By Philip Carter

Geared up into sections, and comprising a an increasing number of demanding array of puzzles and difficulties, it's going to supply all facets of your intelligence a rigorous work out. in addition to proposing verbal, numerical and spatial demanding situations, the booklet will try out your powers of common sense, lateral considering, and correct vs. left mind hemispherical stability. functionality tests on the finish of every part will assist you to computer screen your growth.

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Qxd 31/3/06 12:50 PM Page 29 Common clinical conditions Emotions Irritable, aggressive, fearful Apathetic, labile, irritable Flat, unresponsive or sad; may be irritable Sleep Nocturnal confusion Often disturbed; nocturnal wandering and confusion Early morning awakening Other features Other physical disease may not be obvious Past history of mood disorder Table 6. A comparison of the clinical features of delirium, dementia and depression 100 A detailed history obtained from the resident and relatives/carers will help evaluate101: • cognitive impairment and decline from a former level of functioning: memory, problem solving, language, getting lost, using appliances, failure to recognise people or objects • behavioural and psychological symptoms: depression, withdrawal, aggression, agitation, false beliefs, hallucinations, sleep disturbance, loss of social graces, obsessive-compulsiveness • risk assessment: falls, wandering, nutrition, medication, abuse • alcohol intake • family history • capacity to consent to medical treatment, appoint a representative and make an advance care plan.

194 Impaction may require manual evacuation in some residents, after a premedication for pain. To prevent constipation, ensure adequate dietary fibre and fluid intake, easy access to toilet, and regular exercise within the resident’s ability.

152 Treatment of depressive symptoms involves a combination of nonmedication therapies (eg. patient education, behavioural strategies, psychotherapy) and antidepressant medication. qxd 31/3/06 12:50 PM Page 35 Common clinical conditions situations that are contributing to the depression, adequate treatment of associated medical conditions, and reduction of self harm risk. Monitor progress regularly, and consider specialist referral for patients153: • with severe, melancholic or psychotic depression • who fail to respond to treatment • who are at significant risk of self harm • where the diagnosis is unclear • where specialist treatments are required, eg.

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