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Dementia-a new understanding
The GP and/or family suspect dementia may be
present and refers patient for further assessment.
Full bloods to check if there is nothing else
Seniors Mental Health Team for a Hierarchical
Gradual changes. Build up of “tangles” in centre of
brain cells and “plaques” outside brain cells, disrupting messages within the brain.
– Problems of the circulation of blood to the brain eg.
– Degneration and death of nerve cells in the brain
caused by abnormal lumps inside nerve cells known as Lewy bodies
162,000 people in Aust over 65 estimated to have
By 2006- 195,000 over 65 with moderate to
In City of Albany- Sept-2002 estimated 296 people People as early as 30’s and 40’s.
– 65-69yrs about 1 in 70
– 75-79 about 1 in 18
– 80-84 about 1 in 9
Changes- Three stages. Known as early stage,
Cholinergic treatments offer symptomatic relief
for some people for a limited period of time
Available under PBS under certain conditionsAcetycholinesterase Inhibitor Drugs
– Donepezil Hydrochloride –Aricept– Rivastigamine-Exelon– Galantamine Hydrobromide-Reminyl– Ebixa
– When first taking them-GI, muscle cramps, insomnia,
fatigue, loss of appetite. Also dizziness and nightmares. Need to increase doses gradually
Communicating with someone with dementia
Remain calm and talk in a gentle, matter of fact
way (Determine level of understanding of person) Don’t be condescending.
Keep sentences short and simple, focusing on one
May need to repeat instruction many times.
Body language –made up of 55% of our
Avoid background noise and distractionValidation therapy-going into their reality!Reminiscence
Gather relevant history on patient, from
carer if required. Including social profile.
Note possible illnesses that may cause pain
and how this is expressed if comunication limited. Use of Pain Charts
dementia but do not make any assumptions of inabilities.find out what they can do
Allocate staff according to their skills and
Maintain independence –don’t assume they
cannot do own ADL’s. May need increased guidance as in unfamiliar environment
Minimise physical and chemical restraints
Inform carer of any changes to treatment
and medications. Where possible in writing.
Referral for follow up support –Use of
D- DementiaA- Advocacy and S-SupportN- NetworkI-international
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