Final Clinical Quiz

Dementia is a part of normal aging.

Normal aging forgetfulness does not affect one’s ability to function.

List 6 early signs and symptoms of dementia.

List 5 common problematic behaviors seen in individuals with dementia.

What is dementia?

Which of the following statements are true?

1. Which of the following statements are true?
   1. Alzheimer’s Disease is the 6^th leading cause of death in United States
   2. 5.8 million Americans are living with Alzheimer’s
   3. In 2019, dementia will cost the nation $290 billion
   4. Alzheimer’s is the only top 10 cause of death in the US that cannot be prevented, cured or even slowed
   5. $350,174 is the approximate lifetime cost of care for an individual living with dementia in 2019
   6. All of the above

There are 16+ million caregivers in the US who provide 18.5 billion hours unpaid care for individuals with dementia valued at $234 billion.

Identify three (3) causes of temporary reversible dementia.

The cost of care for individuals with chronic diseases like diabetes, COPD, coronary heart disease, cancer and stroke is almost doubled when dementia is added.

Chronic conditions never exacerbate the progression of dementia.

Identify the four (4) types of communication.

Dementia is a mental disease

Psychiatric conditions may play a role in behaviors and medical symptoms seen with dementia.

Individuals with dementia who fall are 5 times more likely to be hospitalized or live in a long-term setting than individuals with dementia who do not fall.

An individual with dementia who has a sudden change in behavior may have a UTI.

What are five (5) outcomes of poor communication?

60-85% of the elderly with dementia have at least three (3) other chronic diseases.

What is Motivational Interviewing?

Identify four (4) commonly seen and widely prescribed medications that have negative effects on the aging brain.

What percentage of the individuals with dementia are not diagnosed?

Anticholinergic drugs can exacerbate and even cause symptoms of dementia.

Approximately half of all dementia patients routinely receive contraindicated medications.

Problematic behaviors seen with dementia often are the result of an unmet need.

What is communication?

Identify five (5) symptoms of care partner stress.

It is important to understand whether or not the caregiver is ready to make changes.

What are the SMART goals for behavior change?

 Anticholinergics are used to treat various medical conditions that involve contraction and relaxation of muscles.

Identify five (5) health consequences of care partner stress.

The care manager utilizes Motivational Interviewing to help the care partner identify areas of stress or concern, and subsequently create goals to overcome issues.

Providing rewards to the care partner can reinforce positive progress towards goals.

The AlzBetter program focuses only on managing and caring for a dementia patient in the home.

Care Managers can send AlzBetter behavior specific videos to care partners and family members to help them understand how to deal with problematic behaviors.

Identify five (5) conditions that can complicate health management of an individual with dementia.

The effects of anticholinergics on individuals with cognitive issues are short term and always reversible.

The AlzBetter program is compatible with and supportive of,  mental health treatment for individuals with low and moderately severe conditions.

What are the five (5) categories of activities used to create a structure and meaningful day?

The Targeted Stress Assessment is a useful tool to help the caregiver identify the cause and level of stress there are experiencing.

The Caregiver Readiness to Change Worksheet is a tool to assist the Case Manager in determining if the caregiver knows and acknowledges that the family member has dementia.

How can the care manager identify and offer help for managing care partner stress?

For someone with memory loss and cognitive decline, providing purpose and creating structure is essential.

Without activities, there is often boredom, which can lead to problematic or undesirable behaviors.

What activity is able to connect with people even in the advanced stages of the disease because it exists in the area of the brain the goes unaffected by dementia?

Identify three (3) common challenges or barriers with the care partner that the Care Manager may run into.

Identify five (5) types or causes of irreversible dementia.

Alzheimer’s Disease accounts for 60-80% of all dementia.

By 2050, 14 million Americans are projected to be living with Alzheimer’s Disease.

What is a fiblet or therapeutic fib?

Dementia is a loss of both memory and the ability to ___________________?

The cost of dementia is more than financial to families. Identify other types of costs.

To be successful in caring for an individual with dementia, the care partner has to be willing to go where the person is in his/her disease, join the journey.

Workforce ratio trends support the need for family care partner training and support.

Please review the following actual patient scenario, identify needs and potential solutions and what AlzBetter tools you would utilize to better manage this situation.

James is a 92-year-old retired cook with late mid-stage Alzheimer’s. He also has diabetes and hypertension.  Care Partner is checking patient’s blood pressure twice a day, but does not have a glucometer to check his blood sugar levels. Care partner manages James’ medications. She states patient is forgetful, agitated and appears depressed sometimes.  She states that the patient has poor personal hygiene and is noncompliant with bathing and diabetic foot care. He still dresses himself, but has started sleeping in his clothes and doesn’t understand why he needs to change.

Patient is still active and wants to help with cooking, raking leaves, taking out the garbage, getting the mail, all kinds of things, but he is a fall risk and has fallen twice in the past six months. Patient no longer knows how to use the stove, although he occasionally tries to. Caregiver states that patient becomes disoriented, hides things, has accused her of stealing his things.

He often wakes up at night  feeling shaky, emotional, nauseous. Once the care partner found him awake in his room at 1 a.m. arranging his shoes. Patient has started to exhibit wandering tendencies. For example, he has started walking out of church during services, away from care partner and into the parking lot.  Patient used to read the daily paper,  but has recently stopped as though he has lost interest. He no longer knows how to use the phone.

The care partner is the patient’s god daughter.  She runs her own business and is also very active in her church.  Care partner states she has sarcoidosis and is not allowed to do heavy lifting.  She complains that she is often kept from church responsibilities because of James. Patient is very attached to the care partner; she has had trouble finding people he is willing to stay with, or who will stay with him. She has left him home alone for brief periods of time when she has had no other option. She is very disgusted by the patient’s feet and reluctant to perform diabetic foot care duties.