What Are Catastrophic Reactions

What Are Catastrophic Reactions – • Arousal – vocal or mechanical behavior eg. stammering, wandering • Agnosia – the ability to recognize familiar objects • Alzheimer’s disease – a progressive impairment of memory, reasoning and judgment • Aphasia – language difficulties due to brain damage EX. May affect listening, speaking, reading and writing skills; Loss of ability to use or understand language • Apraxia – Loss of ability to perform planned voluntary movements (eg dressing, eating, bathing) • Catastrophic reactions – overreacting to situations.

2 Terms and definitions • Chronic – prolonged, frequent • Fighting – physically aggressive behavior • Confusion about time, place or person – confusion • Dehydration – loss of normal body water, can affect both physical and mental functioning • Delirium – memory and thinking impairment caused by the body’s reaction that often turns to illness or physical • Abnormal memory such as dementia; comes on slowly and worsens over time; Dementia is usually irreversible, depending on the cause

What Are Catastrophic Reactions

3 Terms and definitions • Disorientation – emotional confusion, confusion about person, place or time. • Hallucinations – sensory perceptions that looks real to the person experience them but not to others. Pa • Sundowning – an event when confusion worsens in the evening

Mental Health Nursing Chapter 8:

4 Terms and definitions • Transient ischemic attack (TIA) – an episode of impaired cerebral circulation characterized by visual disturbances, dizziness, weakness, numbness, or loss of consciousness. Attacks are usually brief, lasting a few minutes. • Validation therapy – a technique that creates an environment of acceptance by encouraging the confused resident to explore personal thoughts. It helps confirm emotional feelings. • Wandering – aimless walking, which can cause residents to lose their way

• Function- control and coordinate the functions of the body • Normal aging process causes the loss of brain cells, brain shrinkage. It does not affect the resident’s ability to maintain normal ADLs. • Memory – increased difficulty remembering names of people and things • Slowness – need more time to learn new information and remember previously learned information

6 Nervous system • sensory weakness – loss of sensation in the lower legs; Vision and hearing may be less intense • Sleep – need fewer hours per night; May be unable to sleep • Urinary changes – urinary frequency and mild urination may be due to weak bladder muscles Difficulty with any of the above = memory and thinking impairment (confusion) – not a normal part of aging 2 common types: delirium and dementia.

You Tube Video Acute Delirium, Causes of Sudden Illness, Toxic Reactions, Drug Symptoms Fluctuating Alertness.

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• Urinary tract infection • Seizure • Fever • Uncontrolled diabetes • Fluid and electrolyte imbalance • Hypothermia (low body temperature) • Constipation • Stroke • Lack of oxygen to the brain • Head injury • Alcohol or drug use • Hypothyroidism (hypothyroidism and thyroidism cause hearing loss) Environment – Changes.

10 Definitions Dementia- Severe impairment of cognitive functions such as thinking, memory, and personality that is often irreversible • Begins slowly, gradually worsening the resident’s alertness. Depression in the elderly can mimic dementia. Alzheimer’s disease – the most common form of dementia You Tube Alzheimer’s’ videos can be seen in stroke, brain injury, Parkinson’s disease, multiple sclerosis and AIDS. • Nursing care – see slide 45.

11 Stroke You Tube News Reporter Stroke Symptoms of a stroke (CVA, Cerebrovascular Accident) • Sudden brain damage due to bleeding from a cerebral artery or cerebrovascular accident • Chronic and sometimes regular. Symptoms – Dizziness in you tube videos, HA, slurred speech, difficulty swallowing food, urine or faecal, loss of vision. Memory loss, confusion

• Signs and symptoms may be temporary (for a short time only) • Nursing care Maintain good hygiene and skin care. Assist in ROM exercises. Let B&B nurture the mood. Safety precautions are observed. Nutrition. Prevent injury (eg from falling).

Recognizing & Managing Catastrophic Reactions

Definition of spinal cord damage that causes paralysis, often permanent.

