Question

1. Mr. Heron is a client of your agency. He lives in a retirement home but uses home-support services from your agency two mornings a week. You have been visiting Mr. Heron for a month now. Although he is forgetful, he is a precise person who has definite preferences as to how things should be done.

Four times out of the eight times you have visited Mr. Heron, he has met you at the elevator near his room. Sometimes he is fully dressed; sometimes he is only partially dressed. He is always very anxious. He tells you, “The train is leaving and I have to get on it or I will be late.” You know that Mr. Heron was a high-school principal who lived in Mississauga and worked in downtown Toronto.

1. Explain how Mr. Heron’s personality traits contribute to his reaction? (2 marks)

2. If Mr. Heron’s diagnosis is Alzheimer’s disease, how might memory loss contribute to his reaction? (2 marks)

3. Using effective communication techniques, how would you respond to Mr. Heron’s statement? Explain why this response would be helpful.   (4 marks)

2. Why is depression often mistaken for dementia?   (2 marks)

3. Consider the activity of eating. How would each stage (Early, Middle and Late) of Alzheimer’s affect a person’s ability to eat? As a PSW identify one strategy for each stage that you could use to assist a person with eating. Explain why each strategy would be appropriate and effective.

(3 changes, 3 strategies and 3 explanations for a total of 9 marks)

4. Consider a person diagnosed with Middle-Stage Alzheimer’s living at home. List 5 safety measures to use in this person’s home. Explain why each safety measure is appropriate with specific references to behavioural, cognitive and sensory changes experienced by a person with Middle-Stage Alzheimer’s. (10 marks)

5. Mrs. Green is a client of your agency. She has a diagnosis of vascular dementia. She is only mildly forgetful from time to time. She takes comfort in “getting answers” although she may forget them. She says to you, “Have you seen my daughter? I haven’t seen her in a long time.” You know that the daughter visits on a regular basis, but are not sure when she was last at your client’s home.    

1. What is multi-infarct dementia? (2 marks)

2. How might Mrs. Green’s forgetfulness interfere with her safety needs? (2 marks)

4. Using effective communication techniques, how would you respond to Mrs. Green’s question? Explain why this response would be helpful.   (4 marks)

6. Mr. Black, age 89, has multi-infarct dementia with severe memory loss, impaired judgment, and mood swings. He is also profoundly deaf and has some vision problems. He is increasingly weak and unsteady on his feet and needs to be supervised and assisted with all activities of daily living. He lives in a private room in a long-term-care facility. He will not join in any activities and often refuses to go to the dining room for his meals. Sometimes he has angry outbursts and is often found crying in his room. He says that he should be able to go out and have a job again. He feels that everything has been taken away from him. He often expresses that his life is worthless and he wishes he could die.

Mrs. Black visits her husband every day and attempts to rationalize with him and talk him out of his bad moods. She appears to care for him very much and often tidies his room and changes his clothes. He usually unloads all of his feelings on her and she goes away feeling frustrated and guilty.

1. Explain how failing physical health, affects Mr. Black’s mental and emotional health. (2 marks)

2. Explain how institutionalization and loss affect Mr. Black’s mental health. (2 marks)

3. What are the advantages that Mr. and Mrs. Black each experience as a result of Mrs. Black’s visits? (2 marks)

4. What are the disadvantages that Mr. and Mrs. Black each experience as a result of Mrs. Black’s visits? (2 marks)

Answer 1

Answer : middle stage Alzheimers disease :

It also known as moderate Alzheimers disease, in these diseases the clients needs help in daily living activities. Here we will abserves the severe dementia or cognitive declinement.

Safety measurements at home :

1. Preventing the falls : due to slippery surfaces and some furnitures there will be a chance of fall of dementia clients because they will forgot there will be a furniture like that.

So we need to help them from falls by keeping aside what ever the barrier furniture are there in surroundings.

And keep unslippary floor for dementia clients.

2. Assess and reassess the clients :

If any thing is doing by the Alzheimers clients means in home care takers will be assess and assess again and again. Or check what they are doing whether it is correct or not.

3. Keep adequate temperature water in bath room and tell them, which are the cool, and which are the hot, repeatedly remember to them.

4. Keep adequate light source, because they can't identify the things easily.

5. Keep the doors lock is opened, because some times there will be any need to come out from room and some times they can't open it.

6. Arrange shower chairs and grab bars in bathrooms, because they can't sit and stand again and again. And grabs will help to hold and useful like supportiveness.

a) multi infarct dementia :

Mainly it will seen in the older age people, due to decreased blood supply to the brain tissue leads to multiple stokes it may leads to loss of memory may comes to the older persons. It is called as multi infarct dementia.

b) Mrs. Greens forgetfulness interferes with her safety needs:

* safety needs are house and protecting from harmful things, she might be forget the things which are harmful in surrounding her and there is a chance of forget family members and home and society members.

* and she can't perform the things correctly and she might be get any injuries due to harmful substances.

d) good communication skills are :

Good listening and understanding and patience are the good communication skills to understand her question.

* I will respond to her question like yes, I have seen your daughter, she is coming daily for you.

* these responses is very useful and Better for client, because already she is in dementia, by explaining again and again at least she can remember little bit.