Delirium poses many risks to the elderly population. This condition has been associated with "increased mortality, long-term cognitive decline, and loss of autonomy" (Kukreja, Gunher, & Popp, 2015, p. 655). The course of delirium is acute, and without accurate differentiation and intervention, outcomes can be deleterious (Resmick, 2016). This research question will focus on exploring the care team's knowledge about delirium prevention and assessment and its contribution to outcomes. The boolean search was completed by using search phrases delirium, assessment tools, evidence-based practice, guidelines, elderly. The AND operator was used mostly to find information related to both search terms. This tactic was used to explore the …show more content…
According to Resnick (2016), there are recommendations of care that are supported by the National Institute for Health and Clinical Excellence (NICE). However, these guidelines are not enough. As a result, it becomes imperative to understand how to recognize delirium and develop a culture of care that consistently implements processes that prevent its occurrence. While the awareness and understanding of its impact can influence its recognition, a broader system-wide approach needs to become integrated into the daily practice of geriatric patients to sustain consistent outcomes and improvements in care. The treatment options should be prefaced with knowledge sharing and education surrounding the topic of delirium with the care team. Education will need to include assessment, prevention, and management (Trogrlic et al., 2015, p. 15). Assessment components will need to include an evidence-based tool that is appropriate for the population and applies to patients with and without cognitive impairments (Voyer et al., 2015). Preventive processes need to be taught, understood, and operationalized. This would include identification of reversible causes and risk factors, optimization of medications and elimination of inappropriate medications, integration of family, and team collaboration (Resnick, 2016). Management options will need to include treatment of electrolyte abnormalities, visual screening and correction for an identified impairments, ear aids, bowel
Simon Douglas is a clinical research nurse at the Wolfson Research Centre in Newcastle upon Tyne. He is currently coordinating a number of studies, particularly on dementia in nursing and residential homes and providing input into a new trial of non-pharmacological interventions for dementia. Ian James is a consultant clinical psychologist at the Centre for the Health of the Elderly at Newcastle General Hospital and a
Over one-third of the surgeries in the United States are performed on patients aged 65 and older, and delirium is one of the most common postoperative complications in this population. Despite the high incidence of delirium, the syndrome often goes undiagnosed. Postoperative delirium is associated with adverse functional and cognitive outcomes, increased hospital length of stay, cost of care, and mortality rate. Knowledge of the risk factors that predict postoperative delirium will aid early identification of the patients at highest risk in order to facilitate preoperative optimization by managing comorbidities or employing targeted prevention strategies.
Nearly 135 million people worldwide will be impacted by dementia by 2050 (Robinson, Tang, Taylor,. 2015). Dementia is not a disease, it is an overall term that describes a wide range of symptoms associated with the decline in memory and thinking skills. Dementia is a progressive illness that results in the loss of one’s sense of self (Burns, Byrne, Ballard, Holmes, 2002). The two most common forms of dementia are Alzheimer’s disease and Vascular dementia. Dementia is progressive and people with dementia experience complications with short-term memory, keeping track of personal items, paying bills, taking care of themselves and daily tasks (Haigh, Mytton, 2016). Due to the rising number of individuals developing dementia, it is causing major challenges in the healthcare systems and society (Angermeter, Luck, Then, Riedel-Heller, 2016). Utilizing psychotropic medications are often ineffective or harmful to the individual, therefore, many patients decide to utilize sensory therapy as a form of treatment instead (Livingston, Kelly olmes, et al., 2014). Caregivers of individuals with dementia can also experience health consequences related to caregiving at the end of life. Spousal caregivers are 40.5% higher odds of experiencing frailty as a result of caregiving (Carr, Dassel, 2017). Dementia does not only affect the individual, it affects those around them, society, and the healthcare system.
Excited delirium syndrome is a rare but dangerous disease generally recognized by agitation, aggression, disorientation, and sometimes sudden death. Often associated with drug usage. There has been some documentation as early as the 1800s, but it manly started to come back around in the 1980s. These patients will often need to be restrained, usually by law enforcement, and pose a great danger to the crew’s safety until restrained and sedated. Excited deliriums cause is somewhat unknown. There is much conflict from researcher’s on the why and how.
More than 5 million Americans currently have dementia in the United States and this number is projected to rise to between 8 and 13 million by 2050 (Alzheimer’s Association, 2015). Dementia is known to become more prevalent with age, increasing from 5 to 10 percent in people over 65 years of age to almost one half of people over the age of 85 (Alzheimer’s Association, 2015). Although family members provide the majority of care for people with dementia, increasing needs over time often lead to placement in a long-term care setting. Dementia is the most common reason for entry into long-term care facilities (Zimmerman, 2013) and nearly 90% of persons with dementia will have at least one stay at a nursing home in their lifetime (Grunier, 2007).
Substance abuse continues to be a serious health care concern with millions of American 18 and older using illegal drugs. Substance abuse occurs across all generations, cultures, and occupations, including nursing. “About 1 in 10, or 10-15% of all nurses, may be impaired or in recovery from alcohol or drug addiction” (Thomas & Siela, 2011). When a nurse is impaired they will not be able to function at their normal capacity, and are not able to provide quality patient care. They may not be able to think as quickly, and have a delayed reaction time.
