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Delirium, Dementia, and Amnesia Nursing Guide

Content Contributor: Tiffany Fields, RN, BSN, MSN, DNP, CRNP

Overview: Delirium, Dementia, and Amnesia

This content is intended as a Quick Reference for delirium, dementia, and amnesia will cover an overview and nursing considerations utilizing the nursing process.

Etiology and Epidemiology

In most adults, it is not unusual to forget things such as locating keys, finding a parked car, or recalling someone’s name. During the aging process, adults may need a longer time to remember things but when this memory loss affects activities of daily living it is more serious.

There are three types of memory loss:

  • Dementia, which is a slow decline in learning abilities, problem-solving, memory, or judgement occurring over weeks to months. It can be caused by health conditions such as Alzheimer’s disease and usually affects the population older than 65.
  • Delirium, which is a sudden change in the brain which causes alterations in sleep patterns, mental status, and behaviors. Delirium can be associated with withdrawal from alcohol, drugs, or medications, as well as caused by infections.
  • Amnesia, which is memory loss caused by a stroke, head injury, substance abuse, motor vehicle accident, emotional event, or combat. It can be temporary or permanent depending on the severity.

The presence of memory loss may indicate a risk factor for dementia, which affects 10% of the 65 or older U.S. population (Harvard School of Public Health, 2008). Additionally, delirium can be reversible with proper diagnosing, early detection is the key in treatment (Lippmann & Perugula, 2016).

Diagnosis

To diagnose delirium, dementia, and amnesia, providers should ask about:

  • Medical history
  • Utilization of over-the-counter medications
  • Diet
  • Ability to perform activities of daily living
  • Changes in personality or behaviors

Perform memory tests to assess:

  • Attention
  • Counting
  • Language
  • Problem-solving skills

Diagnostic testing may also be needed and includes:

  • Testing (e.g., magnetic resonance image (MRI), positron emission tomography (PET), and blood and urine tests) to rule out other medical problems
  • Computerized tomography (CT) scan

Management

To manage dementia, delirium, and amnesia, the goals are to:

  • Improve or maintain quality of life
  • Improve cognition, mood, and behavior
  • Promote safe environment
  • Promote social engagements
  • Improve or maintain functioning of daily living

Nursing Care Plan & Considerations

Use the nursing process to develop a plan of care for individuals. The nursing assessment (with common findings listed), diagnosis, interventions, expected outcomes, and education for individuals with Delirium, Dementia, and Amnesia are listed below.

Assessment

Signs and Symptoms:

  • Altered mental status
  • Irritability
  • Social withdrawal
  • Decreased activities of daily living
  • Struggling to work with numbers
  • Losing and misplacing items
  • Changes in behavior and decision making
  • Repeating of questions multiple times
  • Forgetting conversations
  • Unable to multitask
  • Struggling with words for a person, place, or thing

Nursing Diagnosis/Risk For

  • Dehydration
  • Falls
  • Infections
  • Wandering
  • Social isolation
  • Self-care deficit
  • Impaired communication
  • Disturbed thought process

Interventions

  • Collect baseline cognitive level.
  • Assess the ability to read, write, and comprehend.
  • Develop a daily routine.
  • Allow rest time.
  • Avoid reality checks.
  • Provide time to respond to stimuli.
  • Allow time with activities.
  • Maintain weight.
  • Assist with activities of daily living.

Expected Outcomes

  • Remain safe and free from injury
  • Be able to express needs freely
  • Maintain weight
  • Remain free from irritability
  • Maintain or improve level of function

Individual/Caregiver Education

  • Getting regular checkups
  • Eating a healthy diet
  • Getting enough rest
  • Reporting behavioral changes
  • Keeping a daily schedule
  • Avoiding activities that cause behavioral changes
  • Speaking slowly and giving time to respond
  • Assisting with activities of daily living
  • Finding local support
  • Consulting provider, as needed

Dementia in the Older Adult CE Course

1.0 Contact Hours

Delirium: Identification and Management CE Course

1.0 Contact Hours

Additional Information

Content Release Date 

4/1/2022

Content Expiration

12/31/2025

Content Contributor

The content was created by Relias staff writer Tiffany Fields, RN, BSN, MSN, DNP, CRNP.

Tiffany has been a clinical nurse for over 20 years. She was educated and trained as a Licensed Practical Nurse in Alabama, where she practiced as a Gerontological Nurse at the local Nursing Homes. She earned her Associate, Bachelor’s and Master’s degrees in Nursing and a Doctorate in Nursing Practice. She also as a Certified Family Nurse Practitioner degree. Her clinical expertise is Adult-Geriatric Nursing and Medical-Surgical medical complexity. She is currently the Assistant Director of Nursing at a Rural Hospital as well as a writer for Relias.

Resources

References

 

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