dementia /dimen″shə/ [L, de + mens, mind] , a progressive organic mental disorder characterized by chronic personality disintegration, confusion, disorientation, stupor, deterioration of intellectual capacity and function, and impairment of control of memory, judgment, and impulses. Kinds include Pick’s disease, senile dementia–Alzheimer type, senile dementia, toxic dementia, dementia paralytica, secondary dementia. Should not be confused with delirium. ▪ OBSERVATIONS: There is more than one type of dementia, each slightly different from the others in presentation. In general, patients with dementia decline gradually, are confused, and do not have a change in their level of consciousness. The decline of cognitive function eventually becomes severe enough to impact social or occupational functioning. ▪ INTERVENTIONS: Dementia caused by drug intoxication, hyperthyroidism, pernicious anemia, paresis, subdural hematoma, benign brain tumor, hydrocephalus, insulin shock, and tumor of islet cells of the pancreas can be reversed by treating the condition. Other organic forms of dementia such as Alzheimer’s disease are irreversible, progressive, and incurable. However, conditions that cause the decline may be treatable or partly reversible. Medications are available to slow the progression of some forms of dementia. ▪ PATIENT CARE CONSIDERATIONS: As the ability to function effectively declines, care provision by others is increasingly necessary. The health care team should address the needs of dementia caregivers, as well as the patient. The increased burden of caregiving can contribute to numerous chronic health problems in the caregiver. For some patients with dementia, a long-term care facility can provide the most appropriate care. At the end stages, palliative care within a care facility is generally warranted.
