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Such conditions as dementia, depression, and delirium may significantly alter the health of geriatric patients. These disorders are common in older people, but they should not be treated as a normal part of the aging process. It is also vital to recognize that their timely treatment can help geriatric patients to overcome many related issues and avoid complications. Nonetheless, some conditions cannot be fully cured, requiring medical professionals to focus on ongoing health management and support. The presented case discusses an older female patient with progressing Alzheimer’s dementia and the plan for her assessment, treatment, and education.
Illnesses that affect people’s mental health can have devastating effects on older individuals, primarily because of their progressive nature and a wide range of possible causes. For example, the number of geriatric patients with such conditions as dementia continues to increase (Holroyd-Leduc & Reddy, 2012). Both dementia and delirium are characterized by memory impairments, confusion, decision-making problems, and mood changes (Resnick, 2016). Thus, these disorders endanger the safety of frail elders who have an increased risk of falls, fractures, and self-injuries (Holroyd-Leduc & Reddy, 2012). Similarly, depression can also lower the positive effects of nonpharmacological treatments and contribute to social withdrawal. Frail elders usually have multiple comorbidities, and their physical and mental health greatly depends on their ability to perform everyday activities.
Patient Case
The discussed patient is an 80-year-old woman who has been diagnosed with Alzheimer’s disease five years ago. She presents to the office with her daughter who reports that the patients’ condition has been progressing over the last 6 months. The patient is constantly in a state of confusion – she does not recognize her children, cries, and calls for her mother. The patient has also lost the ability to perform daily activities and become incontinent of bowel and bladder. The care plan for the patient includes an ADL assessment to determine how much help would the patient need every day. The symptoms of urinary and bowel incontinence should be checked with samples to exclude infection. The progression of symptoms related to dementia should also be evaluated with cognitive assessment tools. It can be concluded that the patient’s Alzheimer’s disease is progressing, and its moderate form is moving towards the severe one.
Treatment may include the increase in the dose of the patient’s current prescriptions. The current plan incorporates Aricept 10 mg daily and Namenda 5 mg daily, which can be raised to 23 mg and 10 mg respectively (Wang et al., 2015). Pharmacological treatments for incontinence can involve anticholinergics and anti-diarrheal medicine, depending on the patient’s symptoms. A medical professional can recommend using such nonpharmacological treatments for memory problems and agitation as multisensory stimulation and regular communication (Nowrangi, Lyketsos, & Rosenberg, 2015). The patient’s daughter also voiced concerns about not being able to care for her mother efficiently. Thus, the patient may benefit from being transferred to an assisted care facility or hiring a professional caretaker. The patient’s daughter should be educated about the necessity of contact with the patient and possible mobility and other aids to help her with ADL.
Future Considerations
The proposed plan seems to target the problems of the presented case. However, the comments of the patient’s daughter about her inability to care for her mother should be addressed in more detail. It is possible that the patient does not receive sufficient support at home as her daughter has other duties and cannot provide her mother with time. As the patient’s health deteriorates, a conversation about a transfer to a facility or professional support should be considered in the future.
Conclusion
Dementia, depression, and delirium affect geriatric patients and impair their ability to have an independent life. These conditions threaten the physical health of frail adults and increase the risk of falls, fractures, and other injuries. Alzheimer’s disease is a serious progressive condition that cannot be cured completely. Its development, as is described in the presented case, asks for professional help, and caretakers of patients with the condition’s severe form may feel overwhelmed with their responsibilities.
References
Holroyd-Leduc, J., & Reddy, M. (Eds.). (2012). Evidence-based geriatric medicine: A practical clinical guide. Hoboken, NJ: Blackwell Publishing.
Nowrangi, M. A., Lyketsos, C. G., & Rosenberg, P. B. (2015). Principles and management of neuropsychiatric symptoms in Alzheimer’s dementia. Alzheimer’s Research & Therapy, 7(12), 1-10.
Resnick, B. (Ed.). (2016). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (5th ed.). New York, NY: American Geriatrics Society.
Wang, J., Yu, J. T., Wang, H. F., Meng, X. F., Wang, C., Tan, C. C., & Tan, L. (2015). Pharmacological treatment of neuropsychiatric symptoms in Alzheimer’s disease: A systematic review and meta-analysis. Journal of Neurology, Neurosurgery, and Psychiatry, 86(1), 101-109.
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