DEMENTIA AND DELIRIO

Cognitive impairment and dementia are among the issues most important public health in developed countries.

Until recent years, mild cognitive impairment to be related to the aging process itself and was detected in advanced stages of disease. Today, it was determined that these patients be evaluated increasingly early stages and therefore achieves influence the course and the social environment of the patient and family.

The nurse should influence the cognitive symptom onset, rate of progression, recent exacerbations and related factors, history and presence of accompanying psychiatric symptoms, drugs and toxic substances that use or have used, personality changes, impact on ADL and IADL, ceased activities ago, accompanying neurological symptoms and family history of dementia.

Nursing has several scales for a proper assessment of a patient's cognitive impairment. We must make an exhaustive valuation to rule neurological pathologies and to be able to provide appropriate care and treatment.

Here some of the scales more used in this area:

MMSE: examines orientation, attention, calculation, immediate and delayed memory, visuospatial ability, language and constructive ability.

To increase its predictive value is recommended to correct the score depending on the age and educational level

MIS is a short test (passed in four minutes) that explores memory, with four items and facilitated free recall

Test 7 minutes: contains a selection of subtests that explore key issues that are altered in Alzheimer's disease.

Cued recall test, fluency by categories, temporal orientation test and drawing a clock.

I attached a video here really get emotional me one day I saw it. It's about the feelings experienced by a son whose father has Alzheimer's disease:

ALZHEIMER, UN RETO AL CARIÑO

Relevant Practice Guidelines

American Academy of Neurology: Detection of Dementia, Diagnosis of Dementia, Management of Dementia, and Encounter Kit for Dementia: http://www.aan.com/go/practice/guidelines

 American Association of Geriatric Psychiatry: Position Statement: Principles of Care for Patients with Dementia Resulting from Alzheimer’s Disease: http://www.aagponline.org/prof/position_caredmnalz.asp

 Alzheimer’s Foundation of America (AFA): Excellence in Care: http://www.alzfdn.org

REFERENCES:

Kane R, Oustlander J, Abrass . Geriatría Clínica. 4ª ed. México: McGraw-Hill Interamericana; 2001

Sociedad Española de Enfermería Geriátrica y Gerontológica. Cuidados enfermeros en la atención a las demencias. Documento técnico SEEGG Nº2 Mayo 2003