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Module #5 
Dementia & Alzheimer’s Disease

Module #5 focuses on care for patients with dementia or Alzheimer’s disease. Dementia is a general term for a decline in mental ability severe enough to interfere with daily life, while Alzheimer’s is a specific disease. Alzheimer’s is the most common cause of dementia.

Read carefully because at the end of this module is a quiz required for successful completion of this module.

There are 10 questions and 5 minutes to complete. A passing grade is 70%; you must get 7 or more answers correct.  You have 8 chances to pass this module. 

Remember that you must successfully pass 12 in-service modules/year to meet the requirements for home health.

In-Service Exams provided by Essential In-Services for Home Health, 2021

Upon completion this module, you should be able to:

Know the definition and symptoms of dementia.

Understand the relationship between Alzheimer’s disease and dementia.

Know the importance of trying to understand what a patient with dementia is thinking and feeling.

Know some good ways to respond to difficult behavior.

Understand the difficulties faced by someone with dementia.

Dementia is an organic mental disorder involving a general loss of intellectual abilities and changes in personality (organic in the sense means the disorder is caused by physical changes in the brain).

Dementia is a brain disorder that seriously affects a person’s ability to carry out daily activities. It involves the parts of the brain that control thought, memory and language. Healthy brain tissues die or deteriorate, causing a steady decline in memory and mental abilities.

Alzheimer’s disease is the most common form of dementia with 60-80% of dementia being diagnosed as Alzheimer’s. Approximately 5.7 million Americans have Alzheimer’s. It is the 6th leading cause of death in the United States. Late onset Alzheimer’s occurs after age 65 and is the most common type.

Early-onset is an inherited genetic disorder where there is agene mutation of the chromosomes. A child whose biological parent carries the genetic mutation has a very strong probability of developing early-onset Alzheimer’s. Researchers have found that patients with certain variations of a gene known as APOE can increase the risk of Alzheimer’s disease by up to 12 times that of a normal APOE gene.

Many other different disorders can cause dementia. Vascular dementia which often occurs after a stroke is the second most common type of dementia. Other diseases may cause symptoms of dementia, which may be reversible. This includes thyroid crisis, vitamin deficiencies, Parkinson’s disease, brain tumor, head injury, and alcoholism. Researchers have found that people with Alzheimer’s have lower levels of the chemicals that carry these important messages from one brain cell to another. In addition, people with Alzheimer’s have many damaged or dead nerve cells in areas of the brain that are vital to memory and other mental abilities. Although the person’s mind still contains memories and knowledge, it may be impossible to find and use the information in the brain because of Alzheimer’s.

Abnormal structures called plaques and tangles are other characteristics of Alzheimer’s:

  • Plaques. It is believed that plaque deposits form between brain cells early in the disease process.
  • Tangles. This refers to the way that brain cells become twisted, causing damage and nerve cell death.

These structures block the movement of messages through the brain, causing memory loss, confusion and personality changes.

Symptoms can vary greatly, but at least two of the core mental functions below must be significantly impaired to be considered dementia.

  • Memory
  • Communications and language
  • Ability to focus and pay attention
  • Reasoning and judgment
  • Visual perception

You will recognize the following signs in many patients with dementia.

Memory loss:

  • Increasing and persistent forgetfulness
  • Affects recent memories the most
  • Makes it difficult to learn anything new or to follow instructions

Attention loss:

  • Unable to start or stop a task. 
  • Pacing and agitation. 
  • Easily distracted.

Loss of perception or senses:

  • Unable to recognize things or people. 
  • Misinterpretation of what is seen, heard or felt.

Language loss:

  • Makes it difficult to recognize words and understand complex sentences.
  • Makes it difficult to express ideas.
  • May use inappropriate words or curse words.

Judgment loss:

  • Cannot accurately assess circumstances that may be dangerous. 
  • Unable to see the consequences of actions.
  • Difficulties with abstract thinking or complex tasks.

Loss of muscle organization:

  • Unable to perform multi-step tasks. 
  • Requires prompts or cues for routine tasks.
  • Difficulty performing familiar activities such as brushing teeth or bathing.