7 Nursing Diagnosis for Dementia

The most frequent cause of dementia is Alzheimer's disease. The cause of Alzheimer's disease is unknown , but is thought to involve genetic factors, because the disease seems to be found in some families and is caused or influenced by some specific gene abnormality. In Alzheimer's disease, some parts of the brain decline, resulting in cell damage and reduced response to a chemical that transmits signals in the brain.

By: Silvia (2006 ) , dementia associated with some types of diseases as follows :

• Diseases associated with medical syndromes : These include hypothyroidism, Cushing's disease, nutritional deficiencies, AIDS dementia complex, and so on.
• Diseases associated with neurological syndromes : This group includes Huntington's chorea, Schilder's disease, and other demyelinating processes ; Creutzfeldt- Jakob disease ; brain tumors ; brain trauma ; the brain and meningeal infection ; and others.
• Disease with dementia as the only sign of conspicuous : Alzheimer's disease and Pick's disease are included in this category.
• Dementia in terms of anatomy to distinguish between cortical dementia and subcortical dementia. Of the etiology and course of the disease to distinguish between reversible and irreversible dementia.

According to (Silvia , 2006) In general, signs and symptoms of dementia are as follows :

• Decline in memory that continues to happen. In patients with dementia , " forget " become a part of daily life that can not be separated.
• Impaired orientation time and place, for example : forget the day, week, month, year, place of people with dementia are.
• The decline and inability to arrange words into a correct sentence, using words that are not appropriate for a condition, repeat the word or the same story many times.
• Excessive expression, such as excessive crying when she saw a television drama, furious at small mistakes committed by others, fear and nervousness unwarranted. People with dementia often do not understand why these feelings arise.
• A change in behavior, such as : indifferent, withdrawn and anxious.

At first the disease is damaging the nerves cells in the brain that regulate memory, particularly in the hypothalamus and related structures. When the nerve cells of the hypothalamus stops functioning properly, there is a failure of short -term memory, followed by a failure of the ability to perform actions and tasks as usual. The disease is also on the cerebral cortex, particularly the areas responsible for language and thought. A loss of language skills, lower the person's ability to make decisions, and the resulting changes in personality. Explosive emotions and behavioral disorders, such as walking without purpose and agitation began to arise, and the more slowly over the course of the disease (Sylvia, 2005). Finally, many areas are involved, the atrophy and the patient is usually unable to interact with others, and very dependent on other people to do the most basic personal tasks, such as eating, drinking, defecation urination, and defecation. Macroscopically, the brain changes in this disease involves severe damage to cortical and hypothalamic neurons, and amyloid accumulation in the intracranial vessels. Morphological changes consist of two characteristic lesions that eventually evolved into soma degeneration, axons and dendrites of neurons (Wiwik, 2005). One sign of lesion is neurofibrillary tangles, the intracellular structures containing fibers tangled, twisted, which is composed mostly of proteins. In the central nervous system, most of these proteins have been studied as inhibitors structurally related shaper in stabilizing microtubules and is an important component of the cytoskeleton of neuronal cells (Muttaqin, 2008).

According Silvia, (2006), a complication that will arise are as follows :

• Acute or chronic disease, such as congestive heart failure, pneumonia, kidney and liver disease, cancer and stroke.
• Hormonal and nutritional factors, diabetes, adrenal imbalance, or thyroid, malnutrition and dehydration.
• Sensory damage associated with loss of vision and hearing as well as sleep deprivation.
• Treatment, including taking a variety of medications, prescription (especially the drug combinations that are anticholinergic).
• Drugs that interfere with the cholinergic system, and the neurotransmitter acetylcholine can affect memory, learning ability.

7 Nursing Diagnosis for Dementia

1. Relocation stress syndrome
related to changes in the activities of daily life
Characterized by :
confusion, concern, anxiety, looking anxious, irritable, defensive behavior, mental confusion, suspicious behavior, and aggressive behavior.

2. Disturbed Thought Process related to physiological changes (irreversible neuronal degeneration)
Characterized by :
memory loss or memory, loss of concentration, not able to interpret the stimulation and assess reality accurately.

3. Disturbed Sensory perception related to changes in perception, transmission or sensory integration (neurological disease, unable to communicate, sleep disorders, pain)
Characterized by :
anxiety, apathy, anxiety, hallucinations.

4. Distrubed Sleeping Pattern related to changes in the environment
Characterized by : a verbal complaint about difficulty sleeping, constantly awake, not able to determine the needs / sleep time.

5. Self-care Deficit related to activity intolerance, decreased endurance and strength
Characterized by :
decreased ability to perform activities of daily living.

6. Risk for injury related to the difficulty of balance, weakness, uncoordinated muscle, seizure activity.

7. Risk for Imbalanced Nutrition Less Than Body Requirements related to forgetfulness , setbacks hobby , sensory changes .