3. Delirium
•A sudden onset (often within hours or a
few days) of disturbance in mental
abilities that results in a decreased
awareness of environment and confused
thinking
4. Symptoms
•Inability to stay focused
•Withdrawn from environment
•Poor memory, particularly of recent events
•Difficulty understanding speech
5. Symptoms
•Rambling or nonsense speech
•Difficulty reading or writing
•Restlessness, agitation, irritability/combative
behavior
•Disturbed sleep habits
8. Causes
•Poor nutrition, dehydration, chronic or terminal
illness
•Alcohol, drug abuse or withdrawal
•Pain medications (opioids)
•Sleep medications (hypnotics)
•Allergy medications (antihistamines)
9. Investigations
•Mental status assessment
•Physical and neurological exams
•Vision, balance, coordination and reflexes
•Brain-imaging tests (used when a diagnosis can't be
made with other available information)
10. Treatment
•Address any underlying causes or triggers
•Protect the airway, provide fluids and nutrition
•Assist with movement, treat pain, incontinence
•Keep oriented to the surroundings
•A calm, comfortable environment that includes
familiar objects from home
16. •Act on GABA receptors
•Binding results in opening chloride channels &
increased chloride conductance
•Influx of chloride ions causes a small hyper-
polarization therefore inhibiting the formation of
action potential
17.
18. •Drowsiness and confusion: most common side
effects
•Ataxia at high doses
•Cognitive impairment, early morning
insomnia
22. Dementia
•Not a specific disease
•Group of symptoms affecting thinking &
social abilities severe enough to interfere with
daily functioning.
•Alzheimer's disease is most common cause
23. Dementia
•Gradual memory loss
•Impaired judgment or language, and the inability
to perform some daily activities
•Changes in personality and social behavior
•Some causes are treatable and even reversible
24. Symptoms
• Difficulty communicating, performing complex tasks,
planning and organizing
• Difficulty with coordination and motor functions
• Problems with orientation, such as getting lost
• Personality changes, inappropriate behavior
• Paranoia, Agitation, Hallucinations
25. Risk factors
• Age. Increases (especially after 65, not a normal part of aging), can occur in
younger people.
• Family history.
• Down syndrome. By middle age, many with Down syndrome develop plaques
and tangles in brain that are associated with Alzheimer's
• Diabetes. increased risk
• High estrogen levels. years after menopause, greater risk
• Obesity. Being overweight or obese during the middle life may increase risk
26. Risk factors
• Alcohol use. heavy alcohol consumption may have a higher risk
• Atherosclerosis. buildup of fats other substances in artery walls can reduce the
blood flow to brain and lead to stroke. Reduced blood flow to brain can also
cause vascular dementia
• Blood pressure. high or low both may increase risk.
• Cholesterol. high levels of LDL cholesterol, may have an increased risk of
developing vascular dementia or Alzheimer's disease
• Depression. not yet well understood, late-life depression, especially in men,
may be an indication for the development of Alzheimer's-related dementia.
27. Dementia-causes-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
37. Psychologist Role
Required for both patient & family
• Crisis intervention counseling
• Individual counseling
• Family therapy
• Group therapy
• Institutionalization
39. Differences between delirium and dementia include:
• Delirium occurs within a short time, while dementia
usually begins with relatively minor symptoms that
gradually worsen over time.
• Inability to stay focused or maintain attention is
significantly impaired with delirium
• A person in the early stages of dementia remains generally
alert
40. •Delirium symptoms can fluctuate
significantly and often throughout the
day
•People with dementia, memory and
thinking skills stay at a fairly constant
level during the course of a day
