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Harvard
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Health, Medicine, Nursing
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Case Study
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Dementia, Delirium and Depression, Interventions for Mr. David's Health Situation (Case Study Sample)

Instructions:

the sample explains how the various medical conditions that mr. geofferies facing in relation to depression, delirium and dementia. Furthermore, the sample identifies the sings and symptoms of each condition and how Mr. geofferies' conditions relates to them.

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Content:

Dementia, Delirium and Depression
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Introduction
This article is meant to create a clear relation between dementia, delirium and depression and how they are related to Mr. David Geoffries’ health situation in the case study. The case study Mr. Geoffries had been diagnosed with dementia and had past medical history of CVA. The diagnosis of dementia is made by the memory loss and communication difficulties that Mr. Geoffries faces (Cerejeira et al., 2012, p.73). Though dementia also causes communication difficulty, Mr. David got diagnosed 20years with cerebrovascular disease that greatly affect his speech and its one of dementia symptoms that Mr. Geoffries experiences when his grandson speaks on his behalf. Furthermore, Mr. David suffers from atrial fibrillation which also causes confusion, fatigue, and dizziness. He also suffers from Type 2 diabetes which is often caused by the lack production of insulin by the pancreas, moreover, he suffers from depression which is often caused by dementia if it is not treated early. He further suffers from glaucoma which causes severe pain of the eye and headaches that are due to the pains caused by the affected eye. Mr. David appeared confused and even hit out at the person who was trying to shower him which is a clear symptom of delirium (Voyer et al., 2012, p. 264). It is also observed that Mr. David is brought to the hospital due to incontinent in urine and feces which is mainly caused by recurring urinary tract infection, diabetes, old age and senile dementia (Bardsley, 2013, p.41). This article also addresses the interventions that the nurses are to undertake to make sure that Mr. David’s condition improves.
Description of Dementia, Delirium and Depression from the Case Study
1 Dementia
From the case study, it is evident that Mr. Geoffries suffers severely from these diseases which have caused communication difficulty and confusion. For instance, Dementia affects Mr. David in that it has created his memory loss and communication difficulty. Other signs and symptoms include confusion and disorientation which result in difficulty in problem-solving ability. The disorder is one of the primary reasons why the patient got brought to the hospital, and it is clear that dementia could be the most probable cause. Furthermore, on the psychological side dementia is known to cause depression, anxiety and inappropriate behaviors such as aggression when Mr. David hits out at the person who was trying to shower him and he reacts the same way to the nurses (Gitlin et al., 2012, p.2020).
2 Delirium
This disease causes the reduction in awareness of the environment that the patients are within. For instance, due to the confusion and disorientation Mr. David's grandson acts as his guardian because his grandfather is unaware of the environment which he is within. Another symptom includes difficulty in speech, nonsense speech and trouble understanding what is getting communicated to the patient. These symptoms are evident when Mr. David lashes out at the person who was trying to shower him and when his grandson represented him in the hospital as his guardian because his speech was not sufficient (Lundström et al., 2012, p.164). Furthermore, delirium makes the patient feel restless and agitated; these are evident in Mr. David's case when he is restless and keeps wanting to get up from the chair next to his bed. Moreover, Mr. David gets personality and mood changes when he proves difficult to the staff who try to get him into the shower. The unpredicted mood shift that Mr. David experiences are due him suffering from delirium.
3 Depression
Mr. David experiences depression because the doctor believes that he is disinterested in life other than food and his sleeping pattern. These are clear signs and symptoms of depression in that the loss of interest in life is because Mr. Geoffries has no social experience that could excite him. Furthermore, depression may cause decrease or increase in appetite and Mr. David's case it has increased his appetite because that is the only thing that he is interested. Moreover, the sleeping pattern of Mr. Geoffries has changed which is a clear indication of depression (Brown and Harris, 2012). The patient is also unsteady on his feet which proves that he is weak and this is another sign of distress. Therefore, when Mr. David hit out at the nurses who were trying to get him into the shower can be attributed to recession because he proved agitated which is another sign and symptom of depression. Moreover, Mr. David feels worthless because some of the staff members had been heard talking about him saying that Mr. Geoffries is like a baby and they also admonished him. These behaviors demonstrated by the staff members further proved devastating to the state of Mr. Geofferies as he got more depressed and felt neglected.
