Please enable JavaScript.

Coggle requires JavaScript to display documents.

KNOWLEDGE EXTRACTED FROM INCLUDED ARTICLES - Coggle Diagram

- - - - Individualized or group exercise programs are commonly used for fall prevention..
      - The Authors of AR-3 found positive but inconclusive results were found across some included studies and indicated the need for further research consensus.
      - Various types of interventions were tested including graded walking, strengthening, flexibility training , and balanced activity.
    - - Strategies focused on staff-awareness and training to reduce fall risk in individuals with dementia.
      - The results of included articles of AR-3 showed that the intervention led to an approximately 50% reduction in the number of fall people who experienced at least on fall.
      - To enhanced supervision or interventions provided by staff trained in fall prevention would reduces the number of fall.
    - - Comprehensive multidisciplinary team approached were tested for fall reduction including increasing staff , staff education, and rehabilitative care.
      - Some included articles of AR-3 compared multidisciplinary care with standard care for patients who underwent surgical repair of femoral neck fractures showed fewer falls in the multidisciplinary care group.
- - - - Alzheimer's diagnosis involves testing for B12 deficiency, hypothyroidism, Apolipoprotein E4 (ApoE4), and genetic factors using instrumental examinations such as MRI, PET, and SPECT.
      - Early-stage diagnosis was challenging, with a 30–50% probability of error. Drug management includes cholinesterase inhibitors (e.g., Donepezil) and NMDA antagonists (e.g., Memantine) to preserve synaptic functions.
      - Other chemical treatments include antioxidant therapy, hormone replacement therapy, and herbal supplements.
      - Estrogen and NSAIDs have not proven effective. treatment for depression involves antidepressants such as SSRIs and SNRIs.
    - - Modifying the diet is crucial, emphasizing fruits, vegetables, low saturated fats, and adequate intake of folic acid, statins, and moderate alcohol consumption.
      - Poor nutrition is a common risk factor, and the Mediterranean diet is associated with a reduced risk of Alzheimer.
      - Gingko biloba and vitamin E have inconclusive effects. Considerations for eating include avoiding colored tables, using handles on cups, and addressing changes in smell and taste perception.
    - - Caregiver education and techniques optimizing patient-caregiver interaction are crucial in non-pharmacological management. Environmental planning is essential due to visual and auditory impairments and difficulties in walking and orientation. Music therapy from the early stage can preserve language, cognition, and learning. Physical activity and cognitive stimulation promote neuroplasticity, and participation in various activities preserves cognitive functions
    - - Caregivers play a vital role and provide 60-90% of necessary home care. Caregivers often face physical, psychological, emotional, technical, and financial challenges. Caregiver discomfort is influenced by factors such as the patient's advanced age, gender, and marital status. Society needs targeted information and education programs for different caregiver demographics.
      - Caregivers faced high levels of stress, particularly in handling aggressive behaviors and other stressors associated with different stages of the disease. Solutions for caregiver support include longitudinal planning, skills development, education, and increased financial and psychosocial support.
- - - - Unpredictable nature of dementia
        
        Nurses in dementia care face demanding workloads and time constraints due to the unpredictable nature of dementia. The time-consuming nature of dementia care disrupts nurses' daily schedules, leading to time shortages.
      - Ambiguous Communication with Dementia Patients
        
        Nurses experience difficulty in communication with dementia patients, leading to challenges in identifying patients' emotions or intentions. Various verbal and nonverbal communication strategies are employed, such as speaking slowly, establishing eye contact, and interpreting facial expressions.
    - - Aggression in Dementia Patients
        
        Nurses report emotionally startling experiences when dealing with aggressive behaviors exhibited by dementia patients. The need to establish emotional connections with patients while facing aggression creates a challenging and stressful environment for nurses.
      - Apathy
        
        Nurses, faced with challenging decisions and emotional experiences, reported becoming habituated to situations, resulting in emotional numbness. Continuous exposure to critical events, aggression, and death of patients contributed to occupational stress, affecting nurses' occupational identity.
    - - Mediator between Heath Professiionals
        
