In this Assignment, you will review the Atypical Presentation PowerPoint, the Urinary Incontinence PowerPoint, (both of which can be found on the Activities page in this unit) and the screening tools from http://consultgerirn.org/resources/. Read the case study and compose an expository paper in which you respond to the questions below.
Ms. N is a 74 year-old female who is accompanied for admission to the nursing home by her daughter Doris. Ms. N appears distracted and confused repeatedly saying “I want to go home, why am I here?” Doris reports for over the past 3 weeks her mother, who has lived with her for over 10 years, has gone downhill quickly and she can no longer manage her falling and urinary incontinence (UI) at home. Doris has sought nursing home admission for respite for the next few weeks, but plans to admit her mother permanently due to her inability to care for herself.
During your focused interview you learn that Ms. N is actually paranoid, saying, “that lady over there, brought me here to get rid of me, I think she’s trying to kill me.” You quickly integrate questions from the Mini-Mental State Examination into your causal, but focused interview. Ms. N scores a 20/30. You conclude she is probably suffering from Dementia of the Alzheimer’s type. A review of her medical records shows mild benign forgetfulness and recent confusion which was treated with Haldol 0.5 mg BID. Ms. N was independent in activities of daily living (ADL) up until 1 month ago. A typical day was spent driving herself to a part-time job at the local library.
A review of the medical record accompanying Ms. N reveals a recent CAT Scan of the head performed 1 week ago that was normal with no masses or atrophy. All other laboratory data is normal (CBC, B12, folate, and SMA-24). Missing are a routine urinalysis and thyroid function studies.
• What would be a preliminary problem list for Ms. N?
• What is the most important piece of information given in this scenario? Why?
• Identify the atypical presentations and/or geriatric syndromes in this case study.
• What other subjective data do you need to gather? Why?
• What objective data do you need to gather about Ms. N? Why? Which screening tools would be helpful? (review the resources in http://consultgerirn.org/resources/)
• Finish this case study scenario to include the further subjective and objective data you might receive. What interventions would you propose? What would be some realistic and measureable projected outcomes?
The finished Assignment should be 4-5 pages in length, excluding the title page and references. The viewpoint and purpose of this Assignment should be clearly established and sustained.
Notes to the writer. All these parts must be included in the essay. Also refer to the questions above this is an expository essay
1. Creates a complete problem list for patient.
2. Able to defend logically and clearly the choice of important information.
3. Correctly and clearly identifies atypical presentations and/or geriatric syndromes.
4. Completely and clearly identifies relevant needed subjective and objective information with rationale and assessment tools.
5. Thoroughly identifies three relevant interventions with rationale based on further subjective and objective information.
6. Thoroughly describes two realistic and measureable proposed outcomes based on proposed interventions.
I will attach the samples of atypical presentation power point and urinary incontinence power point as different files.
review the resources in http://consultgerirn.org/resources/
This is the link for atypical presentation I also copied and pasted in a different file.
Additional references (I will attach as different files)
Callahan, C. M., Arling, G., Tu, W., Rosenman, M. B., Counsell, S. R., Stump, T. E., & Hendrie, H. C. (2012). Transitions in Care for Older Adults with and without Dementia. Journal Of The American Geriatrics Society, 60(5), 813-820. doi:10.1111/j.1532-5415.2012.03905.x
French, S. L., Floyd, M., Wilkins, S., & Osato, S. (2012). The Fear of Alzheimer’s Disease Scale: a new measure designed to assess anticipatory dementia in older adults. International Journal Of Geriatric Psychiatry, 27(5), 521-528. doi:10.1002/gps.2747
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