Treating Dementia
Assignment Details: Assessing, Diagnosing, and Treating Dementia, Delirium, and Depression
With the prevalence of dementia, delirium, and depression in the growing geriatric population, you will likely care for elderly patients with these disorders. While many symptoms of dementia, delirium, and depression are similar, it is important that you are able to identify those that are different and properly diagnose patients. A diagnosis of one of these disorders is often difficult for patients and their families. In your role as an advanced practice nurse, you must help patients and their families manage the disorder by facilitating necessary treatments, assessments, and follow-up care.
The Situation-Background-Assessment-Recommendation (SBAR) format is a widely recognized method of communication in healthcare settings and assists in organizing and presenting information in a way that is understandable and integrated into the diagnostic process. It can be used to present a case as a nurse to a provider, or provider to provider, during consultations. As a nurse practitioner student and future provider, being able to communicate effectively about a patient to ensure the best and most efficient outcomes, is a critical skill.
In this assignment, you will demonstrate your ability to present a clinical case to another healthcare provider using the SBAR format. Think of this as formal practice in the skill of presenting a case. The following from The Agency for Healthcare Research and Quality (2019) is an example resource for SBAR: https://www.ahrq.gov/teamstepps-program/curriculum/communication/tools/sbar.htmlLinks to an external site.
Using the case assigned, imagine you are presenting this case to your clinical preceptor or another provider, physician or nurse practitioner. You will create a short, less than 3-minute video of you presenting this case using the SBAR format. Please dress as if you were in a professional, clinical setting. Please present the following in your video. You are encouraged to review the peer response prompts for information on how your presentation will be evaluated.
Important: Ensure patient confidentiality by de-identifying any personal health information in your case presentation.
S ituation: Briefly describe the patient\’s current condition and why you are presenting the case.
B ackground: Provide relevant patient history, including past medical history, medications, and pertinent findings from physical examination and diagnostic tests. Keep this section brief and related to the patient’s current condition.
A ssessment: Summarize your assessment findings, including your differential diagnosis and any relevant diagnoses.
R ecommendation: Present your recommendations for further management, including potential interventions, medications, referrals, and follow-up plans, or ask for consultation/the provider’s expertise.
Please post your video presentation by Day 3 of the week assigned. Then, please thoughtfully respond using the prompts below to at least two peers over the course of two separate days, by Day 6, to earn full credit in discussion.
Link to MMSE info Mini-Mental State Exam (MMSE) Test for Alzheimer’s / Dementia
https://nam12.safelinks.protection.outlook.com/?url=httpswww.dementiacarecentral.commini-mental-state-exam&data=0502jinga.oglesbymail.waldenu.edu242f4292a24a456b999708dd5a9ee94f97fb1a0766ed498398cd2b41977edc2500638766363004524254UnknownTWFpbGZsb3d8eyJFbXB0eU1hcGkiOnRydWUsIlYiOiIwLjAuMDAwMCIsIlAiOiJXaW4zMiIsIkFOIjoiTWFpbCIsIldUIjoyfQ0&sdata=Yf6AtgjDPI6u9CihcuJQpASSimZskSBveWqY5xX61Y&reserved=0
Ms. Carter is a 68-year-old who is brought to your office by her daughter with concerns of “forgetfulness.” She has lived with her daughter for 4 years now, and her daughter reports noticing she asks the same questions even after they have been answered. She even reports her mom getting lost in Walmart recently. Ms. Washington has lived with her daughter since losing her husband of 57 years, about 4 years ago. Her daughter states her mother is a retired teacher and usually very astute but notices more forgetfulness.
According to Ms. Carter’s daughter, Amanda, her mom has been demonstrating increased forgetfulness of more recent things but can easily recall historical moments and events. She also reports that sometimes her mom has difficulty “finding the right words” in a conversation, and then will shift to an entirely different line of conversation. She also said her mother will “laugh off” things when she forgets important appointments and/or become upset or critical of others who try to point these things out.
Note: Be sure to review the Mini-Mental State Exam (MMSE) and how to interpret results.