        Nurses, as primary caregivers, found themselves in the role of coordinators and mediators between healthcare professionals. In the absence of resident physicians, nurses faced moral distress when unable to obtain cooperation from visiting doctors, leading to emotional exhaustion.
      - Mediator with patients and family caregiver
        
        Nurses had to navigate cooperation with patients' family members, who provided valuable information. However, difficulties arose when family members lacked understanding of dementia symptoms, leading to emotional challenges for nurses.
    - - Lack of Human Resources
        
        Nurses reported a shortage of manpower, leading to time constraints and frustration. Prioritizing paperwork over patient-centered care and the resulting guilt added to nurses' stress.
      - Lack of Educational Resources
        
        Nurses expressed the need for professional education to address the challenges in nursing elderly dementia patients. Limited past education and the unpredictable nature of dementia prompted nurses to seek practical education on dementia-related knowledge and communication methods..
      - Lack of Material Resources
        
        Nurses faced challenges in providing sufficient care due to a lack of material resources, including necessary equipment for dementia patients' care. Insufficient wages and lack of necessary support added to nurses' frustration.
- - - - AR-6 emphasized the progressive and variable nature of chronic confusion associated with AD, involving issues such as memory recall, language, attention, problem-solving, comprehension, judgment, abstract thinking, reasoning, communication, emotional expression, and routine task performance.
      - AR-6 highlighted is the need for a careful and thorough assessment by nurses when dealing with patients with or suspected of having AD.
      - AR-6 provided specific communication strategies for dealing with patients experiencing confusion. These include focusing on one piece of information at a time, using yes or no questions, addressing the patient by name, employing simple reminders for time and place, and speaking slowly and softly with short, simple words and phrases.
      - The Authors of AR-6 suggested modifying medical and nursing interventions over time as cognitive function deteriorates. Safety measures, such as affixing indication labels and removing potentially hazardous objects from the patient's environment, are crucial. Visual reminders to promote patient independence and reduce environmental stimuli are also recommended.
    - - According to Gitlin & Hodgson (2018), despair often arises from the belief that nothing can be done due to the absence of a cure for AD. However, the nurse's role is to highlight that various treatments exist to alleviate and slow down the symptoms' decline.
      - The nurse was advised to assess the level of despair in patients and evaluate the impact of providing appropriate information and support. Realistic information should be shared with sensitivity, considering the family and patient's capacity to handle it. Sometimes, advising the family without the patient's presence might be necessary.
      - AR-6 discussed the psychological impact of Alzheimer's Disease (AD) on patients and their families, emphasizing the initial feelings of frustration and helplessness. The progressive and irreversible nature of the disease often diminishes hope, making it crucial for individuals to develop psychological adaptability on a day-to-day basis.
      - To support positive family ties and communication, nurses are encouraged to promote mutual respect among family members. Strong family relationships and friendships are highlighted as essential in making life meaningful and balancing the burden of the disease.
    - - AR-6 highlighted the prevalence of anxiety symptoms in patients with Alzheimer's disease (AD), ranging from 8% to 71% for anxiety symptomatology and 5% to 21% for anxiety disorders.
      - Managing anxiety in AD patients poses a significant challenge for caregivers. Patients may experience increased periods of irritation in the afternoon or evening, with some even waking up at night with profound anxiety, fear, or panic.
      - Consistent maintenance of daily habits and providing a structured daily routine are recommended to create a sense of reassurance and reduce stress.
      - The planning of set rest periods during the day is advised, as fatigue contributes to stress and rest helps in reducing stress levels. Engaging patients in quiet activities, such as listening to music in the afternoons or early at night, may help mitigate the 'sun-down' effect.
    - - When the patients with Alzheimer's Disease (AD) discharged from hospital, AR-6 emphasized the crucial role of community nurses in continuing patient and family education about the disorder. The nurse should be aware of the potential shock or denial experienced by patients and their families, especially in the initial stages of the disease, necessitating repeated explanations.
      - The primary objective of patient education is to maintain an environment that balances minimal restriction with patient safety.
