and our client is using oxygen via nasal cannula while smoking. Would picking up the trash and organizing the house fix the problem? Fifty percent of the students verbalized wanting to clean up during their assessment visit and some asked if they could tidy up upsetting the client.
Every problem deserves a viable solution. A comprehensive geriatric assessment is in order and interventions need to follow by assembling the geriatric team.
Our client's assessment findings were all high risk.
View the geriatric assessment scales with how to administer articles & videos at http://consultgerirn.org/resources.
What do we do next? We need to assemble the geriatric team to intervene.
View assembling the geriatric team "Assessments and Referrals" at http://www.environmentalgeriatrics.org/cme/extra/noCredit.html.
Hopefully at minimum the discharging physician ordered the home health care services necessary to bridge our client's hospital to home care.
If the geriatric assessment scales were performed prior to hospital discharge the physician should have recognized that with all her high risk findings she should not have been discharged home alone. At minimum she requires 24 hour supervision for safety.
The students all felt our client was confused and attributed it to her whiskey drinking, but after performing her Mini Cog they realized she was screening positive for dementia. How many clients slip through the cracks because of lack of assessment?
Our client confabulated and was quite convincing until the students saw her clock draw. Now they knew environmental observations were much more important than client self-report.
A picture is worth a thousand words. We fail our clients until we learn the assessment skills required to paint an accurate picture.