1 Cindy Mann, RN, BSN Unit Manager Centra Senior Psychiatric Program
2 Sundowning Physical aggression Wandering Identification of Problematic Behavior Verbal aggression Hiding possessions Combativeness with interaction
3 Type of dementia CONSIDER Area of brain affected Stage of disease
4 Is NOT a specific disease. Alzheimer's disease is the most common cause of a progressive dementia. Is a GROUP OF SYMPTOMS affecting intellectual and social abilities severely enough to interfere with daily functioning. Memory loss generally occurs in dementia, but memory loss alone does not imply you have dementia. E
5 Alzheimer s Disease Vascular Dementia Mixed Dementia Parkinson s Disease Dementia Dementia with Lewy Bodies Frontotemporal Dementia
6 ALZHEIMER S DISEASE Brain disorder, most common form of dementia Affects 5% of people at age 65 Increased Confusion Affects 50% of people age 85+ Increased Anxiety Late-onset (65+) is most common, slowestprogressing Increased Frustration Average course of DAT: 6-20 years
7 VASCULAR DEMENTIA 2nd most common dementia after Alzheimer's disease Result of a damage to the brain caused by problems with the arteries serving the brain or heart Poor Impulse Control ASSOCIATED SYMPTOMS: Confusion and agitation; depression Unsteady gait Problems with memory Urinary frequency, urgency, incontinence Night wandering Decline in ability to organize thoughts/actions, difficulty planning Poor attention/concentration Impaired Judgment Inability to Make Decisions Approx % of all dementias are VaD
8 LEWY BODY DEMENTIA Deposition of Lewy bodies in both, cortical and subcortical SYMPTOMS - Core criteria (must have two): Fluctuating attention and concentration Recurrent, well-formed visual hallucinations Newly emerged PD-type motor problems Visual Hallucinations Affects 1% of those age 65, 5% over age 85 Usually progresses more rapidly than DAT (average = 6 years)
9 FRONTOTEMPORAL DEMENTIA Group of diseases characterized by the degeneration of nerve cells in the F-T areas of the brain (Fronto-temporal areas of the brain are generally associated with personality, behavior and language). In these dementias, portions of these lobes atrophy. ASSOCIATED SYMPTOMS: socially inappropriate behaviors loss of mental flexibility decline in personal hygiene language problems, and movement disorders difficulty with concentration and thinking. Changes in personality Changes in temperament Begins earlier and progresses faster than AD Changes in demeanor Occurs at ages younger than AD, i.e.,
11 Physical Changes, Illness or Injury? Is the person responding to Changes in hearing/vision OR Delirium OR Pain
12 FALL RISKS Fall Risks Vision Changes Medications Sedation Orthostatic Hypotension Muscle Weakness Orthopedic changes
13 Is there an underlying Mood Disorder? Are they depressed? Are they anxious?
14 SUICIDE RISK History of depression, suicidal ideation/attempts Family history of suicide reduces the taboo Medical advances increase life expectancies Fear of institutionalization Financial stressors of growing older Grief (family, friends, career, autonomy, health, wealth)
15 Is there an Underlying Thought Disorder? Having Trouble Processing Psychotic Fearful
16 Identification of Triggers What precipitated the behavior?
17 Could it have been.. Over- Stimulation? Fatigue? Change of Residence or Caregiver? Misinterpretation of Situation? Receptive Aphasia?
18 Know the Person Know their Life Story To better understand WHY a person responds the way they do Understand WHO a person is and has been.
19 A traumatic or abusive history? The lifestyle or work history they led? Are their behaviors or responses related to. Their level of education? Relationships they ve had? Religious or Cultural backgrounds? Medical history?
20 Are their needs being met? Potty Positioning Pain Personal Items P.O. intake
21 Tools and measures have been developed to help predict aggression in acute inpatient psychiatric settings
23 IRRITABILITY IMPULSIVITY UNWILLINGNESS TO FOLLOW DIRECTIONS SENSITIVITY TO PERCEIVED PROVOCATION EASILY ANGERED WHEN REQUESTS ARE DENIED NEGATIVE ATTITUDE ANXIOUS OR FEARFUL LOW EMPATHY OR REMORSE PAST VICTIM OF SEXUAL OR PHYSICAL ABUSE PHYSICAL AGGRESSION TOWARD OBJECTS IN PAST 24 HOURS VERBAL AGGRESSION TOWARD A PERSON IN PAST 24 HOURS PHYSICAL AGGRESSION TOWARD A PERSON IN PAST 24 HOURS
24 Inform ALL Care Providers and Increase Monitoring Responses to Warning Signs Possible Changes in Medication Re-assess Behavioral Strategies
25 Remain Positive & Focus upon the feelings of the individual, not the facts. In most situations, their behaviors are telling you what the person no longer can.
