The world’s population is ageing rapidly, and with it is coming to a significant increase in the number of
older people with dementia. This increase presents major challenges for the provision of healthcare
generally and for dementia care in particular, for as more people have dementia, there will be more
people exhibiting behavioural and psychological symptoms of dementia (BPSD).
BPSD exact a high price from both the patient and the caregiver in terms of the distress and disability
they cause if left untreated. BPSD is recognisable, understandable and treatable. The recognition and
appropriate management of BPSD are important factors in improving our care of dementia patients
and their caregivers,
The world’s population is ageing rapidly, and with it is coming to a significant increase in the number of
older people with dementia. This increase presents major challenges for the provision of healthcare
generally and for dementia care in particular, for as more people have dementia, there will be more
people exhibiting behavioural and psychological symptoms of dementia (BPSD).
BPSD exact a high price from both the patient and the caregiver in terms of the distress and disability
they cause if left untreated. BPSD is recognisable, understandable and treatable. The recognition and
appropriate management of BPSD are important factors in improving our care of dementia patients
and their caregivers,
topic on dementia covering all aspects regarding classification,pathophysiology and treatment .Difference between MCI and DEMENTIA .best for post graduates ,house officers and medical students
topic on dementia covering all aspects regarding classification,pathophysiology and treatment .Difference between MCI and DEMENTIA .best for post graduates ,house officers and medical students
This slide contains information regarding Dementia. This can be helpful for proficiency level and bachelor level nursing students. Your feedback is highly appreciated. Thank you!
Homeopathic Doctor - Dr. Anita Salunke homeopathic clinic for DimentiaShewta shetty
Homeopathic Doctor Anita Salunke practices in Chembur, Mumbai, India in her homeopathic clinic Mindheal. Find more information about homeopathic treatment at Mindheal. Welcome to safe, sure and effective homeopathic treatment Dimentia
“Patient Education is an individualized, systematic, structured process to assess and impart knowledge or develop a skill in order to effect a change in behavior. The goal is to increase comprehension and participation in the self-management of health care needs.”
“A restraint is any manual method, physical or mechanical device, material or equipment that immobilizes or reduces the ability of a patient to move his/her arms, legs, body or head freely” (e.g. -Safe keeper bed, Posey bed, safety mitt, soft limb restraint), or a restraint is a drug or medication when it is used as a restriction to manage the patient's behavior or restrict the patient's freedom of movement and is not standard treatment or dosage for the patient's condition A restraint does not include devices, such as orthopedically prescribed devices, surgical dressings or bandages, protective helmets, or other methods that involve the physical holding of a patient for the purpose of conducting routine physical examinations or tests, or to protect the patient from falling out of bed, or to permit the patient to participate in activities without the risk of physical harm., side rails, airways, trapeze etc.
Unit 10 Promoting Safety in Health Care Enevronment (FON).pdfKULDEEP VYAS
Healthcare environments need to provide a balance between the need for practical and clinical activities or procedures to take place within them, while creating an environment that can contribute to a good experience.
International Nurses Day
IND is celebrated around the world every May 12, the anniversary of Florence Nightingale's birth. ICN commemorates this important day each year with the production and distribution of the International Nurses' Day (IND) resources and evidence.
Fluorosis is a cosmetic condition that affects the teeth. It's caused by overexposure to fluoride during the first eight years of life. This is the time when most permanent teeth are being formed. After the teeth come in, the teeth of those affected by fluorosis may appear mildly discolored.
Evaluation is a process used to determine what has happened during a given activity or in an institution.Evaluation requires many skills that are as important as other elements of the instructional process.
Human resource management in hospital and community servicesKULDEEP VYAS
HRM is the function within an organization that focuses on recruitment ,managing and providing direction for the people working in that organization.
*It is the organizational function dealing with issues related to people such as hiring, compensation, performance management ,safety, organization development, wellness, benefits, employee motivation, communication, administration and training.
Moulding or training of the mind and character to bring about desired behaviour is known as discipline.it helps a person to have some control over another person.
Patient ASSIGNMENT does not only mean that dividing the patient among available staff nurses but it is assigning an individual patient or group of patients to nurses according to the required nursing care needs and nurses capability to provide the quality care
Directing leading in hospital and community servicesKULDEEP VYAS
Directing is the fourth phase of the management process, it can also be called as coordinating or activating
*Here the leadership and the management skills are both required in order to accomplish the goal of the organization.
