Alzheimer’s and Delirium
| Delirium is Curable | Alzheimer's (No Cure) | |
|---|---|---|
| Risk Factors | Acute/Sudden onset that may last from hours to days Hospitalizations ICU Polypharmacy Old age Stroke Surgery Restraints Electrolyte imbalances Infection Substance Abuse | A decline of function that occurs from months to years. Part of the umbrella term of dementia Genetics Head Injury with lasting effects Advanced age Poor lifestyle (inactivity, obesity, & poor diet) |
| Symptoms | Disorientation that occurs mostly at night ↓ Memory Anxiety and agitation Delusional thinking Lethargy Hypervigilance | Symptoms occur through stages: Mild: memory lapses, misplacing things, poor focus, can still care for themselves. Moderate: Now symptoms noticeable to others. Personality changes. Gets lost and wanders. Can do some ADLs. Short-term memory loss Severe: Needs help with ADLs, unable to walk, swallow, and may eventually die. |
| Nursing Interventions | Safety first Prevent harm to self Avoid restraints  Meet physical needs Anti-anxiety & Anti-psychotics Treat the cause: O2 for hypoxia, antibiotics for infection | Complex care is required May need extended care Optimize nutrition, weight & fluid status. Maintain quiet environment Cholinesterase Inhibitors: Do not cure. Just help with symptoms: Donepezil (Aricept), galantamine (Razadyne), Rivastigmine (Exelon). They prevent an enzyme called acetylcholinesterase from breaking down acetylcholine in the brain. They are cholinergis. As a result, an increased concentration of acetylcholine leads to increased communication between nerve cells. Communication: Speak slowly. Give one direction at time. Don't ask complex or open ended-questions. Ask simple questions. Face client when speaking.  |