26 Beth B. Ulrich, LCSW Community Liaison, Centra Senior Psychiatric Program
27 PREVENTION Affection Control Security Basic Needs Inclusion
28 PREVENTION Challenging behaviors, including aggression, are usually the person s search for security, control, identity, affection or a sense of purpose or achievement.
29 PREVENTION Goal of Prevention Not stopping the behavior but addressing the needs that lie behind it.
30 PREVENTION Fundamental Questions How do we perceive behaviors? Person s effort to cope/communicate a need NOT something that must be eliminated. The approach is to identify alternatives and increase understanding rather than imposing controls.
31 REWARDS AND CONSEQUENCES DO NOT WORK
32 PREVENTION Fundamental Questions How do we see our role with cognitively impaired patients? Paternalistic versus becoming her partner Paternalistic determining what she needs or what is best for her Becoming her partner entering her world
33 Get to know the patient It is important to engage with the patient. Life story Preferences Food Activities Values Identity Mother Husband Vocation How do we see our role with cognitively impaired patients? Paternalistic versus becoming her partner Paternalistic determining what she needs or what is best for her Becoming her partner entering her world
34 PREVENTION Fundamental Questions How do we understand the behavioral and functional manifestations of dementia? Caregiver must understand the disability in order to meet the needs of the patient. Apraxia Aphasia Amnesia Agnosia Executive dysfunction
35 PREVENTION Do we ask our patients to do things that are impossible for them to do?
36 PREVENTION Fundamental Questions How do we respond to an individual s needs? The need to meet physical & psycho-social needs Security or Restriction? Identify compensation measures to meet the needs of the patient i.e., providing specific activities and forms of assistance, addressing specific needs.
37 THE 4-D APPROACH Define Decode Devise Determine Observations, details, facts Where, when, how, with whom, after/ before what? What may be contributing to cause the problem? Treatment Plan: What are we going to do? What outcome is expected? Do the interventions work?
38 DEFINE DIFFICULT BEHAVIORS VERBAL yelling, screaming, threatening through body posture PHYSICAL hitting, pushing, shoving, kicking, spitting Focus on specific behavior e.g., hits while being bathed Usually a precipitant or provocation can be identified related to the behavior.
39 DEFINE Serious problem leading to injury, distress in patients & distress to others The form the behavior takes It is important to describe: Against whom it is directed The context in which it occurs Consequences, such as injury DIFFICULT BEHAVIORS Time of day Also to examine: Frequency What the patient says
40 Decode: HEAR Health & Medical Conditions Environment Approach Resident Factors
41 Decode: HEAR Health and Medical Conditions Psychiatric Disorder or History may be related to delusions, hallucinations, suspicious behavior or paranoia Medical Disorder/History Also depression, mania, sleep deprivation Delirium Pain Constipation Visual/Hearing Impairments Certain medications (steroids, etc.) Hydration and nutrition A thorough medical exam including consideration of psychiatric history should be conducted. Include a head CT.
42 Decode: HEAR Environment over stimulating or under stimulating? Is there a lack of structure and activity?
43 Decode: HEAR Approach being pushed, approached from behind, inadequate communication A supportive and attentive approach helps to prevent problematic behaviors.
44 Decode: HEAR Resident Factors Be aware of patients Needs Wants Habits Desires
45 Decode Aphasia patient may be frustrated by an inability to express himself or to understand something being said to him. Agnosia patient may not recognize a person who is approaching him and may strike out in self defense Consider the symptoms of dementia or other cognitive disorders Apraxia patient cannot identify an object so he throws it (i.e. TV or lamp) Amnesia patient tells the same story repeatedly or cannot remember what he had for breakfast Executive Disorder inhibitions related to aggressive urges no longer exist
46 Decode Could it be a catastrophic reaction?
47 Decode Catastrophic Reaction Sudden expression of negative emotion i.e., crying, yelling precipitated by an environmental event or a task failure Person behaves as if a catastrophe has happened even though the precipitant is minor.