*It consists of 2 major components like guidance and supervision which is to be done during job process which help the nurses to utilize their total skills and knowledge in providing the quality care.
Commonly used Insecticides and Pesticides KULDEEP VYAS
Pesticides include insecticides, herbicides and fungicides. There are several thousand different types in use and almost all of them are possible causes of water pollution. For example, DDT, malathion, parathion, delthametrine and others have been sprayed in the environment for long periods of time for the control of disease vectors such as mosquitoes, and to control the growth of weeds and other pests.
Material management in hospital and community servicesKULDEEP VYAS
Material management is a methodical technique that includes planning strategies, systemizing and regulating the flow of material from procurement till the point of disembarkation.
It is the process of coordination and controlling the activities in an organization. It includes the responsibility of purchasing the materials, their scheduling from supply or from other internal sources, their handling, storage and movement through the organization, and their delivery.
-It is a statement of anticipated results during a designated
time period expressed financial and nonfinancial terms.
-Three essential steps in the control process are establishing standards, comparing results with standards and taking corrective action.
-Budgeting process starts when top-level management establishes the strategies and goals for the organization.
The client classification system or patient classification system is the cluster of clients that has been categorized on the specific characteristics, needs ,requirements and their severity of the disease conditions based on which patient assignment is made to provide nursing care.
Tom Selleck Health: A Comprehensive Look at the Iconic Actor’s Wellness Journeygreendigital
Tom Selleck, an enduring figure in Hollywood. has captivated audiences for decades with his rugged charm, iconic moustache. and memorable roles in television and film. From his breakout role as Thomas Magnum in Magnum P.I. to his current portrayal of Frank Reagan in Blue Bloods. Selleck's career has spanned over 50 years. But beyond his professional achievements. fans have often been curious about Tom Selleck Health. especially as he has aged in the public eye.
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Introduction
Many have been interested in Tom Selleck health. not only because of his enduring presence on screen but also because of the challenges. and lifestyle choices he has faced and made over the years. This article delves into the various aspects of Tom Selleck health. exploring his fitness regimen, diet, mental health. and the challenges he has encountered as he ages. We'll look at how he maintains his well-being. the health issues he has faced, and his approach to ageing .
Early Life and Career
Childhood and Athletic Beginnings
Tom Selleck was born on January 29, 1945, in Detroit, Michigan, and grew up in Sherman Oaks, California. From an early age, he was involved in sports, particularly basketball. which played a significant role in his physical development. His athletic pursuits continued into college. where he attended the University of Southern California (USC) on a basketball scholarship. This early involvement in sports laid a strong foundation for his physical health and disciplined lifestyle.
Transition to Acting
Selleck's transition from an athlete to an actor came with its physical demands. His first significant role in "Magnum P.I." required him to perform various stunts and maintain a fit appearance. This role, which he played from 1980 to 1988. necessitated a rigorous fitness routine to meet the show's demands. setting the stage for his long-term commitment to health and wellness.
Fitness Regimen
Workout Routine
Tom Selleck health and fitness regimen has evolved. adapting to his changing roles and age. During his "Magnum, P.I." days. Selleck's workouts were intense and focused on building and maintaining muscle mass. His routine included weightlifting, cardiovascular exercises. and specific training for the stunts he performed on the show.
Selleck adjusted his fitness routine as he aged to suit his body's needs. Today, his workouts focus on maintaining flexibility, strength, and cardiovascular health. He incorporates low-impact exercises such as swimming, walking, and light weightlifting. This balanced approach helps him stay fit without putting undue strain on his joints and muscles.
Importance of Flexibility and Mobility
In recent years, Selleck has emphasized the importance of flexibility and mobility in his fitness regimen. Understanding the natural decline in muscle mass and joint flexibility with age. he includes stretching and yoga in his routine. These practices help prevent injuries, improve posture, and maintain mobilit
Prix Galien International 2024 Forum ProgramLevi Shapiro
June 20, 2024, Prix Galien International and Jerusalem Ethics Forum in ROME. Detailed agenda including panels:
- ADVANCES IN CARDIOLOGY: A NEW PARADIGM IS COMING
- WOMEN’S HEALTH: FERTILITY PRESERVATION
- WHAT’S NEW IN THE TREATMENT OF INFECTIOUS,
ONCOLOGICAL AND INFLAMMATORY SKIN DISEASES?
