NR 601 FINAL WK 7-8 DEMENTIA,
DELIRIUM, AD, GRIEF, PALLIATIVE,
HOSPICE EXAM QUESTIONS &
DETAILED CORRECT ANSWERS
Types of elder abuse
· Sexual abuse:sexual contact with a vulnerable elder without his or her consent
Types of elder abuse
· Physical abuse: causing physical pain or injuring a vulnerable elder
Types of elder abuse
Consider this? for those who present with unexplained STDs. Test for STDs if you suspect this?
sexual abuse
Types of elder abuse
· Exploitation: the taking of funds, property, or any assets of a vulnerable elder without legal
consent and not for the benefit of the elder
Types of elder abuse
· Neglect: failing to provide food, shelter, health care, or protection for a vulnerable elder
Types of elder abuse
· Emotional abuse: using verbal or nonverbal means to cause mental pain, anguish, or
distress in an elder
Types of elder abuse
· Exploitation: Who is most vulnerable to exploitation or more at risk for financial abuse Those
with diminished cognitive function
Types of elder abuse
· Self-neglect: the elder fails to perform the needed activities to protect his or her own health
and safety (lacks food/utilities, refuses medications, hoards, lives in unsafe conditions, neglects
,his or her grooming/appearance, is unable to handle finances, is isolated, is disoriented,
develops a dependence on drugs and/or alcohol)
Types of elder abuse
· Abandonment: deserting the vulnerable elder once someone has assumed responsibility
for that individual
elder abuse
Victims of elder abuse who do not report their abuse do not b/c ofembarrassment, the feeling
of some sort of responsibility for the abuse, fear of retaliation from the abuser, fear of increased
abuse, fear of being placed in the nursing home, the belief that no one will believe them, or a
lack of awareness that the situation is abusive
Risk factors of elder abuse
Occurs in one in ten older Americans & all ethnic groups and socioeconomic classes.
Risk factors of elder abuse
Lachs and Pillemer (2015) suggest that the abused elder is more likely what Women are more
likely to be what as opposed to men an older female. She generally has a physical impairment
and is in poor health. She may either live alone, with the abuser, or in a household with many
members; victims of elder abuse than men.
Risk factors of elder abuse
1. The abuser is generally found to be what gender? male who has a history of past or
current substance abuse, has mental health issues, is socially isolated, and has a history of past
trouble with law enforcement
Risk factors of elder abuse
The abuser may be financially dependent on the elder and be under major stress.
Risk factors of elder abuse
1. What contributing factors do victims of have Social isolation, frailty, physical or mental
disability, and dependency are some of the contributing factors, Living with others can also be a
risk factor
Provider responsibilities in suspected abuse
If elder abuse is suspected, who has a legal obligation—to report this to either 911 or the state
elder abuse hotline health-care professional's
,Provider responsibilities in suspected abuse
If suspecting elder abuse Carefully collect information regarding the patient, using what findings
physical findings, patient's functional abilities, testing results, and verbal information
from the patient and his or her caregivers.
Provider responsibilities in suspected abuse
Use the interdisciplinary team and speak with social workers, nursing staff, and others who
may have interacted with the patient and caregiver.
Provider responsibilities in suspected abuse
Document all findings, because they may be required to be presented in court later.
Provider responsibilities in suspected abuse
Especially document any differences in verbal accounts between the patient and his or her
caregiver.
Provider responsibilities in suspected abuse
It is also prudent to photograph suspicious injuries, as well as measuring or comparing size
of injury with a familiar object if a ruler is not available
Provider responsibilities in suspected abuse
When a patient has dementia, a history can be difficult to evaluate. This collection of
information will assist the adult protective services case workers in their case investigation. The
information may protect the patient from further exploitation, neglect, or abuse.
Provider responsibilities in suspected abuse
Be sure to follow up with the case workers to determine the outcome of the case.
Alzheimer's Dementia (Kennedy)
Distinguishing features- symptoms, subjective complaints, objective findings
Probable Alzheimer's disease is diagnosed if there is Evidence of a causative marker; explain
AD genetic mutation from family history or genetic testing.
Alzheimer's Dementia (Kennedy)
Distinguishing features- symptoms, subjective complaints, objective findings
, · All three of the following are present: o Clear evidence of decline in memory and learning
and at least one other cognitive domain (based on detailed history or serial neuropsychological
testing)
o Steadily progressive, gradual decline in cognition, without extended plateaus
o No evidence of mixed etiology (i.e., absence of other neurodegenerative or cerebrovascular
disease, or another neurological, mental, or systemic disease or condition likely contributing to
cognitive decline)
Alzheimer's Dementia (Kennedy)
Distinguishing features- symptoms, subjective complaints, objective findings
· AD is dx'ed if The disturbance is not better explained by cerebrovascular disease, another
neurodegenerative disease, the effects of a substance, or another mental, neurological, or
systemic disorder.
Alzheimer's Dementia Screening from Lecture
What tests do you want to run Focused history, cognitive & functional assessment, CBC
CBC, CMP panel & vitamin B12(looking for deficency); will also order MRI
AD Staging guidelines (Kennedy p.444)
Preclinical AD includes what featuresImpaired memory, excused or covered Insidious
instrumental ADLs losses (money handling, bills) Preserved basic ADLs Poor judgment and
decisions Subtle personality changes
Decreased spontaneity, sense of initiative Increased anxiety, socially normal
2-4 years or longer
AD Staging
mild disease starts in what lobe of the brain medial temporal lobe and progressive to the lateral
temporal lobe and parietal lobe.
AD Staging
In moderate, the disease spreads to what lobe of the brain lateral lobe.
AD Staging
In severe, the disease spreads to what lobe of the brain occipital lobe.
