Cases reported "Dementia"

Filter by keywords:



Filtering documents. Please wait...

1/11. Living with dementia: communicating with an older person and her family.

    This article is designed to explore and examine the key components of communication that emerged during the interactional analysis of a role play that took place in the classroom. The 'actors' were nurses who perceived the interaction to reflect an everyday encounter in a hospital ward. Permission to tape the interaction was sought and given by all persons involved. The principal 'players' in the scenario were: the patient, a 70-year-old-woman who had been admitted with dementia, her son and daughter, and the nurse in charge of the ward. The fundamental dynamics of the use of power and restriction, truth telling, family stress, interpersonal conflict, ageism, sexism, empathy and humanism surfaced during the analysis. The findings show that therapeutic communication should be the foundation on which nursing should stand. The article continues with an exploration of the theoretical frameworks that guided the analysis of interaction and concludes by suggesting tentatively some meaningful implications for nursing practice. It plans to furnish provocative new insights into the sometimes covert communication dynamics occurring within the nurse-patient relationship. Finally, it aims to generate discussion on this little-charted realm of human social interaction.
- - - - - - - - - -
ranking = 1
keywords = communication
(Clic here for more details about this article)

2/11. Selective impairment of verb processing associated with pathological changes in Brodmann areas 44 and 45 in the motor neurone disease-dementia-aphasia syndrome.

    We report six patients with clinically diagnosed and electrophysiologically confirmed motor neurone disease (MND), in whom communication problems were an early and dominant feature. All patients developed a progressive non-fluent aphasia culminating in some cases in complete mutism. In five cases, formal testing revealed deficits in syntactic comprehension. comprehension and production of verbs were consistently more affected those that of nouns and this effect remained stable upon subsequent testing, despite overall deterioration. The classical signs of MND, including wasting, fasciculations and severe bulbar symptoms, occurred over the following 6-12 months. The behavioural symptoms ranged from mild anosognosia to personality change implicating frontal-lobe dementia. In three cases, post-mortem examination has confirmed the clinical diagnosis of MND-dementia. In addition to the typical involvement of motor and premotor cortex, particularly pronounced pathological changes were observed in the Brodmann areas 44 (Broca's area) and 45. The finding of a selective impairment of verb/action processing in association with the dementia/aphasia syndrome of MND suggests that the neural substrate underlying verb representation is strongly connected to anterior cortical motor systems.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = communication
(Clic here for more details about this article)

3/11. A case of cortical deafness and anarthria.

    Generally, cortical deafness is not complicated by anarthria and cortical anarthria does not affect auditory perception. We report a case of simultaneous progressive cortical deafness and anarthria. At the age of 70 years, the patient, a woman, noticed hearing problems when using the telephone, which worsened rapidly over the next 2 years. She was then referred to our hospital for further examinations of her hearing problems. Auditory tests revealed threshold elevation in the low and middle frequencies on pure-tone audiometry, a maximum speech discrimination of 25% and normal otoacoustic emissions and auditory brainstem, middle- and long-latency responses. An articulation test revealed abnormal pronunciation. Because of these problems only written and not verbal communication was possible; her ability to read and write was unimpaired. She showed no other neurological problems. brain MRI demonstrated atrophic changes of the auditory cortex and Wernicke's language center and PET suggested low uptake of (18F) 2-fluoro-2-deoxy-d-glucose around the Sylvian fissures in both hemispheres. Neurologically, the patient was suspected of having progressive aphasia or frontotemporal dementia. Her cortical deafness and anarthria are believed to be early signs of this entity.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = communication
(Clic here for more details about this article)

4/11. Dramatic improvement in down syndrome-associated cognitive impairment with donepezil.

    OBJECTIVE: To report 2 cases of patients with down syndrome and severe cognitive impairment who gained dramatic improvements in quality of life (QOL) upon donepezil treatment. CASE SUMMARIES: Case 1. A 38-year-old woman with down syndrome, diagnosed with secondary progressive dementia when her mental state had deteriorated rapidly after graduation from junior high school, started donepezil treatment. The loading dose was 3 mg/day and was increased to 5 mg/day for maintenance. One month after the dose was increased, adverse effects such as soft stool and urinary incontinence appeared. These adverse effects disappeared when the dose was decreased again to 3 mg/day. Her QOL improved dramatically with this minimal dose. She recovered verbal and written communication skills that she had lost for the past 21 years. Case 2. A 22-year-old man with down syndrome, who had been diagnosed as having severe mental retardation, was put on donepezil therapy. Both loading and maintenance doses were 3 mg/day. His QOL had also dramatically improved, with some recovery in verbal communication. Transient agitation/violence and transient muscle weakness appeared during the first few months of treatment. DISCUSSION: patients with down syndrome may be more sensitive to donepezil therapy than others and may benefit from this medicine, although they may also have adverse effects more frequently. CONCLUSIONS: Donepezil may be a useful medicine for some patients with down syndrome with severe cognitive impairment or mental retardation if the adverse effects are manageable.
- - - - - - - - - -
ranking = 0.66666666666667
keywords = communication
(Clic here for more details about this article)

5/11. Cultural factors in dementia: perspectives from the anthropology of aging.

