1.mild dementia: disoriented to time2.moderate dementia: time and place3.severe stage: self.Visual hallucinations are most common and generallyunpleasant..Clients are likely to believe the hallucination is reality.
Judgment and InsightClients with dementia havepoor judgmentin light of the cognitive impairmentClients cannot evaluate situationsfor risks or danger.Insight is limited.
Self-Conceptclients may be angry or frustrated with themselves forlosing objects or forgetting important things.Some clients express sadness at their bodies forgetting old and at the loss of functioning.Clients lose that awareness of self, which graduallydeteriorates until they can look in a mirror and fail torecognize their own reflections
Roles and RelationshipsDementia profoundly affects the client’s roles andrelationships.1.work performance2.Roles as spouse, partner, or parent deteriorate.Eventually, clients cannot meet even the most basicneeds.
Physiologic and Self-CareConsiderationsClients with dementia often experiencedisturbed sleep–wake cycles: they nap duringthe day and wander at nightignore internal cues such as hunger or thirstbladder and even bowel incontinencefrequently neglect bathing and groomingEventually, clients are likely to requirecomplete care from someone else to meetthese basic physiologic needs
NURSING DIAGNOSES• Risk for Injury• Disturbed Sleep Pattern• Risk for Deficient Fluid Volume• Risk for Imbalanced Nutrition: Less Than Body Requirements• Chronic Confusion• Impaired Environmental Interpretation Syndrome• Impaired Memory• Impaired Social Interaction• Impaired Verbal Communication• Ineffective Role Performance
Outcome IdentificationTreatment outcomes for a client with dementia mayinclude the following:• The client will be free of injury.• The client will maintain an adequate balance of activity and rest,nutrition, hydration, and elimination.• The client will function as independently as possible given his orherlimitations.• The client will feel respected and supported.• The client will remain involved in his or her surroundings.• The client will interact with others in the environment.
InterventionInterventions are rooted in the belief that clients with dementiahave personal strengths.They focus on demonstrating:1.Caring2.keeping clients involved by relating to the environment andother people3.validating feelings and dignity of clients by being responsive tothem4.offering choices, andreframing(offering alternative points ofview to explain events).Education for family members caring for clients at home
Promoting the Client’s SafetySafety considerations involve:1.
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