48 DEVISE Change caregiver approach Remove the precipitant Use distraction Stay calm Keep patient out of harm s way even if it means grabbing the patient or blocking him Make environmental changes Pay attention and spend time with your patient develop a trusting relationship Know how to identify precipitants especially related to catastrophic reactions
49 DEVISE CHANGE CAREGIVER APPROACH Stop correcting Don t argue (delusions and hallucinations) The patient is always right Walk away and try again later with a different approach Show the person what you want him or her to do by demonstrating and praising nonverbally through hugs or a caring smile Don t talk about the person in front of him/her
50 DEVISE REMOVE THE PRECIPITANT Certain people Time of day Certain places Understand the task failure Reassure And use distraction
51 DEVISE USE DISTRACTION What does he/she like to do? Reminisce Favorite foods Favorite music Avoid TV, especially soaps and talk shows (old sit coms and old Westerns are better).
52 DEVISE STAY CALM I m sorry. Listen without judgment
53 DEVISE KEEP PATIENT OUT OF HARM S WAY Even if it means grabbing the patient or blocking him Learn caregiver protection techniques-mandt Blocking arm swings Getting out of holds Controlling patients hands
54 DEVISE MAKE ENVIRONMENTAL CHANGES Temperature Noise level Providing comfortable clothes Decorating with familiar pictures Soothing aromas Enjoyable sounds
55 DEVISE Develop a Trusting Relationship Get to know her history
56 DEVISE Provide activity and structure Examine communication techniques
57 COMMUNICATION Speak slowly in a lowpitched voice Enunciate your words Begin your conversations socially Use short, familiar words and simple sentences Talk in a warm, easygoing, pleasant manner Ask simple questions that require a choice of a yes/no answer Listen carefully Give positive instructions and avoid don t... can t or negative commands Avoid questions that require short-term memory; e.g., Did your son come to see you today? Communicate using the person s long-term memory: I hear you have a wonderful son. Give simple instructions for one task at a time (the simple task of brushing teeth contains 11 steps) Keep talking to the person with dementia, even if he cannot talk back Focus on a word or phrase that makes sense Respond to the emotional tone of the statement, not the words Stay calm and be patient Ask family members about possible meanings for words, names, or phrases Respond as though you understand Try a hug and change the subject Simply say, Wow! Whoa!
58 DEVISE Learn caregiver protection techniques MANDT Blocking arm swings Getting out of holds Controlling patients hands Hospitalization on Geri Psych may be indicated if patient is a danger to self or others Medication interventions may be necessary
59 DETERMINE May not reach complete resolution but minimize the behavior and its consequences as much as possible It may take several weeks so... BE CONSISTENT!
60 Labeling behavior can hide the real problem.
61 In Conclusion...
62 Person with problematic behavior can actually be: Defending himself Paying someone back Letting someone know that he has had enough Telling someone he is in pain Protecting something precious
63 Is attacking her Is threatening her The solution is to identify and stop what the patient feels: Started it Is hurting her Is antagonizing her
64 Problematic behavior is generally not a vindictive action, though it may feel like an attack.
65 THE ULTIMATE RESULT Problematic behavior is reduced, improving the quality of life for the patient. The caregiver-patient relationship improves, preventing compassion fatigue and caregiver burnout.
