Dementia, delirium, and depression are serious conditions that significantly affect older adults physical and mental health, decreasing their autonomy and engagement with the world. These disorders interfere with one’s social life and ability to perform daily activities (Brigola et al., 2015). Dementia is especially hurtful, as it is often nonreversible, and it impacts one’s memory and thinking. Apart from limiting people’s cognitive performance, such disorders expose one to other problems, including poor nutrition, low medication adherence, behavior change, personal safety, and various comorbidities (Holroyd-Leduc & Reddy, 2012). Therefore, these conditions cannot be treated in isolation and require a multifaceted approach.
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In the present case, an 84-year-old White female came into the office with her daughter, who said that her mother’s dementia had worsened. The woman has been diagnosed with dementia before the visit, but the care plan included an assessment of her cognitive skills to determine the rate of progression. I talked to the patient’s daughter to get additional information about the patient’s medical history and symptoms. Then, I performed several memory, orientation, attention, and language skills tests. I ordered diagnostic tests to determine any nutritional deficiencies since the patient might have forgotten to eat regularly. Furthermore, I reviewed the patient’s medication to see whether any dosage changes may lead to some improvements. The patient’s drug treatment already contained acetylcholinesterase inhibitors and memantine (Donegan et al., 2017). It is a commonly used combination for treating dementia, and the patient did not have any negative responses to the medications.
I offered the patient’s daughter some ways to engage her mother in simple tasks, including light exercise, art therapy, journal writing, and family gatherings. Moreover, I educated the daughter about the approach to communicating with her mother in a calm, supportive, and encouraging manner. Overall, the care plan did not differ significantly from the one developed upon the initial diagnosis. It included more activities to help family members reconnect. In the future, I will consider more therapies and lifestyle changes to offer to the patient.
Brigola, A. G., Rossetti, E. S., Santos, B. R. D., Neri, A. L., Zazzetta, M. S., Inouye, K., & Pavarini, S. C. I. (2015). Relationship between cognition and frailty in elderly: A systematic review. Dementia & Neuropsychologia, 9(2), 110-119.
Donegan, K., Fox, N., Black, N., Livingston, G., Banerjee, S., & Burns, A. (2017). Trends in diagnosis and treatment for people with dementia in the UK from 2005 to 2015: A longitudinal retrospective cohort study. The Lancet Public Health, 2(3), e149-e156.
Holroyd-Leduc, J., & Reddy, M. (Eds.). (2012). Evidence-based geriatric medicine: A practical clinical guide. Hoboken, NJ: Blackwell Publishing.