- ARTIFICIAL INTELLIGENCE AND ETHICS
- GENE THERAPY
- BEYOND BORDERS: GLOBAL INITIATIVES FOR DEMOCRATIZING LIFE SCIENCE TECHNOLOGIES AND PROMOTING ACCESS TO HEALTHCARE
- ETHICAL CHALLENGES IN LIFE SCIENCES
- Prix Galien International Awards Ceremony
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
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micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
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Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
2. DEMENTIA
• DEFINITION:
– Group of symptoms that can be caused by over
60-70 disorders.
– Syndrome which refers to progressive decline
in intellectual functioning severe enough to
interfere with person’s normal daily activities
and social relationships. (National Institute on Aging-
1995 No. 95-3782)
3. Dementia
– Marked by progressive declines in
• memory.
• visual-spatial relationships
• performance of routine tasks
• language and communication skills
• abstract thinking
• ability to learn and carry out mathematical
calculations.
4. Dementia
• Two Types:
– Reversible
– Irreversible
• Individuals must have intensive medical
physical to rule out reversible types of
dementia.
5. Delirium vs. Dementia
• Delirium defined--- characterized by a disturbance
of consciousness and a change in cognition that
develop over a short period of time
• About 10-15% of surgical patients experience
delirium, and 15-25% of medicine inpatients will
experience delirium
• 30% Surgical Intensive Care Unit patients develop
delirium, and up to 30% of AIDS patients while
inpatient, will develop delirium
6. Delirium vs. Dementia
• A major risk factor is advanced age
Other factors include very young people (children),
organic brain damage including stroke, MVA, etc,
substance use, previous delirium, malnutrition, sensory
deprivation (hearing or visual loss), diabetes, cancer
Having an episode of delirium is more than just
inconvenience
3 month mortality following an episode of delirium is
25-30%. 1 year mortality after an episode of delirium
may be as high as 50%.
8. Delirium vs. Dementia
• Could be psychiatric disorder, i.e. major
depression or generalized anxiety disorder, in
which case need to initiate treatment for this
disorder, i.e. get a psych consult
• Or is the cause a delirium from other meds or an
infection, in which case should look at labs and
med list.
• Or is cause alcohol withdrawal, in which case
need to treat w/d with benzodiazepines
• If patient is having chronic trouble sleeping, a
good choice to help them is Ambien/zolpidem or
Sonata/zaleplon
9. Delirium vs. Dementia
• Watch for alcohol withdrawal as cause of
delirium. If elevated pulse and blood
pressure, see elevated MCV, and patient
begins to act bizarre, talk to family if at all
possible, about substance use. If patient
enters delirium tremens (DT’s), untreated
has a mortality rate of 20%.
10. Delirium vs. Dementia
• How is delirium treated?
First line treatment for delirium is to treat underlying
cause. Often will need many labs- Complete Metabolic
Panel, Complete Blood Count, TFT, EEG if indicated,
CT/MRI of head, sometimes LP, etc.
A psychiatric or psychological consult might be needed
for agitation.
Meds- Haldol 2.5-5 mg (less for geriatric) or now,
Geodon 10-20 mg IM or Ativan IM
11. Delirium vs. Dementia
• A common problem in the US
– 5% of those over 65 have severe dementia, 15%
have mild dementia
– 20% those over 80 have severe dementia
– One of first distinctions you must make is
reversible from nonreversible.
– Only about 10-15% are reversible
12. Delirium vs. Dementia
• Nonreversible does not mean non treatable!
• Non reversible dementias-
– Alzheimer’s is most common by far, accounting for
about 70% of dementias.
– See a tempero-parietal wasting at first, leading you to
see the memory loss and speech problems first. The
“lost keys”sign.
– Then will progress to global atrophy of brain.