66 References Rabbins, Peter V.; Lykestsos, Constance G.; Steele, Cynthia D. Practical Dementia Care. New York: Oxford University Press, 2006 Mace, Nancy L.; Rabbins, Peter V. The 36-Hour Day. New York: Wellness Central/ The Johns Hopkins Press, 1999 Brackey, Jolene. Creating Moments of Joy. West Lafayett: Perdue University Press, 2007
67 CONTACT Cindy Mann, RN, BSN Unit Manager Centra Senior Psychiatric Program Beth B. Ulrich, LCSW Community Liaison Centra Senior Psychiatric Program
Delirium Introduction Delirium is a complex symptom where a person becomes confused and shows significant changes in behavior and mental state. Signs of delirium include problems with attention and awareness,
Caring for Persons with Dementia during an Influenza Pandemic PREPARED BY: Alzheimer s Association American Association of Homes and Services for the Aging American Health Care Association American Medical
NURSING B29 Gerontology Community Nursing UNIT 2 Care of the Cognitively Impaired Elder in the Community INTRODUCTION The goal of this unit is for the learner to be able to differentiate between delirium,
Mayo Alzheimer s Disease Research Clinic Education Center 2016 Programs & Information BROCHURE TITLE FLUSH RIGHT for Persons & Families impacted by Mild Cognitive Impairment Alzheimer s Disease Dementia
MEDICAL ASSISTANT : COMMUNICATION WITH PATIENTS. The most important abilities of a CMA are: the ability to Communicate effectively, with professionalism and diplomacy to all types of patients. Recognize
Dementia is the permanent loss of multiple intellectual functions resulting from neuronal death. Dementia afflicts 10% of individuals over the age of 65 and these patients survive approximately seven years
DEMENTIA TRAINING FOR CAREGIVERS BY LINDA THOMSON LPN/ ADMINISTRATOR ALF INTRODUCTION TO TRAINING IDENTIFY WHAT NEUROCOGNITIVE DISORDERS ARE STAGES HOW DO WE COMMUNICATE TO PERSON WITH DEMENTIA BEHAVIORS
Progression MIDDLE STAGE This document is one in a five-part series on the stages of Alzheimer s disease and is written for the person with the disease, their family and caregivers. The middle stage of
Brain Injury: Stages of Recovery Recovery after brain injury is a process that occurs in stages. Some people move quickly through the stages, while others make slow, but steady gains. The Rancho Los Amigos'
Mental health issues in the elderly January 28th 2008 Presented by Éric R. Thériault email@example.com Cognitive Disorders Outline Dementia (294.xx) Dementia of the Alzheimer's Type (early and late
Dr. Maissa Eid Afifi Consultant of Psychiatry.Institute of Psychiatry Ain Shams University 1-History. 2-Prevalence. 3-Types of Dementia. 4-Aim of Education programs. 5-Common problems of behavior. 6-The
USVH Disease of the Week #1: Posttraumatic Stress Disorder (PTSD) Effects of Traumatic Experiences A National Center for PTSD Fact Sheet By: Eve B. Carlson, Ph.D. and Josef Ruzek, Ph.D. When people find
PARTNERING WITH YOUR DOCTOR: A Guide for Persons with Memory Problems and Their Care Partners Alzheimer s Association Table of Contents PARTNERING WITH YOUR DOCTOR: When is Memory Loss a Problem? 2 What
SUPPLEMENT 1: (Supplementary Material for online publication) Antipsychotic drug prescription for patients with dementia in long-term care. A practice guideline for physicians and caregivers About this
Anxiety, Agitation, Delirium, Depression Across the Palliative Spectrum Practical Pearls Presented by Nancy E. Joyner, RN, MS, APRN CNS, ACHPN Disclosures Nancy E. Joyner has no real or perceived conflicts
Implementing a Fall Alarm Program to Reduce Fall Risk Rein Tideiksaar, PhD FallPrevent, LLC This program was supported by a grant from Implementing a Fall Alarm Program to Reduce Fall Risk Rein Tideiksaar,
switching seats in the classroom stealing money Take Action Against Bullying spreading rumors pushing & tripping U.S. DEPARTMENT OF HEALTH & HUMAN SERVICES Substance Abuse and Mental Health Services Administration
Alzheimer s disease Guide for law enforcement Law enforcement and Alzheimer s disease As our population ages, the number of people with Alzheimer s continues to grow as does the likelihood that you will
Schizophrenia Schizophrenia is a chronic, severe, and disabling brain disorder which affects the whole person s day-to-day actions, for example, thinking, feeling and behavior. It usually starts between
Release: 1 HLTEN515B Implement and monitor nursing care for older clients HLTEN515B Implement and monitor nursing care for older clients Modification History Not Applicable Unit Descriptor Descriptor This
ASSESSMENT AND MANAGEMENT OF PSYCHOSIS IN PERSONS WITH DEMENTIA Overview: Psychosis is a common clinical feature of dementia. Hallucinations and delusions are the two most common types of psychotic symptoms
Introduction Dementia Awareness 1 These learning resources and assessment questions have been approved and endorsed by NCFE. Disclaimer: All references to individuals, groups and companies contained within
Behaviour Management: Partnering To Bridge The Continuum Presented by: Nancy Boaro, MN, CNN(C), CRN(C) Karey-Anne Fannon, BA, BST, RRP Objectives Review some of the behaviours exhibited by patients with
Neuropsychiatry Disorders Larry Fisher, Ph.D., ABN UHS Neurobehavioral Systems (Copyright UHS 2009; All rights reserved) For more information: Larry Fisher, Ph.D., ABN UHS Neurobehavioral Systems 12710
Intensive Residential Treatment Services -IRTS Program Description A highly structured non-hospital based treatment setting that brings comprehensive and specialized diagnostic and treatment services to
Traumatic brain injury EMOTIONAL AND BEHAVIOURAL CONSEQUENCES OF HEAD INJURY Traumatic brain injury (TBI) is a common neurological condition that can have significant emotional and cognitive consequences.