      - Specific practical tips, such as labeling drawers and rooms to aid patient navigation, are suggested to enhance patient independence. Consistency and stability in the environment and daily routine are deemed integral to care. The importance of adapting care and communication to the patient's potential and managing expectations was underscore.
      - Mutual support groups and discussions with individuals facing similar challenges are recommended to address the stress experienced by caregivers. Regular rest periods are advocated to reduce stress and fatigue in patients.
      - The nurse was advised to reassure families that additional services are available if the caregiving situation becomes overwhelming. Options include short respite care at the patient's home or a short-stay care facility, offering temporary relief for caregivers.
    - - The symptoms of memory impairment in AD include repetitive questioning, forgetting names, misplacing items, difficulty in completing tasks, and getting lost in familiar areas. AR-6 emphasized that memory impairment is a diagnostic criterion for the early stage of AD, and interventions for treating memory loss should be introduced at this stage.
      - Supplementary therapies (e.g., meditation, massage, gymnastics) to reduce stress associated with memory loss. Practical strategies include using a diary, making task lists, and utilizing reminders from third parties.
      - Memory loss in the context of aging, particularly focusing on Alzheimer's disease (AD) as a condition where memory impairment is a clinical feature. It highlights that memory loss is not just a normal part of aging but a significant aspect of AD, which progresses gradually and negatively impacts various aspects of an individual's life, including work, social interactions, and relationships.
      - The use of pill containers with recorded medication schedules and suggests alternative cooking methods for safety concerns. Additionally, less obvious measures like listing emergency numbers or setting reminders on electronic devices are proposed to enhance patient safety and reduce stress for both the patient and caregiver.
- - - - Nursing interventions focused on addressing the physical, mental, and social needs of both elderly individuals with Alzheimer's and their family caregivers. Strategies included the development of nursing diagnoses, goal setting, and care planning to promote cognitive improvement in affected elderly individuals while supporting family caregivers.
      - The nursing process is highlighted as a valuable tool for identifying crucial points in the care of elderly individuals with Alzheimer's, leading to the formulation of specific nursing prescriptions. These prescriptions encompass measures to promote healthy eating, encourage self-care, and improve cognitive functions through activities like games, readings, and other stimulating exercises.
      - AR-8 highlighted several key findings related to the nursing approach in caring for elderly individuals with Alzheimer's disease and their family caregivers. The analysis of various included studies indicates a lack of sufficient knowledge among nurses working in inpatient units, particularly in areas concerning Alzheimer's disease, its phases, drug therapy, and specific nursing care for affected elderly individuals.
    - - AR-8 discussed the legal frameworks provided by the Statute of the Elderly to ensure rights and comprehensive healthcare for elderly individuals. According to Article 15, the statute guarantees universal and equal access to healthcare through the SUS (Unified Health System), encompassing prevention, promotion, protection, and recovery of health, with special attention to diseases affecting the elderly.
      - AR-8 highlighted that these standards only partially meet the needs of elderly individuals, particularly those with Alzheimer's disease. The existing legal and healthcare protocols are criticized for being detached from the reality experienced by elderly individuals, their families, and caregivers, rendering them ineffective in addressing the specific challenges posed by Alzheimer's care.
    - - The impact of Alzheimer's disease on family members is noted at various levels, with changes in the disease stages affecting daily lives and caregiving tasks. Such changes result in emotions such as sadness, fear, and anxiety among family members.
      - Understanding the daily lives of individuals living with a family member affected by Alzheimer's disease is emphasized as crucial for comprehending the emotional challenges and exhaustion faced by caregivers. This strain often leads to negative effects on the caregiver's life, such as leaving employment, sacrificing leisure activities, and experiencing a reduction in social interactions.
      - The main consequence of being the primary family caregiver was the experience of negative feelings due to the daily challenges and strain involved in caregiving. This burden is particularly evident when only one family member assumes the caregiving role, as indicated in 69% of the studies
      - Despite the challenges, AR-8 identified positive elements in caregiving, such as satisfaction derived from providing care and the sense of retribution expressed by family caregivers toward their loved ones. The relationship of affection is particularly highlighted in caregiving activities, with bathing being identified as a crucial form of care that significantly contributes to the caregiver's satisfaction.