– Genetics a risk factor (up to 35-40% patients have a
family history of Alzheimer’s
13. Dementia
• Reversible:
– D= Drugs, Delirium
– E= Emotions (such as depression) and
Endocrine Disorders
– M= Metabolic Disturbances
– E= Eye and Ear Impairments
– N= Nutritional Disorders
– T= Tumors, Toxicity, Trauma to Head
– I= Infectious Disorders
– A= Alcohol, Arteriosclerosis
15. Dementia
• Irreversible:
– Alzheimer's most common type of irreversible
dementia
– Multi-Infarct dementia second most common type of
irreversible dementia
• Death of cerebral cells
• Blockages of larger cerebral vessels, arteries
• More abrupt in onset
• Associated with previous strokes, hypertension
• Can be traced through diagnostic procedures
16. Dementia
– Lewy Body Dementia
• Episodic confusion with intervals of lucidity with at
least one of the following:
1. Visual or auditory hallucinations
2. Mild extrapyramidal symptoms (muscle rigidity, slow
movements
3.Repeated unexplained falls
• Progresses to severe dementia—found at autopsy.
17. Dementia
Diagnosis of Frontemporal Dementia (Pick’s
Disease)
Pick’s bodies in cells.
Personality changes
Behavioral dis-inhibition.
Loss of social or personal awareness.
Disengagement with apathy
Maintain ability to draw and calculate well into later
stages
18. Alzheimer's Disease
• Estimated that 4,000,000 people in U.S.
have Alzheimer's disease.
• Estimated that 25-35% of people over age
85 have some time of dementia.
• After age 65 the percentage of affected
people, doubles with every decade of life.
• Caring for patient with Alzheimer's disease
can cost $47,000 per year (NIH).
19. Changes Caused by Alzheimer's
• Diminished blood flow
• Neurofibrillary Tangles
• Neuritic Plaques
• Degeneration of hippocampus, cerebral
cortex, hypothalamus, and brain stem
21. Compare central sulcus of
Alzheimer’s patient with normal
81 year old woman
From Whole Brain Atlas at http://www.med.harvard.edu/AANLIB/home.html
22. 74 year old AD patient: reduced blood
flow on SPECT in temporal areas
23. Normal vs AD Brain
Normal brain Alzheimer’s brain
24. AD Prognosis
• Alzheimer’s has a slowly progressive
decline. These meds can slow the
progression, NOT halt it.
Time
Function
25. Pick’s disease
• 25 times rarer than Alzheimer’s dementia
• Frontal lobe clinical features
• Assymetrical frontal or temporal atrophy
• Has been connected with semantic
dementia, but evidence is not conclusive yet
26. Case history: Pick's Disease
This 59 year old woman had a three year history of a
progressive alteration in social behavior which included
apathy and occasional disinhibition. Images reveal severe
focal shrinkage of temporal and frontal lobes bilaterally.
27. Degeneration of the basal ganglia
• Huntington’s disease
– Rare: 5 in 100,000
– abnormal ‘exaggerated movements
• Parkinson's disease
– Common: 1 in 100 over age 65
– General slowing of voluntary movements
• Both diseases involve the basal ganglia, but
in large opposite ways
31. Viral dementia: HIV
• 20-60% of HIV patients suffers from
dementia
• Cerebral atrophy may be caused by
microglial nodules
32. Vocational Rehabilitation and
Dementia
• Can dementia occur while an individual is
employed?
• Is dementia covered under the American’s with
Disabilities Act?
• Can jobs and tasks be modified to assist
individuals with mild forms of dementia?
• Can job discrimination occur for these
individuals?
• What types of job modifications and/or assistive
technology can you think of for an individual with
dementia?