Care Manager Resources: Common Questions & Answers about Treatments for Depression Questions about Medications 1. How do antidepressants work? Antidepressants help restore the correct balance of certain
CARING FOR PERSONS WITH DEMENTIA Many people are caring for an elderly parent or other loved one with dementia. This is a practical guide, in a question and answer format, designed to help caregivers assist
POSITION STATEMENT on Management of Challenging Behaviours in People with Dementia 1. AIM OF THE POSITION STATEMENT This position statement applies to people living in supported accommodation and those
Continence in Dementia. Elizabeth Rand Manager, Cognitive Dementia & Memory Service (CDAMS) Caulfield Hospital Continence Adequate stimulus to initiate voiding reflex Neuromuscular and structural integrity
Clinical Audit: Prescribing antipsychotic medication for people with dementia Trust, team and patient information Q1. Patient's DIS number... Q2. Patient s residence: Home Residential Home Nursing Home
Methamphetamine Introduction Methamphetamine is a very addictive stimulant drug. People who use it can form a strong addiction. Addiction is when a drug user can t stop taking a drug, even when he or she
1 Kids Have Stress Too! Especially at Back to School Time As a Parent, You Can Help! Stress can infect and affect the physical, emotional, intellectual and academic well being of children. It can interfere
Caring for Survivors of Trauma and Disaster: An Introduction to Psychological First Aid Biographical Information Rev. William F. Engfehr III LutheranChurch MissouriSynod DisasterResponseChaplain Senior
LAW ENFORCEMENT TRAINING MATERIAL ALZHEIMER S DISEASE AND THE SAFE RETURN PROGRAM N.J.S.A. 52:17B-77.7 Peter C. Harvey, Attorney General October 2005 LAW ENFORCEMENT TRAINING MATERIAL ALZHEIMER S DISEASE
Psychotic Disorders Introduction Psychotic disorders are severe mental disorders that cause abnormal thinking and perceptions. These disorders cause people to lose touch with reality. As a result, people
Responding to the Needs of Justice-Involved Veterans Mark Mayhew, LCSW VA Justice Outreach Coordinator There is inherent sympathy for those who sustain damage in defense of country, whether that damage
Employee Drug-Free Workplace Education South Carolina State University Alcohol- and Drug-Free Workplace Provided by the Office of Professional Development & Training SC State University Employee Education
Royal Manchester Children s Hospital Supporting your child after a burn injury Information for Parents and Carers of Young Children 2 Contents Page Introduction 4 Trauma and children 4 Normal reactions
Prescription Drug Abuse Introduction Most people take medicines only for the reasons their health care providers prescribe them. But millions of people around the world have used prescription drugs for
APPROVED: Memory Care Requirements for Nursing Care Center Accreditation Effective July 1, 2014, The Joint Commission will implement new memory care requirements designed to help accredited nursing care
Bip at W t What Is Bipolar Disorder? D DD Ds Dis DIDIsDsD D DJane F. Mountain, MD DWh Dha Dat Dt What Is Bipolar Disorder? Jane F. Mountain, MD PLEASE NOTE: This book is not meant to substitute for medical
Prescription drugs are the 3 rd most commonly abused drugs amongst teens in Nebraska, and the same statistic holds true on a national level. The rise in prescription drug abuse is becoming increasingly
Counseling Services Faculty/Staff Referral Guide for Students in Crisis The purpose of this guide is to provide faculty and professional staff with information about counseling services, referral information,
Non pharmacological Approaches to Managing Challenging Behaviors in Dementia Presented by Lori Nisson Waldberg, MSW, LCSW Robin P. Bonifas, PhD, MSW This webinar series is made possible through the generous
CP Factsheet Challenging behaviour and cerebral palsy What is challenging behaviour? The term challenging behaviour has been used to describe "difficult" or problematic behaviour. The more severe challenging