Interventions for Mr. David’s Health Situation
Mr. David is placed on antibiotics and the use of incontinence pads continues with an order of zinc cream application to the groin. The zinc cream is applied on Mr. David on the weepy or bleeding areas three times a day and whenever stooling occurs. It is also essential that when the next application happens, the zinc cream should not get scrubbed entirely. The stool should be gently stooled off and this should be done daily using oil to soften it and balance Mr. David’s skin pH level then the stool is gently removed with incontinence cleanser (Junkin, 2008). Also, Mr. David can be positioned semi-prone for about 30 minutes twice or thrice per day to expose the affected skin to the air, and this gets done so that the affected area may dry up which fastens the healing process. The care practitioner should also consider treatment that reduces moisture which gets done by using low air loss mattress and more frequent turning of Mr. David so that the affected skin may not get tampered. Moreover, Mr. Geoffries is given antibiotics because he is in pain due to the urinary tract infection which causes pain whenever he goes for a short call (Silver, 2017). Furthermore, the doctor considers prescribing respiridone for his aggression and an antidepressant because the doctor assessed Mr. David as being depressed. The doctor prescribed the respiridone because it is an antipsychotic drug which is used to treat restlessness, psychotic symptoms such as hallucination and aggression which are often present with people who have contracted dementia. The doctor also prescribes antidepressant drugs which are most used to reduce aggression and create a calm feeling for patients such as Mr. David who have dementia (Ames, 2016, p.2).
Physical Aspects and Psychosocial Needs
Physical aspects may include performing various physical activities by the patient under the supervision of a professional health practitioner. These physical activities should be safe, and the training should at least take 30 minutes. Physical exercise is a certified useful method that improves the condition of dementia patients such as Mr. David. The physical exercise intervention would effective on Mr. Geoffries because it is often used on old individuals who are affected by dementia to improve their health and well-being (Zeng et al., 2016, p.168). Moreover, physical activity programs are helpful in that they help relieve dementia patients who have mild and moderate conditions such as Mr. David who is often aggressive and restless. Another significant purpose of physical activities is that they improve the structure and functioning of the brain which is key to enhancing Mr. David's situation because he experiences memory loss. From the case study, Mr. Geoffries’ son sometimes plays poker with him when he visits which help in brain structure and functioning. It is also seen that Mr. David is unsteady on his feet and physical activities can improve the balance, stride length and performance on his daily living activities (Zeng et al., 2016, p.168).
Psychosocial interventions have a purpose of improving the quality of life of the patient and maximizing it in spite of the existing challenges. This intervention uses various methods which include behavior-oriented approach, stimulation-oriented approach, and emotional-approach. Therefore, most psychosocial interventions are aimed at improving the cognitive skill and behavior of the patient following diagnosis of dementia (Vernooij-Dassen et al. 2010, p.1121). Psychosocial interventions help the patient and their family to come to terms with the fact that their loved one is affected by dementia. From the case study, Mr. Geofferies appears depressed and spends most of his time sleeping due to the infection rendering him dependent on the nurses. Furthermore, this intervention helps Mr. David and his family to maintain their social life and relationship even after the diagnosis are made that he is affected with dementia (Guss et al., 2014, p.2). We can see that his family visits him frequently and even his son tries to play poker with him when he visits. Moreover, the family has placed photographs around the room of Mr. Geofferies, and they start a diary of their visits which is a significant example of psychosocial intervention. Another purpose of psychosocial response is to reduce stress and improve the mood of Mr. David and improve his memory and thinking. From the case study, we can see that this is effective in that Mr. Geofferies appears awake, happy and interacts with his children and grandchildren when they visit. Moreover, he is also able to answer closed-ended questions and has a good memory because he can remember his children and grandchildren.
Addressing the Environmental Considerations
It is essential to create a soothing and calming environment which is helpful in the recovery of patients with dementia. The essence of this is that the calm atmosphere will minimize the chances of confusion and...
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