This chapter presents a comprehensive understanding of dementia as a commonly encountered condition/syndrome in the nursing care of older adults and offers insights into the health challenges faced by people living with dementia. It will provide nurses with the knowledge to be able to assess, manage, and care for people with dementia in an evidence-based and person-centred way. After a comprehensive overview of the causes, risk factors, and impact of dementia, it will outline best practice to deliver care, as well as to prevent or minimize further ill-health. Nursing assessments and priorities are highlighted throughout, and the nursing management of the symptoms and common health problems associated with dementia can be found in Chapters 14 and 17, respectively. In the past, dementia was most often described in terms of mental disability. However, it is now more often described in terms of neurological disability (i.e. changes in the brain). For example, the Mental Health Foundation describes dementia as:…A decline in mental ability which affects memory, thinking, problem-solving, concentration and perception….The NHS Choices website states:…Dementia describes the effects of certain conditions and diseases on a person’s mental ability, personality and behaviour….Dementia is generally classified according to two international classification systems: the American Psychiatric Association Diagnostic and Statistical Manual of Mental Disorders fourth edition (DSM-IV); and the International Classification of Diseases tenth edition (ICD-10). Dementia can be defined as a syndrome whereby there is gradual death of brain cells, resulting in a loss of brain ability that is severe enough to interfere with normal activities of living for more than 6 months. Problems with brain function should not have been present at birth and it is not associated with a loss or alteration of consciousness. This latter point distinguishes dementia from delirium, which is a state of mental disorientation that can happen if you become medically unwell, also known as an ‘ acute confusional state’ (Royal College of Psychiatrists, 2009). (See Chapter 11). It is vital that nurses hold central what dementia means for people living with it. For example, people will commonly experience changes to their perception, senses, memory, and the range of skills they need to carry out everyday activities.
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