Question

A 74-year-old male, retired accountant, with a long-standing history of hypertension and atherosclerosis, begins to exhibit some personality changes, deterioration in grooming, trouble understanding news events, and difficulty managing personal finances. He also stopped attending social events and dropped out of his chess club. His wife of 50 years becomes concerned and schedules an appointment with his healthcare provider, who diagnoses him with Vascular Dementia, Alzheimer’s type. Arrangements have been made for a visiting RN to come to the house once weekly.

Initial Discussion Post:

Address the following:

In what stage of Alzheimer’s disease is this client? What criteria did you use to determine this?

What are 3 priority RN assessments when home visits are made?

What are some anticipated caregiver issues that this client’s spouse will personally experience?

List and describe 3 intercollaborative referrals that may be needed for this client within the next year or so.

Answer 1

1. The patient is in mild cognitive impairment stage, that is second stage of Alzheimer's disease. The diagnostic guidelines of The National Institute on Aging and the Alzheimer's Association was used to determine the patient’s Alzheimer's disease stage.
2. The three priority RN assessment are:
• Check for the cognitive status
• Assess for the patient's self care abilities
• Assess for the ability and level of support for the patient by the caregiver.
3. Some of the anticipated caregiver issues are:
• Social withdrawal
• Anxiety
• Depression
• Exhaustion
• Sleeplessness
• Irritability
• Lack of concentration
• Other health problems
4. The intercollaborative referrals are:
• Rehabilitative team
• Geriatric team
• Occupational therapist
• Support service
• Nursing
• Counsellor