Depression in Older Persons How common is depression in later life? Depression affects more than 6.5 million of the 35 million Americans aged 65 or older. Most people in this stage of life with depression
Domestic Violence, Mental Health and Substance Abuse Sue Parry, PhD NYS Office for the Prevention of Domestic Violence Why does domestic violence (DV) have so many mental health effects? Put yourself in
The emotional and behavioural effects of Brian Injury can be the most difficult to understand and treat. Many of the people who sustain a brain injury are left with some form of emotional or behavioural
Inpatient Behavioral Health and Inpatient Substance Abuse Treatment: Aligning Care Efficiencies with Effective Treatment BHM Healthcare Solutions 2013 1 Presentation Objectives Attendees will have a thorough
Meeting the Needs of Aging Persons with Developmental Disabilities Cross Network Collaboration for Florida Aging in Individuals with a Developmental Disability Module 3 Based on ADRC training developed
THE Lewy Body society The more people who know, the fewer people who suffer Lewy body dementia Referral for a Diagnosis Lewy Body Dementias REFERRAL FOR A DIAGNOSIS In the UK people with all forms of dementia
Mental Health Awareness 2015 Haley Berry and Nic Roberts Nottinghamshire Mind Network The aim of this training:! to provide you with a basic understanding of mental health and mental illness. What do you
O: Gerontology Nursing Alberta Licensed Practical Nurses Competency Profile 145 Competency: O-1 Aging Process and Health Problems O-1-1 O-1-2 O-1-3 O-1-4 O-1-5 O-1-6 Demonstrate knowledge of effects of
23 Chapter 4: Eligibility Categories In this chapter you will: learn the different special education categories 24 IDEA lists different disability categories under which children may be eligible for services.
E-Resource January, 2014 BIPOLAR DISORDER IN PRIMARY CARE Mood Disorder Questionnaire Common Comorbidities Evaluation of Patients with BPD Management of BPD in Primary Care Patient resource Patients with
HOW WOULD I KNOW? WHAT CAN I DO? How to help someone with dementia who is in pain or distress Help! 1 Unusual behaviour may be a sign of pain or distress If you are giving care or support to somebody with
By Lori Boyce, AVP Risk Management and R&D Underwriting long term care insurance: a primer Every day Canadians die, are diagnosed with cancer, have heart attacks and become disabled and our insurance solutions
: It s Not Just Forgetfulness Alzheimer s Disease Research 2 Alzheimer s disease affects people s memories, but it involves far more than simple forgetfulness. It is a progressive, degenerative, and incurable
Healing the Invisible Wound Recovery and Rehabilitation from a Post Traumatic Stress Injury By Dr. Amy Menna Post Traumatic Stress Disorder can affect anyone. It is a term used to describe a reaction to
Understanding Suicidal Thinking Suicidal thoughts are temporary. Suicide is permanent. Don t give in to suicidal thoughts you can overcome them. If depression or bipolar disorder (also known as manic depression)
INFORMATION SHEET Age Group: Sheet Title: Adults Depression or Mental Health Problems People with Asperger s Syndrome are particularly vulnerable to mental health problems such as anxiety and depression,
Dementia Information for service users and carers RDaSH Older People s Mental Health Service What is Dementia is a term that is used to describe the symptoms that occur when the brain is affected by specific
Self Assessment: Substance Abuse Please respond TRUE (T) or FALSE (F) to the following items as they apply to you. Part 1 I use or have used alcohol or drugs for recreational purposes. I use alcohol despite
Traumatic Brain Injury NICHCY Disability Fact Sheet #18 Updated, July 2014 Susan s Story Susan was 7 years old when she was hit by a car while riding her bike. She broke her arm and leg. She also hit her
FACULTY AND STAFF GUIDE ASSISTING TROUBLED STUDENTS Table of Contents Introduction 1 Depression and Suicide 1 Anxiety 2 Substance Abuse 3 Angry Students 3 Grieving Students 4 Consultation, Referral, and
North Carolina Department of Health and Human Services Update Preadmission Screening and Review (PASRR) Process for Adult Care Homes licensed under G.S. 131D, Article 1 and defined in G.S. 131D-2.1 Preadmission
