• Topic: Falls, cognition, Depression, and Dementia
•  
• Define
• Provide background on the topic as it relates to the older adult or its applicability to the older adult.
• What is the role of the APRN as it relates to the topic?
• How will you make changes to your practice with regards to the topic?
• What assessment tool if any is appropriate to assess the topic/condition?

 

Falls, cognition, Depression, and Dementia

Define

A fall can signal the onset of a new and dangerous medical condition that needs care. Conditions such as dehydration or urinary tract infection might cause an older person to become debilitated and fall. Cognitive health, or the ability to think, learn, and recall things clearly, is a crucial part of daily life. Generally, brain health includes more than just cognitive wellness (Molony et al., 2018). Depression is characterized by emotions of deep melancholy. It refers to both a mood and a condition, and it progresses more quickly than dementia. Even though they have memory gaps, people who are depressed will be able to recall anything if they are questioned. In people who are depressed, their judgment is frequently impaired. Lack of concentration is the most common cause of impaired judgment in those who are depressed.

Provide background on the topic as it relates to the older adult or its applicability to the older adult.

As the severity of dementia progresses over time, cognition and motor functions such as muscle strength, balance, and gait are disturbed, and they eventually increase the risk of falls in patients with dementia. In community-dwelling older persons, cognitive and mobility deficits are frequent and underdiagnosed chronic illnesses. Medication side effects, delirium related to sickness such as UTI, depression, and dementia are all possible causes of cognitive impairment in older persons (Fernando et al., 2017). Some factors, such as drug side effects and depression, can be treated and reversed. Others, such as Alzheimer's, can't be reversed, but symptoms can be managed for a while, and families may plan for foreseeable changes and handle safety issues.

Falls in dementia patients are linked to a variety of intrinsic and extrinsic risk factors, some of which are common in older people in general and others that are specific to the disease. Adults with dementia or cognitive impairment who live in the community or institutions have different risk factors (Allan et al., 2009). Dementia patients fall more frequently than cognitively healthy older persons, although the causes are unknown. To determine a fall risk profile for this population, a review is required. The goal was to conduct a thorough review of the literature and discover factors linked to the risk of falling in dementia patients. Mild cognitive impairment and mild dementia are distinct as the latter involves more than one cognitive domain and causes significant difficulties with everyday life. The history and cognitive evaluation are essential in making the diagnosis of moderate cognitive impairment and mild dementia.

What is the role of the APRN as it relates to the topic?

Advanced practice registered nurses (APRN) play a significant role in dementia.APRNs support hospital-wide case identification and screening procedures, conduct additional extensive evaluations and initiate referrals to specialists for diagnostic evaluation. They help to spread and execute best practices for preventing damage and improve assessment and identification of dementia-specific risk factors and individual signs of distress. In situations such as pre and postoperative units, APRNs provide specialized consultation and assessment. They check medications and make sure that patients are referred to liaison psychiatry services as soon as possible.

How will you make changes to your practice with regards to the topic?

As a healthcare practitioner, I'll be the first to respond to a patient's concerns about memory loss or dementia. I'll look for new cognitive deficiencies and their likely causes, then treat the problem if it's a reversible health issue. If dementia is detected, you and I will be on the front lines, assisting patients and carers in planning for the future. I will promote diet, sleep/rest patterns, physical comfort, and pain management to effect transformation. I'll offer emotional support and sympathetic listening, as well as encourage the expression of emotions and instill optimism. I will educate patients and their families about depression and how to treat it effectively.

What assessment tool if any is appropriate to assess the topic/condition?

Montreal Cognitive Assessment (MoCA), Mini-Mental State Exam (MMSE), and Mini-Cog are the most frequent cognitive assessment tools used to assess patients with potential cognitive impairments.

The Montreal Cognitive Assessment and the Mini-Cog test are the best alternative screening tests for dementia, and the ACE-R is the best option for moderate cognitive impairment. Personal history, physical examination, and laboratory tests, and brain imaging techniques are some of the other dementia evaluation tools.