Caring For a Person with Confusion and Dementia (Part 1)

צוות iSavta | 13.11.2019

Aging and certain diseases cause changes in the brain. No matter the cause, changes in the brain can affect a person's cognitive function. Cognitive functioning relates to memory, thinking, reasoning, ability to understand, judgment, and behavior. Quality of life is affected by a person’s cognitive functioning.

CONFUSION:

Confusion has many causes. Diseases, infections, hearing and vision loss, and drug reactions are causes. So are brain injury and aging. With aging, there is reduced blood supply to the brain and progressive loss of brain cells. Personality and mental changes may result. Memory and the ability to make good judgments are lost. A person may not know people, the time, or the place. Some people slowly lose the ability to perform activities of daily living. Behavior changes are common. The person may be angry, restless, depressed, or irritable.

Acute confusion (delirium) occurs suddenly and is usually temporary. Causes include infection, illness, injury, drugs, and surgery. Treatment is aimed at the cause of the confusion.

Confusion caused by physical changes cannot be cured. Some measures help to improve the person’s functioning. The person’s physical and safety needs must be met.

DEMENTIA:

Dementia is the loss of cognitive function caused by changes in the brain. De means from. Mentia is from the Latin word for mind. Early warning signs are:

Recent memory loss that affects job skills.
Difficulty with familiar tasks (Ex: dressing, cooking, driving)
Problems with language: forgetting simple words.
Getting lost in familiar places.
Misplacing things and putting things in unusual places (Ex: putting a watch in the oven).
Personality changes.
Poor or decreased judgment (EX: going outdoors in the snow without shoes).
Loss of interest in life.

Some dementia’s can be treated. Treatable causes include drugs, infection, and depression. Parkinson’s disease and cerebrovascular disease cause permanent changes in the brain. Multi-infarct dementia (MID) is caused by many strokes. The stroke leaves an area of damage. Alzheimer’s disease is the most common type of permanent dementia. Permanent dementia’s have no cure. The loss of cognitive function becomes progressively worse.

Pseudodementia means false (pseudo) dementia. The person has the signs and symptoms of dementia. However, changes in the brain do not occur. This can occur with depression.

DELIRIUM AND DEPRESSION:

Delirium and depression can be mistaken for dementia. Delirium is a state of temporary but acute mental confusion. It occurs suddenly. Delirium is common in older persons with infections, heart and lung diseases, poor nutrition, and hormone disorders. Hypoglycemia, alcohol and drugs are other causes. Signs and symptoms include anxiety, disorientation, hallucinations and delusions. The person may have tremors and disturbances in attention. Level of consciousness may decline. The person needs emergency care.

Depression is a common mental health problem in older persons. It is often overlooked. Depression, aging, and side effects of some drugs have similar signs and symptoms. They include sadness, inactivity, and difficulty thinking and concentrating. The person may have feelings of despair, problems sleeping, appetite changes, fatigue, and agitation.

Source: Assisting with Assessment in Caregiving