INPATIENT SERVICES Inpatient Mental Health Services (Adult/Child/Adolescent) Acute Inpatient Mental Health Services represent the most intensive level of psychiatric care and is delivered in a licensed
Caregiving Issues for those with dementia and other cognitive challenges. Sue Maxwell, MSW Director of Gerontology Lee Memorial Health System Fort Myers, Florida August 2009 Goals & Objectives Understand
Dementia & Movement Disorders A/Prof Michael Davis Geriatrician ACT Health & GSAHS ANU Medical School Eastern Dementia Network Aged and Dementia Care Symposium Bateman s Bay, 22 October 2010 Types of Dementia
Introduction Amphetamines, which are classified as stimulants, work by using the dopamine reward system of the brain. When these drugs are used, the user s central nervous system is simulated which causes
School-Age Child Guidance Technical Assistance Paper #2 School-age Child Guidance High quality out-of-school time programs promote school-age children s emotional and social development as well as their
Depression Signs & Symptoms Contents What Is Depression? What Are The Signs And Symptoms Of Depression? How Do The Signs And Symptoms Of Depression Differ In Different Groups? What Are The Different Types
Definition of Dementia (de mens) Latin for out of mind Permanent loss of multiple intellectual functions Alois Alzheimer first described this disease in 1906 in a brain specimen from an autopsy. Alzheimer
Guide for family and friends of people affected by bipolar disorders www.douglas.qc.ca This guide is intended for families, friends and other people who are interested in understanding the different aspects
Michael Brennan, MA, LMHC Providence St. Peter Hospital Crisis Services Welcome to the E.R.: Emergency: noun Webster 1. a sudden, urgent, usually unexpected occurrence or occasion requiring immediate action.
UTAH DEPARTMENT OF HUMAN SERVICES DIVISION OF SUBSTANCE ABUSE AND MENTAL HEALTH ADULT CASE MANAGEMENT EXAM Name Examiner s Name Examiner s Signature Date Score This exam is designed to test your knowledge
MEDICATION GUIDE WELLBUTRIN (WELL byu-trin) (bupropion hydrochloride) Tablets Read this Medication Guide carefully before you start using WELLBUTRIN and each time you get a refill. There may be new information.
BEHAVIOURAL ASSESSMENT FORM PLACEMENT SERVICES Client Name: Date of Birth: HCN: Date of Completion: (Last Name, First Name) (Day/Month/Year) (Day/Month/Year) (Version Code) INSTRUCTIONS: Frequency scales
Diagnosis, Intervention and Care for Patients With Cognitive Impairment Eric J. Freitag, Psy.D, FACPN Diplomate, American College of Professional Neuropsychology Mt. Diablo Memory Center Founder/Executive
Traumatic Brain Injury NICHCY Disability Fact Sheet #18 Resources updated, March 2011 Susan s Story Susan was 7 years old when she was hit by a car while riding her bike. She broke her arm and leg. She
Iowa Governor s Office of Drug Control Policy medicines or take them in a manner not prescribed, we increase the risk of negative effects. It is estimated that over 35 million Americans are ages 65 and
TRAUMATIC BRAIN INJURY AND DOMESTIC VIOLENCE Women who are abused often suffer injury to their head, neck, and face. The high potential for women who are abused to have mild to severe Traumatic Brain Injury
Overview Neuropsychological Assessment in Stroke Brandon Ally, PhD Department of Neurology What is Neuropsychology Stroke Specific Neuropsychology Neuropsychological Domains Case Study What is Neuropsychology?
Bipolar Disorder This factsheet gives information on bipolar disorder. It explains the symptoms of bipolar disorder, treatments and ways to manage symptoms. It also covers what treatment the National Institute
National Institute on Aging AgePage Depression Everyone feels blue now and then. It s part of life. But, if you no longer enjoy activities that you usually like, you may have a more serious problem. Feeling
Adult Information Form Page 1 Client Name: Age: DOB: Date: Address: City: State: Zip: Home Phone: ( ) OK to leave message? Yes No Work Phone: ( ) OK to leave message? Yes No Current Employer (or school