Nursing & Elderly: NEUROLOGICAL DISEASES, COGNITIVE IMPAIRMENT AND DEMENTIA

It is defined as "cognitive impairment and dementia in particular, is the most common neurological disease and disabling in the elderly patient. It is a public health problem of the first order, only after cancer and acute myocardial infarct"

The nursing staff plays a very important role in this type of disease, as it will account for a number of alterations and changes: start, attention, collaboration, movement, level of care ...

We will have to know the difference between: DELIRIUM, DEPRESSION AND DEMENTIA.

• Delirium: acute onset clinically characterized by impairment of consciousness, changes in cognitive functions (memory, language, thought, etc..) And perceptual disorders Very common in hospitalized elderly, to be attentive to this symptoms that may appear in our patients.

• Depression: Depression in the elderly is a widespread problem, but it isn´t a normal part of aging. Often not recognized or treated. The nursing staff plays a very important role in this pathology as it must contribute to the patient's emotional support serving a great support.

• Dementia: The aging process creates this condition, rather than a specific disease is a group of symptoms caused by changes in brain function, is chronic and degenerative, influencing both the quality of life of patients and the quality of life of the carer.

Highlights and attaches great importance to Alzheimer's within these "cortical dementias;". Alzheimer's disease is a form of dementia that gradually gets worse over time and affects memory, thinking and behavior.

It is characterized by a change in behavior, thinking, cognitive skills ... its definitive diagnosis is by histopathological study, and there is no cure, the goal of treatment in this disease will alleviate progress.

We will value the patient by "global scale of Reisberg detioration", The scale identifies seven (7) stages:

1. Normal;

2. Objectively normal, but complaints of mild memory loss; \

3. Mild cognitive impairment

4. Early Dementia

5. Moderate Dementia

6. Moderately severe dementia, and

7. Severe dementia.

According to the GDS, the ability to live independently is compromised from the fourth stage. "Complex Care" is the usual care for those in stages 6 or 7.

The rapidity with which the patient gets worse varies from person to person, usually develops rapidly and therefore worsen quickly.

NURSING ACT IN EACH STAGE AS FOLLOWS:

- Stage 1 mild. Determine when the patient needs help, keep feeding, his pattern sleep / rest, avoid stress ...

- Stage 2 moderate: Prevent injury, reduce incontinence, preservation activities, help to ADL as independent as possible.

- Stage 3 severe: to provide necessary care to protect their health and proper nutrition. Controlling the disposal / hygiene and recognize demonstrations of pain and fatigue.