Dementia is an extremely common disease among the elderly, with 4 million Americans currently suffering from the Alzheimer’s type alone. Figures show that 3% of people between the ages of 65-74 suffer from the disease, rapidly increasing to 19% for the 75-84 age bracket, and as high as 47% for the over 85s. Therefore, it is easy to see why Dementia is such a large part of many people’s lives, whether they are suffering from the condition themselves, or have an elderly relative who requires full time care just to undertake simple day to day tasks. The disease can be extremely traumatic for the patient and their families, as the person, who may have been extremely lively and bright throughout their
“Fall may be defined as an unexpected event in which the person comes to rest on the ground, floor, or lower level” (Struksness, Lindström, Lord, Slaasletten, Johansson, et al., 2011). In older populations, falls are quite common, but with a mental illness such as dementia, the problem is worsened. This cross-sectional study showed that the most common causes of falls reported by nursing staff were individual factors like physical impairment and mental impairment.
As people get old a few of them will experience changes in cognition with age related capacity rather than intellectual capacity. There are some people who get both disparities of mentally and physically impaired that will led into depression due to aging process of their body. Even though, the forgetfulness is a common among older adults, we as healthcare providers must evaluate altered mental status of the patients. “The evaluation and management of altered mental status are broad and require careful history and physical examination to eliminate life-threatening situations”(Patti & Dulebohn, 2017). Therefore, it is very important to recognize the importance of difference between normal age-related symptoms and developing new health problems that can arise in this specific population. As elders get older their memory lapses it frustrating to them leading them to be more worried about changes in their memory. Nurses have a unique capability to promote a cognitive health and determine the possibilities of potential cases of the impairment in elders. The movie “On Golden Pond” Mr. Norman was a perfect example and showed that his symptoms were interfering with his everyday live when he almost burns down the house with fire, calling Bill by his daughter’s name Chelsea and getting lost in on the lake. Even though, Mr. Norman had heart and dementia problems his wife never discouraged him to do what he liked such as
Delirium, Depression, and Dementia are some of the most common psychological diagnoses in the elderly today. The three D’s are difficult to differentiate between in older adults because they overlap with each other and can all exist in the same patient at once. Delirium, Dementia, and Depression all affect the elderly’s quality of life and often increase the risks for one another (Downing, Caprio & Lyness, 2013). For the purpose of this paper I will be focusing primarily on the diagnosis of Dementia, the prevention, and nursing measures associated with it, but first I would like to differentiate between Delirium and Depression because Dementia is often associated with the two in the older adult population.
Providing care for a person with dementia is like being on a roller coaster ride that never ends and the ride can make the caregiver sick. In order to discuss dementia caregiving, a definition of dementia and the impacts of dementia are needed. Dementia is the generic term used by health care professionals to describe a person’s symptoms of memory and judgment issues (Alzheimer’s Association, 2015b) and furthermore is a growing problem in the United States of America (USA) and around the world. Currently 5.3 million people in the USA have been diagnosed with Alzheimer’s or other dementias, and dementia numbers are expected to increase by 40% in the next decade (Alzheimer’s Association, 2015a). Dementia care is
During my first clinical rotation as a nursing student, I was assigned to care for several older adults suffering from dementia. Although all of my patients ranged in severity from mild to severe progression of dementia, they all experienced moments of agitation, anxiety, or disturbed behaviors related to their disease. It occurred to me after careful review of several patient charts that despite often being prescribed pharmaceutical regimes for other comorbidities, these patients were rarely prescribed medications, besides those to control anxiety, specifically targeted at treating their progressing dementia. Through some research I discovered that the significant number of individuals affected with dementia is a growing public health concern in part due to the current limited ability of pharmaceutical treatments to treat the disease (Samson, Clement, Narme, Schiaratura, & Ehrle, 2015). This revelation began my interest in current nonpharmacological treatments being implemented in controlling adverse behaviors and feelings in patients diagnosed with dementia.
Mr McCue says that he is drinking more often in an attempt to get a better night sleep. However Vinson (2010) believes this could hinder the patient’s sleep pattern (Vinson et al, 2010). Furthermore he goes on to say that drink can initially help the person sleep but as the drinking becomes more intense it becomes a dependent, where restless sleep is common and trying to get back to sleep is ineffective (Vinson et al, 2010). Moreover Stein (2005) agrees and says alcohol has a massive effect on sleep and the distribution of sleep. He acknowledges that alcohol can be seen as a sedative to some. However like Vinson (2010) acknowledges the more alcohol that is being consumed insomnia is likely to become a feature in the sleep pattern. Moreover he goes on to say that if the nursing staff is alerted to this in a timely fashion something can be done about it (Stein, 2005). In the care plan it has been shown in the assessment that he drinks alcohol to enhance sleep but nothing has been done to reduce this problem which may be linked to other factors. Moreover in the assessment it has been shown that he does not feel rested on been wakened. Stein (2005) says this can be due to the alcohol it has a greater effect on the brain and causes a dependence on the alcohol which in return disturbs sleep and can leave people to feel un-rested and moody(Stein & Friedmann, 2005). Stein (2005) and Vinson (2010) both
at the time of your visit. We have divided the DGA in two parts, each with three