Therapist's Guide to Clinical Intervention - Sigmund Freud

7. Risk for Injury
A. Assess
1. Psychosis
2. Disorientation
3. Wanders off
4. Agitation unmanageable
5. Excessive hyperactivity
6. Muscular weakness
7. Seizures
'Agitation and psychosis are a common presentation in individuals with dementia. If these
symptoms are present, a through evaluation to determine what may underlie the
disturbance is recommended.
B. Precautions
1. Caretaker to remain in close proximity for monitoring, check frequently
2. Objects/furniture in room should be placed with function and safety in mind
3. Remove potentially harmful objects
4. Padding of certain objects may be necessary
5. Educate caregiver on safety and management issues
8. Risk of Violence
A. Assess level of agitation, thought processes, and behaviors indicative of possible
episode of violent acting outing potentially directed toward self or others
B. Keep environmental stimuli to a minimum, and remove all dangerous objects
C. Encourage caregiver to maintain a calm manner
D. Gently correct distortions of reality
E. Evaluate need for higher level of care
9. Caregiver Stress
A. Encourage appropriate expression of feelings such as anger and depression
B. Identify ways to effectively deal with emotions
C. Identify feelings of stress and loss in relationship to the person they are taking
care of
D. Identify family conflict related to issues of care
E. Identify how their own lives have been interrupted/interfered with by caregiver role
E Develop rotations of time off to take care of own needs and have time to themselves
G. Refer to community support group focusing on caregiver situation
DEFINING SPECIFIC DEMENTIAS
1. Alzheimer's Disease: Dimension with an insideous onset, gradual progression,
with initial memory deficits. After several years, aphasia, apraxia and agnosia
as well as deficits in executive function follows.
*Executive function: High level decision making, performing multiple step tasks, etc.
Alzheimer's subtypes: with delirium, with delusions, with depressed mood and
uncomplicated
34 1. Treatment Planning-. Goals, Objectives, and Interventions