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“Every soul is beautiful and precious; is worthy of dignity and respect, and deserving of peace, joy and love.”

–Bryan H. McGill


  • Study assessment criteria for dementia

  • Find out how to prevent dementia patients from escalating

  • Identify effective de-escalation techniques for dementia patients

  • Consider the importance of maintaining quality of life for dementia patients

Dementia is a syndrome characterized by generalized progressive cognitive deterioration impairing both social and vocational functioning. Dementia results in changes of behavior, perception, memory, problem-solving abilities, and judgment that interfere with normal daily life and functions (American Psychiatric Association [APA], 2013; Kneisl & Trigoboff, 2009).

The DSM-5 lists dementia under a new name: major neurocognitive disorder. It describes diagnostic criteria as a significant cognitive decline from a previous level of performance in one or more cognitive domains. These cognitive domains include complex attention, executive function, learning and memory, language, perceptual-motor, and social cognition. (It should be noted that the cognitive deficits do not occur exclusively in the context of delirium [APA, 2013].) Concerns about cognitive deficits might be expressed by the individual, a knowledgeable informant, or a clinician. Declines in cognitive performance are ideally documented by standardized neuropsychological testing or another quantified clinical assessment.

A prominent type of dementia is neurocognitive disorder due to Alzheimer’s disease. Neurocognitive disorders of the Alzheimer’s variety have multiple possible causes, including acetylcholine alterations, plaque, and tangles in the brain. In addition, there is a possible genetic predisposition to Alzheimer’s disease. Head trauma may also be a factor in development of Alzheimer’s.

Dementia interferes with the individual’s ability to maintain independence and to perform everyday tasks. At a minimum, patients who suffer from dementia will require assistance with complex instrumental activities of daily living such as paying bills and managing medications.


Between 1.4% and 1.6% of Americans between the ages of 65 and 69 suffer from dementia; the percentages climb to 16% to 25% for those over age 85. Nearly 5.2 million Americans over 65 have dementia. Dementia is the fourth most prevalent cause of death in adult populations (APA, 2013; Townsend, 2015).


Nurses must be aware of early warning signs of dementia. Examples of early warning signs are if a person:

  • Repeatedly asks the same question or repeats the same answer over and over

  • Has trouble organizing time, such as a work or social schedule

  • Forgets to pay bills on time

  • Frequently misplaces objects

  • Forgets to bathe or has poor personal hygiene (e.g., has body odor, dirt under fingernails, tangled hair, or mussed clothing) (Kneisl & Trigoboff, 2009; Schuurmans, Duursma, & Shortridge-Baggett, 2001)

  • Wears clothing that is inappropriate for the season

  • Demonstrates apathy in affect (facial expression) and demeanor

  • Has trouble learning or remembering new information

  • Forgets the names of family members

  • Forgets to take regularly ...

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