    The plasticity of cultural constructs of dementia is shown in two societies: japan, and an American Indian nation. By demedicalizing the analysis of dementia, the social and cultural factors that influence recognition of symptoms, help-seeking strategies, caregiving behaviors, and adherence to biomedical and sociocultural coping advice become more obvious. Notably in the Japanese example, motivation toward primary prevention behavior is clear in the context of boke since it is an undesirable condition of frailty and cognitive decline considered to be preventable by remaining active. In the American Indian example, the hallucinatory symptoms are positively valued communications with the "other side" rather than pathologically defined. The findings show the need to extend dementia models beyond the biomedical in order to optimize prevention and management of this complex, chronic condition.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = communication
(Clic here for more details about this article)

6/11. Subjective memory complaints are not sine qua non as diagnostic criteria for MCI: the Tajiri project.

    BACKGROUND: To investigate whether subjective memory complaints are sine qua non as diagnostic criteria for mild cognitive impairment (MCI), a comprehensive approach is required. Information from a memory clinic and an epidemiologic field are required, and both are available in the Tajiri Project. methods: We report two MCI cases, one of a patient complaining of memory decline, and the other of a patient without such complaints. Also, epidemiologic data were obtained from the healthy and MCI groups, and we analyzed the relationship between the Everyday memory checklist scores obtained from the participants and their families. RESULTS: For both cases, MRI were compatible with Alzheimer's disease (AD), and the both actually progressed to clinical AD. Based on the epidemiologic survey, two patterns emerged regarding the relationship between subjective complaints and family observations: the "anosognosia" pattern associated with the memory questions, and the "self-recognition" pattern related to the questions on communication problems. CONCLUSIONS: The case studies and the epidemiologic data suggest that subjective memory complaints have no significant meaning for distinguishing MCI patients from healthy subjects. Hence, we consider that subjective memory complaints are not sine qua non as diagnostic criteria for MCI.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = communication
(Clic here for more details about this article)

7/11. frontal sinus osteoma with complicating intracranial aerocele.

    An elderly man, who presented initially with clinical features of dementia, was found to have an intracranial tension aerocele due to an underlying osteoma of the frontal sinus. Plain skull roentgenograms and computerized tomography did not reveal the osteoma, although a communication between the frontal sinus and the aerocele was present. Surgical aspiration of the aerocele and excision of the osteoma produced an excellent clinical result.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = communication
(Clic here for more details about this article)

8/11. Progressive dementia: strategies to manage new problem behaviors.

    The primary care physician plays a key role in the diagnosis and treatment of progressive dementia and in coordinating supportive care with the patient's caregivers. When a patient exhibits a new symptom such as wandering or verbal abuse, your initial workup should eliminate acute medical illness, psychiatric disorders, and drug reactions that may present as behavioral symptoms. In the home, the main focus of care is to provide a safe and secure environment, using preventive measures to minimize the risk of injuries. When caregivers become exhausted from dealing with nocturnal wakenings, a short course of sleep medication for the dementia patient is often necessary. To improve communication, avoid stressful and confusing situations that compound the patient's difficulty in understanding messages or expressing thoughts.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = communication
(Clic here for more details about this article)

9/11. multiple sclerosis: improvement of visuoperceptive functions by picoTesla range magnetic fields.

    The occurrence of cognitive deficits in multiple sclerosis (MS) has been recognized since 1877 when Charcot first observed "enfeeblement of memory" in his patients. Recent studies employing standardized neuropsychological tests have confirmed the high incidence of cognitive deficits in MS patients particularly those with a chronic progressive course of the disease. Visuoperceptive and visuomotor deficits commonly occur in MS patients and are thought to reflect damage to attentional systems due to interruption by demyelinating plaques of nerve conduction along the ascending projections from the brainstem reticular formation to the cortex. Impairment of synaptic conductivity due to serotoninergic depletion (5-HT) may contribute to the emergence of cognitive deficits in MS. The present communication concerns a 36 year old patient with MS in whom external application of picoTesla range magnetic fields (MF) resulted in rapid improvement of symptoms including visuoperceptive functions as demonstrated on various drawing tasks. The report confirms the efficacy of picoTesla range MF in the treatment of MS and demonstrates beneficial effects on cognitive functions as well.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = communication
(Clic here for more details about this article)

10/11. Rapid improvement of visuoperceptive functions by picoTesla range magnetic fields in patients with Parkinson's disease.

    Impairment in perceptual motor or visuospatial tasks is among the most frequently encountered abnormality in neuropsychological testing of patients with Parkinson's disease, being present in up to 90% of cases. Visuoperceptive deficits can result from cortical and subcortical lesions involving the right hemisphere, thalamus, and basal ganglia and are thought to reflect a defect in attentional-arousal mechanisms induced by lesions that interrupt a cortical-limbic-reticular activating loop. Clinically, the presence of visuoperceptive impairment may not be noted by Parkinsonian patients but may contribute to various disabilities including difficulty driving a vehicle and difficulties performing daily tasks which require intact visuospatial abilities (i.e., walking, dressing, drawing and copying designs). The present communication concerns two fully medicated Parkinsonian patients who responded to extracranial treatment with picoTesla range magnetic fields (MF), behaviorally and also demonstrated rapidly and dramatically enhanced visuoperceptive functions as demonstrated on various drawing tasks. These findings demonstrate the efficacy of extremely weak MF in enhancing cognitive functions in patients with Parkinson's disease.
- - - - - - - - - -
ranking = 0.33333333333333
keywords = communication
(Clic here for more details about this article)
| Next ->


Leave a message about 'Dementia'


We do not evaluate or guarantee the accuracy of any content in this site. Click here for the full disclaimer.