Chapter 5: Confusion, Dementia, and Alzheimer’s Disease
Confusion, dementia, and Alzheimer’s disease are conditions that affect how residents
think, remember, and function in daily life. While confusion may be temporary and
caused by issues such as infections, dementia and Alzheimer’s are progressive and
impact memory, judgment, and independence.
Nursing assistants play a critical role in supporting residents by using calm
communication, creating safe environments, and encouraging independence whenever
possible. This chapter provides practical strategies for understanding behaviors,
promoting dignity, and responding effectively to the challenges residents face.
Understanding Confusion and Cognition
• The ability to think logically and clearly is called cognition.
• Confusion can be caused by various medical issues. One cause may be a urinary
tract infection (UTI). Mental status change or change in behavior is usually the
first sign that an older adult has a UTI. Always report new or worsening confusion
to the nurse.
• When a resident is confused, the nursing assistant should stay calm and provide a
quiet environment.
Alzheimer’s Disease (AD) Basics
• Alzheimer’s disease (AD) is not a normal part of aging; it is a progressive disease.
Do not assume that all confusion, behaviors, or a mental status change is AD.
• Alzheimer’s disease: Residents often show the same signs at the same times of the
day or in similar situations.
• With AD, skills residents may have learned over a lifetime (like reading, eating, or
basic habits) are usually kept longer.
• Residents with AD should always be treated with patience, dignity, and respect;
not every symptom should be managed by doing things for them. We still want to
promote independence when possible.