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Module 4: Cognitive Loss

Module 4 addresses:

1) Stages of dementia;
2) Related disability from specific cognitive impairments;
3) Steps to address acute changes in cognitive status.

When the Mind Falters: Cognitive Losses in Dementia

Joel Streim, MD
Associate Professor of Psychiatry
Director, Geriatric Psychiatry Fellowship Program
University of Pennsylvania
VISN 4 Mental Illness Research Education and Clinical Center
Philadelphia VA Medical Center

Dementia, and the cognitive losses and behavioral changes it causes, presents major challenges to nursing home staff. With an improved understanding of how cognition becomes impaired and the stages of dementia, direct care staff can better assess residents' abilities and issues, and respond to them appropriately. The loss of mental function and behavioral changes caused by dementia are frequent reasons for nursing home admission. As a result, up to two-thirds of nursing home residents have dementia. Approximately 70% of those persons are thought to have dementia with Alzheimer's disease. Dementia is a major health problem in the U.S., with over 4 million cases. Epidemiological studies have shown that up to 8% of all individuals over 65 have Alzheimer's disease. For those living beyond age 80, studies suggest that somewhere between a quarter and half are affected by Alzheimer's disease.

Download either the complete module, watch a video, or print various sections, such as presentation tools for the instructor as well as handouts and evaluation forms for the participants.

Teaching Materials:

Video (6:27 minutes)

Module 4: Cognitive Loss

For the Instructor:

Instructor's Slides with Notes

For Participants:

Module 4: Cognitive Losses (Handouts)

Evaluation of Module


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