AD Staging guidelines (Kennedy p.444)
DELIRIUM, AD, GRIEF, PALLIATIVE,
HOSPICE EXAM QUESTIONS &
DETAILED CORRECT ANSWERS
Types of elder abuse
· Sexual abuse:sexual contact with a vulnerable elder without his or her consent
Types of elder abuse
· Physical abuse: causing physical pain or injuring a vulnerable elder
Types of elder abuse
Consider this? for those who present with unexplained STDs. Test for STDs if you suspect this?
sexual abuse
Types of elder abuse
· Exploitation: the taking of funds, property, or any assets of a vulnerable elder without legal
consent and not for the benefit of the elder
Types of elder abuse
· Neglect: failing to provide food, shelter, health care, or protection for a vulnerable elder
Types of elder abuse
· Emotional abuse: using verbal or nonverbal means to cause mental pain, anguish, or
distress in an elder
Types of elder abuse
· Exploitation: Who is most vulnerable to exploitation or more at risk for financial abuse Those
with diminished cognitive function
Types of elder abuse
· Self-neglect: the elder fails to perform the needed activities to protect his or her own health
and safety (lacks food/utilities, refuses medications, hoards, lives in unsafe conditions, neglects
,his or her grooming/appearance, is unable to handle finances, is isolated, is disoriented,
develops a dependence on drugs and/or alcohol)
Types of elder abuse
· Abandonment: deserting the vulnerable elder once someone has assumed responsibility
for that individual
elder abuse
Victims of elder abuse who do not report their abuse do not b/c ofembarrassment, the feeling
of some sort of responsibility for the abuse, fear of retaliation from the abuser, fear of increased
abuse, fear of being placed in the nursing home, the belief that no one will believe them, or a
lack of awareness that the situation is abusive
Risk factors of elder abuse
Occurs in one in ten older Americans & all ethnic groups and socioeconomic classes.
Risk factors of elder abuse
Lachs and Pillemer (2015) suggest that the abused elder is more likely what Women are more
likely to be what as opposed to men an older female. She generally has a physical impairment
and is in poor health. She may either live alone, with the abuser, or in a household with many
members; victims of elder abuse than men.
Risk factors of elder abuse
1. The abuser is generally found to be what gender? male who has a history of past or
current substance abuse, has mental health issues, is socially isolated, and has a history of past
trouble with law enforcement
Risk factors of elder abuse
The abuser may be financially dependent on the elder and be under major stress.
Risk factors of elder abuse
1. What contributing factors do victims of have Social isolation, frailty, physical or mental
disability, and dependency are some of the contributing factors, Living with others can also be a
risk factor
Provider responsibilities in suspected abuse
If elder abuse is suspected, who has a legal obligation—to report this to either 911 or the state
elder abuse hotline health-care professional's
,Provider responsibilities in suspected abuse
If suspecting elder abuse Carefully collect information regarding the patient, using what findings
physical findings, patient's functional abilities, testing results, and verbal information
from the patient and his or her caregivers.
Provider responsibilities in suspected abuse
Use the interdisciplinary team and speak with social workers, nursing staff, and others who
may have interacted with the patient and caregiver.
Provider responsibilities in suspected abuse
Document all findings, because they may be required to be presented in court later.
Provider responsibilities in suspected abuse
Especially document any differences in verbal accounts between the patient and his or her
caregiver.
Provider responsibilities in suspected abuse
It is also prudent to photograph suspicious injuries, as well as measuring or comparing size
of injury with a familiar object if a ruler is not available
Provider responsibilities in suspected abuse
When a patient has dementia, a history can be difficult to evaluate. This collection of
information will assist the adult protective services case workers in their case investigation. The
information may protect the patient from further exploitation, neglect, or abuse.
Provider responsibilities in suspected abuse
Be sure to follow up with the case workers to determine the outcome of the case.
Alzheimer's Dementia (Kennedy)
Distinguishing features- symptoms, subjective complaints, objective findings
Probable Alzheimer's disease is diagnosed if there is Evidence of a causative marker; explain
AD genetic mutation from family history or genetic testing.
Alzheimer's Dementia (Kennedy)
Distinguishing features- symptoms, subjective complaints, objective findings
, · All three of the following are present: o Clear evidence of decline in memory and learning
and at least one other cognitive domain (based on detailed history or serial neuropsychological
testing)
o Steadily progressive, gradual decline in cognition, without extended plateaus
o No evidence of mixed etiology (i.e., absence of other neurodegenerative or cerebrovascular
disease, or another neurological, mental, or systemic disease or condition likely contributing to
cognitive decline)
Alzheimer's Dementia (Kennedy)
Distinguishing features- symptoms, subjective complaints, objective findings
· AD is dx'ed if The disturbance is not better explained by cerebrovascular disease, another
neurodegenerative disease, the effects of a substance, or another mental, neurological, or
systemic disorder.
Alzheimer's Dementia Screening from Lecture
What tests do you want to run Focused history, cognitive & functional assessment, CBC
CBC, CMP panel & vitamin B12(looking for deficency); will also order MRI
AD Staging guidelines (Kennedy p.444)
Preclinical AD includes what featuresImpaired memory, excused or covered Insidious
instrumental ADLs losses (money handling, bills) Preserved basic ADLs Poor judgment and
decisions Subtle personality changes
Decreased spontaneity, sense of initiative Increased anxiety, socially normal
2-4 years or longer
AD Staging
mild disease starts in what lobe of the brain medial temporal lobe and progressive to the lateral
temporal lobe and parietal lobe.
AD Staging
In moderate, the disease spreads to what lobe of the brain lateral lobe.
AD Staging
In severe, the disease spreads to what lobe of the brain occipital lobe.
AD Staging guidelines (Kennedy p.444)
