Teaching Case Studies: Managing Aberrant Behavior In Patients With Dementia
Title: Insomnia and Mild Cognitive Impairment
Goals and Objectives
This activity is intended for health care providers, family, and/or caregivers who provide care for patients with dementia.
Insomnia is a common problem in older people, especially in patients with dementia whose circadian rhythm is often impaired. Insomnia exerts such a toll on caregivers that it is often the main reason for seeking to institutionalize their loved ones with dementia. Three different types of insomnia are recognized: sleep-onset or initial insomnia, sleep maintenance or middle insomnia and late insomnia or early morning awakening. Nocturnal hypoglycemia, as a cause of middle insomnia, is the main focus of this case study. Other types of insomnia are also briefly reviewed. The management of insomnia is then discussed including sleep hygiene, the usefulness and potential drawbacks of dietary supplements, non-prescription over-the-counter preparations and prescription hypnotics. Sleep architecture is then briefly reviewed, emphasizing the importance of its integrity and the role of each sleep stage. Upon completion of the activity, providers should be able to:
- Apply the material addressed in the scenario when advising caregivers seeking help with similar situations.
- Provide advice to caregivers about how to avoid aberrant behaviors from developing, escalating, and erupting, along with steps that can be taken to prevent it from occurring.
Before beginning this CME activity, you must review the article in its entirety, located here:
R. C. Hamdy1, J. V. Lewis1, A. Kinzer2, A. Depelteau3, R. Copeland4 , T. Kendall-Wilson1,5, K. Whalen1
1East Tennessee State University, Johnson City, TN; Department of Geriatric Medicine
2East Tennessee State University, Johnson City, TN; Communication & Performance
3East Tennessee State University, Johnson City, TN; Innovation Laboratory
4East Tennessee State University, Johnson City, TN; Department of Internal Medicine
CME Release Date: June 5th, 2018
Content Reviewed: April 3, 2019
Valid for credit through: June 5th, 2020
Course type: Journal CME
This activity has been planned and implemented in accordance with the accreditation requirements and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint providership of Southern Medical Association and SAGE Publishing. Southern Medical Association is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Southern Medical Association designates this Journal CME Activity for a maximum of 1 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
For information on applicability and acceptance of continuing education credit for this activity, please consult your professional licensing board. All healthcare professionals who are not MDs or DOs will receive a certificate of participation.
Instructions for Participation and Credit
This activity is designed to be completed within the time designated; learners should claim only those credits that reflect the time actually spent in the activity. To successfully earn credit, participants must complete the activity online during the valid credit period noted, following these steps:
- Read the goals and objectives, accreditation information, and author disclosures.
- Study the educational content and references.
- Online, choose the best answer to each test question. To receive a certificate, you must receive a passing score of 80%.
- Complete the activity evaluation and attestation.
Upon successful completion of the test, evaluation and attestation, your certificate will be processed and emailed from firstname.lastname@example.org within approximately 1 hour. Credits will be archived for 6 years; at any point within this time period you may login to your account to print a duplicate copy of your certificate.
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