33. End-stage Dementia
Prognosis < 6 mos:
• Severe dementia with need for total assistance in
ADLs (dressing, bathing, continence), unable to
walk, only able to speak a few words
• Comorbid conditions – aspiration pneumonia,
urosepsis, decubiti, sepsis
• *Unable to maintain caloric intake with weight
loss of 10% or more in 6 months (and no feeding
tubes)
34. Complications from dementia
• Delusions in up to 50%, most with paranoia
• Hallucinations in up to 25%
• Depression, social isolation may also occur
• Aggressive behavior in 20-40% (may be related to
above problems, misinterpretation)
• Dangerous behavior – driving, creating fires,
getting lost, unsafe use of firearms, neglect
• Sundowning – nocturnal episodes of confusion
with agitation, restlessness
35. Treatment of complications
• Hallucinations, delusions, agitation, sun-downing may be
improved with anti-psychotics like haloperidol, risperdal,
mellaril…
• If any signs of depression, may be beneficial to treat
• Anxiety may respond to benzodiazepines
• Behavioral mod – reinforce good behavior, DON’T fight
aggressive behavior
• Familiarity (change in environments make things worse)
• Safety – key locks, knobs off stoves, take away car
keys/cigarettes/firearms…, lights, watch stairs
• Avoid restraints, use human contact/music/pets/
distraction
36. Artificial Nutrition in Dementia
• Many excellent reviews demonstrate no
improvement in quality of life and quantity
of life with G-tubes.
• 5% morbidity and mortality with the
procedure itself
• No decrease in aspiration with them
• Risk of infection
• Can keep patient comfortable without it
37. Complications from dementia
• Delusions in up to 50%, most with paranoia
• Hallucinations in up to 25%
• Depression, social isolation may also occur
• Aggressive behavior in 20-40% (may be related to
above problems, misinterpretation)
• Dangerous behavior – driving, creating fires,
getting lost, unsafe use of firearms, neglect
• Sundowning – nocturnal episodes of confusion
with agitation, restlessness
38. Drug treatment in Alzheimer’s
disease
• Many drugs aim to stimulate the cholinergic
system
• These drugs have limited positive effects
and do not reverse the causes of AD
39. Dementia patients are very
sensitive to additional disabilities
• Illness
• Pain
• Medications
• Poor hearing
• Poor vision
40. Management of depression at end
of life
• Psychotherapy – behavioral, cognitive, and other
supportive approaches by psychologists, licensed
social workers, chaplains, even bereavement
counselors may help
• New coping strategies like meditation, relaxation,
guided imagery, hypnosis may help
• Medications
41. Suicide
• Women attempt it twice as much, but men are 4x more
likely to succeed
• White men over 85 are at highest risk to do it
• All patients with depressive symptoms should be assessed
for it
• Talking about it can decrease risks
• High risk of attempt if thoughts are recurring or if have
thought out the plan
ONE OTHER POTENTIAL EMERGENCY:
• If risk high – DON’T leave client alone, immediately
consult a psychiatrist – may need in-patient care or
involvement of authorities
42. Anxiety
• May be a normal response to the situation – fears,
uncertainty, reaction to physical condition, social
or spiritual needs
• Usually with 1 or more of the following signs –
agitation, restless, sweating, tachycardia,
hyperventilation, insomnia, excessive worry,
tension
• Look for signs of depression, delirium,
alcohol/drug abuse, caffeine abuse
• About 5% are affected by agoraphobia
43. Related anxiety conditions
• Panic attacks – acute onset of palpitations,
sweating, hot, shaking, chest pain, nausea, dizzy,
derealization, fear, numbness; usually short lived
• Phobias – fears with avoidance, feelings of being
trapped, exposed
• Post-traumatic Stress Syndrome – in response to
severe trauma, get more intense fear, terror,
dreams, feelings of helplessness, detachment that
can occur later on
44. Other EOL care needs for dementia
• In bedbound, watch out for and prevent decubiti
• Feeding instructions to prevent aspiration – head
up, chin tucked, thick consistency foods like
pudding/jello/ice cream…
• Caregiver stress – difficult care, poor sleep,
education to prevent aggressive behavior, early
bereavement losing loved one before they are
gone, need for support/respite
45. Summary
• A change in mental or emotional status of the
patient is not uncommon with a life-threatening
illness
• Need to be aware of conditions that may be
normal reactions or have causes that are
potentially reversible, but at the end of life, may
need to focus on acute management of these
conditions
• Need compassionate, supportive care for patient
and caregiver, always addressing safety
46. Links
• Alzheimer’s Association: http://www.alz.org/
• National Institute of Neurological Disorders
and Stroke’s page on dementia:
http://www.ninds.nih.gov/disorders/dementias/dementia.
• How to manage difficult behaviors from the
Association for Frontotemporal Disorders:
http://www.ftd-picks.org/?p=caregiver.managing