Diseases of brain cells that control movement • Often respond well to drug therapy • Symptoms are slow, short-term; Anxious posture, tendency to fall, shaking hands, difficulty breathing, mouth gaping

17 Parkinson’s disease • Mental function is usually normal, sometimes impaired. About 1/3 of people with Parkinson’s disease have Alzheimer’s disease. • Medicines can cause confusion • Nursing care – keep the resident moving or he will lose function quickly.

Definition – Degeneration in the brain, spinal cord and nerves; advanced disease; Currently, there is no known cure • Symptoms of paralysis of the legs and arms, numbness, blindness and deafness, speech and mental problems • Nursing care provides a safe environment. Take care of the skin. Give B&B retraining. Give an exercise program.

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You Tube Dementia Definition – a chronic disorder of the mental process caused by brain disease or injury and pathology characterized by memory disorders, personality changes and reasoning impairment – You Tube – Pathology of Alzheimer’s complex, brain cell death (entanglement) and disruption of communication due to brain cell death (entanglement) and disruption of communication of life plexm cells (brain). Our assumptions about what it means to be a person. YouTube – Twins who care for parents with Alzheimer’s describe dementia as ‘living death’

20 Dementia Overview Listening to them talk allows us to understand their thoughts and feelings. Show respect The hardest part of dementia care is dealing with behavioral problems.

• Acute onset problems often indicate a medical illness. Changes in medication, pain (former arthritis), acute infection, or injury • Environmental changes eg. Unfamiliar places, changes in caregivers, fearful experiences, hunger, fatigue, caregivers, environmental factors (such as distractions, noise, changes in surroundings), interpersonal factors (such as arguments or corrections with residents) cause behavioral problems. It is important to address these factors.

Notice changes in actions and behavior. (See HO 3.) • Memory – changes in ability to remember past events (eg, resident just ate breakfast) • Personality changes Mood swings Confusion about suspicion • Confusion about day of the week, season of year, or time of day Trouble finding a way around a place when unable to remember employee’s name or family member’s name.

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• Symptoms of language aphasia Repetitive behavior or difficulty understanding spoken words Difficulty following directions • Loss of judgment – social skills can not make the right choice • Decreased ability to perform daily activities, neglecting the room does not socialize with others or maintain previously established friendships.

• Difficulty with ADLs Needs prompting to bathe and dress properly Needs help with hair and facial care Disordered eating Repeated or multiple layers of clothing causing sleep disturbances including bowel and bladder problems.

• Sexually aggressive behavior may be due to neurological disorders, medications, fever, and dementia Residents may confuse staff with their partners Residents may be unable to control their behavior due to changes in emotional functioning Touching may be an attempt to attract staff attention and may be mistaken for sex.

Diseases of the central nervous system (brain) Lack of oxygen in the brain of water, electrolytes, and nutritional problems (dehydration) Undiagnosed infection (high temperature), UTI, pneumonia Elimination of difficulty (constipation) Effects of drugs – alcohol addiction in the past or present HIV.

Pdf) Surviving Catastrophic Reaction After Brain Injury: The Use Of Self Regulation And Self–other Regulation

Lack of stimulation or excessive stimulation (sensory overload) Wrong interpretation of sensory input (either poor vision, hearing, or brain damage – aphasia, agnosia) Depression Hallucinations, confusion • Environmental factors New environment (adaptation) Isolation (except human contact with other environment decreases)

• Emotions or physical reactions suspicious of being rude, angry, disrespectful, erratic or talking about things that are not there, hearing voices from the past, situations in the past do not respond to anything.

• Behavioral reactions Remembering how to do simple tasks or not doing them, wasting time and who, hiding or forgetting things and walking around looking for all things or getting lost • Reactions at work can’t dress themselves, can’t feed themselves, shower or shave or intestinal inflammation.

• Stroke (see slide 11.) • Traumatic brain injury (for example, from a car accident) • Age-related dementia (AD) of the Alzheimer type is one of the most common.

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• Stage 1 – slight deformity – may seem normal, able to work

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