Use the MMSE, in the attached document, to determine the patient’s MMSE score.
Make sure you present the patient’s score in your video presentation posted in discussion:
Ms. Carter is a 67-year-old female who is alert, cooperative with today’s clinical interview. Her eye contact is fair. Speech is clear and coherent but tangential at times. She makes no unusual motor movements and demonstrates no tics. She denies any visual or auditory hallucinations. She denies any suicidal thoughts or ideations. She is alert and oriented to person, partially oriented to place but is disoriented to time and place. (She reported that she thought was headed to work but “wound up here,” referring to your office, at which point she begins to laugh it off.) She denies any falls or
pain.
All other Review of System and Physical Exam findings are negative other than stated.
PMH: Hypertension, Hyperlipidemia, Osteoporosis
Allergies: Penicillin, Lisinopril
Medications:
• Amlodipine 10mg PO daily
• HCTZ 12.5mg PO daily
• Multivitamin PO daily
• Atorvastatin 40mg PO daily
• Alendronate 70mg PO once a week
Social History: As stated in Case Study
ROS: As stated in Case Study
Diagnostics/Assessments done:
1. CXR—no cardiopulmonary findings. WNL
2. CT head—diffuse Cerebral Atrophy
3. MMSE—Ms. Carter scores 18 out of 30 with primary deficits in orientation,
registration, attention and calculation, and recall. The score suggests moderate dementia.
Learning Resources
Required Readings
Kennedy-Malone, L., & Groenke-Duffy, E. (2023). Psychosocial disorders. In Advanced practice nursing in the care of older adults (3rd ed., pp. 502-541). F.A. Davis.
Kennedy-Malone, L., & Groenke-Duffy, E. (2023). Appendix B: Laboratory values in the older adult. In Advanced practice nursing in the care of older adults (3rd ed., pp. 581-582). F.A. Davis.
Note: See the labs that are relevant to this week’s topics.
Laske, R. A., & Stephens, B. A. (2018). Confusion states: Sorting out delirium, dementia, and depression. Nursing Made Incredibly Easy!Links to an external site., 16(6), 13–16. https://doi.org/10.1097/01.NME.0000546254.38666.1f
NIH National Institute on Aging. (2017). Basics of Alzheimer’s disease and dementia: What is Alzheimer\’s disease?Links to an external site. [Multimedia file]. https://www.nia.nih.gov/health/what-alzheimers-disease
Required Media
Hartford Institute for Geriatric Nursing. (2013, September 24). Elder mistreatment assessmentLinks to an external site. [Video]. YouTube. https://youtu.be/L8jzycu0eTo
Note: The approximate length of this media piece is 39 minutes.
Recommended Media
Engage-IL (Producer). (2017f). Dementia: Patient-centered dementia care—understanding patient and caregiver expectationsLinks to an external site. [Video]. https://engageil.com/modules/patient-centered-dementia-care-understanding-patient-and-caregiver-experiences
Note: View the Dementia: Patient-centered Dementia Care—Understanding Patient and Caregiver Experiences video module available in this free course.
Engage-IL (Producer). (2017g). Depression and delirium of the older adultLinks to an external site. [Video]. https://engageil.com/modules/depression-and-delirium-of-the-older-adult
Note: View the Depression and Delirium of the Older Adult video module available in this free course.
Engage-IL (Producer). (2017k). Elder abuse and self-neglectLinks to an external site. [Video]. https://engageil.com/health-professional-ce/psychosocial-needs/elder-abuse/
Note: View the Elder Abuse and Self-Neglect video module available in this free course.
Engage-IL (Producer). (2017z). Sleep quality of the older adultLinks to an external site. [Video]. https://engageil.com/modules/sleep-quality-of-the-older-adult
Note: View the Sleep Quality of the Older Adult video module available in this free course.
Paper Format: APA
Number of pages: 2
Powerpoint slides:
550 words approx
Sources: 4
Answer preview to Treating Dementia
APA
600 WORDS
