Dementia is a chronic organic brain syndrome characterized by a gradual progressive often irreversible loss of intellectual capacities, resulting from structural changes in the brain.
Causes of Dementia
- idiopathic
- hereditary
- nutritional deficiencies; lack of vit B1 and B6
- Trauma; epilepsy, head injury
- Toxic substances
- neurodegeneration
- neoplastic
- untreated condition that gives rise to acute confussional states.
Types
This disease condition can come in two types;
1. Presenile: occurs before 65 years of age
2. Senile: occurs above 65 years of age
1. Presenile
This occurs before 65 years of ages. It can be caused by;
huntinton’s chorea
this type has 50% chance of inheritance. The foci of pathology is the basal ganglia. It is characterised by memory loss jerky movement from one part of the body to another resulting in constant motion termed St. Vitus Dance
Pick’s Disease
it is characterized by a stiff gait on walking, abrupt mood changes, impulsiveness/ lack of inhibition.
Alzheimer’s disease
this is precipitated by a general atrophy of the brain. It is characterised by memory loss, forgetfulness, loss of interest in activities previously enjoyed, deterioration in social skills, emotional unpredictability
General Signs and Symptoms of Dementia
- Impaired intellectual functioning
- Amnesia
- Confabulation
- Diminution of awareness
- Dis-inhibition e.g spontaneous undressing with no regard to privacy, physical and verbal aggressiveness, inappropriate sexual overtures to friends/family members.
- functional psychotic symptoms such as delusion, hallucinations, emotional liability, depression, wandering tendencies.
General management
There is no definite cure for Dementia, rather palliative measures are employed to best manage them
A. Medical Care
- Chemotherapy
- anxiolytics/antipsychotics
- other somatic drugs
- speech therapy
B. Nursing Management
- Admission; brief periods of admission to hospitals may ne necessary in severe cases, and to relief burden on family
- physical care; personal hygiene, care of excretory channels, meeting food/nutritional need, active and passive exercise
- psychological care; spend time to converse with patient, show sympathy/understanding, encouragement and give patient both physical and mental dependence
- social care; involve family, friends, religious groups in his/her ,management. Encourage patient to partake in religious activities.
- Special Care; This is aimed at main;y promoting physical safety.
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