Recognizing Dementia, Depression, and Delirium in Older Adults
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1. Download the PowerPoint document labeled Is It Dementia, Depression, or Delirium Game. The document is a PowerPoint presentation of a game students can play, directed by a faculty facilitator. This strategy promotes active learning as the platform to discuss dementia, depression, and delirium. The speaker’s notes have additional information for the facilitator to continue the discussion. These notes also link to applicable tools that are pertinent to the content. It may be helpful to assign students a reading from their text books or prepare by reading an article such as:
Edwards, N. (2003). Differentiating the three D's: Delirium, dementia, and depression. Medsurg Nursing, 12(6), 347-57; quiz 358.
a. The PowerPoint presentation needs to be viewed in slide show mode to play.
b. Click to advance the slides to the next question, and double click to reveal the answer choices, then single click to reveal the correct answer. Repeat this to go through all fourteen questions.
c. There are points assigned to each question if the facilitator chooses to use the game in a competitive manner.
d. The slides can be edited at the discretion of the facilitator to include any additional information.
2. All of the simulation cases; Ertha Williams, Judy Jones and George Palo have elements of dementia, depression, and delirium and can be used in an active way to help students identify differences and interventions. These simulations can be utilized after the students play the game; Is It Dementia, Depression, or Delirium or independent of the game. In addition, any of the monologues could be used at the start of a lecture to spark discussion and have the students link the content to a first-person case study. These monologues can also be a dynamic part of an online discussion on dementia, delirium, and depression as the instructor can guide the learner to the audio clip of the case. In each case the patients have a level of confusion with an array of other symptoms that require the student to think about how they would further assess the patient and what interventions they would put into place based on the diagnosis and behavioral concerns.
a. Judy Jones has an underlying dementia with a superimposed delirium resulting in an acute change in mental status and behavioral changes.
b. George Palo has a mild cognitive impairment with worsening of cognitive impairment with a superimposed depression.
c. Ertha has progressive Alzheimer’s dementia with worsening of her symptoms with time and transition.
d. Utilize the Confusion Assessment Method in each of these simulation monologues to start the discussion on the differentiation between dementia and delirium: Tool - Video
e. Utilize the following questions (Benner) to help further process the content in monologues:
- What are your concerns about this patient?
- What is the cause of the concern?
- What information do you need?
- What are you going to do about it?
- What is the patient experiencing?