So what are we going to be thinking
about when we're taking care of patients
with neurocognitive disorders?
It's really important once again
that we're focusing on the person
and the way that this disease
might affect their life and their
own relationship to the people
around them and themselves.
So the first thing, because
there's confusion in all of these,
let's think about how can
they take care of themselves?
There will be a self-care deficit.
We're also going to be thinking about the fact
that they won't be able to manage their own health.
So one of the nursing diagnosis might
be ineffective self-health management.
How are they going to be able to
determine how to get to the doctors,
how to be able to do the
regimens that they need to do?
How can they cook for themselves if
their tremors are getting in the way?
We also want to know that because they
may not be able to cook for themselves
and not everyone is living with a family.
A lot of our patients and
clients are living on their own.
How are they going to go shopping? How are
they going to be able to remember how to cook?
So they are at risk for imbalanced nutrition.
Chronic confusion is a symptom that we want
to think about and how it impacts their life
and some of the ways that we can assist
them to alleviate some of the confusion.
There are patients that now use their cell phone.
When they understand they're going
to go to the store and come home,
they can put the store in and they can follow
the directions on how to get to the store
and follow the directions how to get home
to allow them to maintain their greatest
amount of ability to take care of themselves.
They also are very prone to risk.
Falling, burning themselves, eating
something perhaps that is toxic.
So not having a good cognition, a capacity
for self care and for understanding
what we're putting in our body, what we
need to do to keep ourselves healthy,
these are all risk prone behaviors.
And remember, we were talking about driving.
It's very hard to have someone give up
their driving because that is their freedom.
But if you don't know how to make the
cargo or you forget where is the brake,
or you have a sudden jerking movement
in your leg that you can't control
and it happens to be on the gas gauge,
we have to really be thinking globally on
how these brain disorders are affecting
every aspect of this person's life.
Also, they have a risk for self
directed or other directed violence.
Remember, they have this mood lability, so they
might be and one moment really angry with someone.
They might not even know who that person is.
They might think that you or
another person taking care of them
is someone who's come in to rob
them and they might throw things.
So we have to make sure that we're
providing a safe environment,
one where they can feel safe,
where we can also feel safe.
And if they have self-directed problems, if they
are saying that they want to hurt themselves
One to one constant observation
is a must in these situations.
Family education is also a must, because if it
happens to be a mom or a dad or a grandma or grandpa,
it's very hard to have the family
understand that these outbursts
are not directed towards them
individually, that this is a brain disease
and that these behaviors are
a symptom of a brain disease.
So as I'm saying this, I'm hopeful that you're
all thinking about how difficult this must be
for the family members as they
see somebody who has always been
someone who they love, who they respect,
who has been in charge of things
deteriorating in front of their own eyes and
perhaps not even remembering who they are.
So caregiver strain is a very big piece of coming
up with some sort of solutions for the families
who are dealing with these neurocognitive disorders.