1400 words +/-10% Assessment LO2 understand experiences of ageing and how these are impacted by biopsychosocial, spiritual and cultural factors; (GA1, GA4) LO3 demonstrate advanced knowledge of pathophysiology related to the ageing process; (GA5) LO4 critically apply the Roper-Logan-Tierney Model of Nursing to the context of ageing; (GA1, GA4, GA5, GA9) LO6 critically apply legal and ethical principles related to care of the older adult. 1.5 spacing; 11-point Arial or Calibri font. No cover page is to be included. Document must be in Word format. Headings are to be used; Question One and Question Two and so on. Referencing APA 7th Edition. References must meet the academic standards of recency, relevance and reliability. As a guide a minimum of 8-10 current (within five years) and credible references should be used. Intext citations are required for all content not your original thought. Task The following case study is designed to demonstrate the integration of various principles of managing the care of older adults. Students are to answer all seven (7) questions. Answers are expected to total 1400 words . Suggested number of words for each answer is provided in the rubric. Answers need to be supported by current, credible research with intext citations where appropriate. Case Study Scenario Edith, a 77-year-old lady presented to the emergency department (ED) via ambulance after falling in her home. On assessment Edith does not have any fall related injurie other than a minor graze on her left elbow. Edith appears slightly confused and is asking for Margaret, her daughter. When contacted Margaret attends the ED department and informs staff that Ediths local doctor recently identified Edith as recently been experiencing dementia, most probably due to Alzheimers disease. Margaret states that Edith does not appear more confused than normal. Given this the ED team do not suspect a potential alternative diagnosis of delirium. Social History Edith is a widow of five years, lives in her own home with minimal support from Margaret. Edith is relatively independent. She still drives a car, she self-regulates by not driving at night and only driving to her local shops, a friends house and her GP when needed. At the shops Edith pays for her groceries with larger notes as she seems unclear of how much to pass to the cashier. She became lost on the way home from the shops last week and was upset as she could not recognise where she was. After an hour she found her way home. Margaret gave her mother a mobile phone for just this type of emergency but Edith cannot understand which buttons to push and finds using the mobile phone frustratingMargaret is worried that Edith may not be eating as well as she used to and at 48kgs, has lost 10kgs over the past 2 years. Margaret brings four or five frozen home cooked meals which she leaves in Ediths freezer. Edith used to be a very good cook. She is famous for her elaborate birthday cakes. These days she has lost interest in cooking. Margaret visited Edith last week and found five meals still in Ediths freezer. Edith has forgotten how to use the microwave and did not want to ask for help. Edith has been more forgetful over recent months, misplacing her purse and car keys only to find them in the oven. Margaret says her mother is afraid someone will rob her so she sometimes puts her purse in odd paces them cannot find it. Edith arrives hours early for appointments and sometimes on the wrong date. Edith hides her inability to understand time by saying she likes to be early. Edith is generally a social lady, visiting her friend twice a week at 10 am on Tuesdays and Fridays. Conversations are getting more difficult as Edith is slow to find the right word. Last week she drove to her friend at four in the morning thinking she might be late. Medical History AMI – 10 years ago, currency in rate controlled AF. Bilateral cataract extraction and insertion of IOLs 8 years ago, required maintaining her driving licence. Skin lesion on lower leg, dressed and healing – 4 weeks walked into her coffee table. Medications Apixaban 5mg BD (AF) Rosuvastatin 20mg Daily (hypercholesterolaemia) Centrum Advance 50+ for adults Multivitamin and mineral. Daily (general health , in particular Thiamine supplementation) Paracetamol 1gram no more than 6hourly as needed. End of Scenario Answer the following seven (7) questions. Use evidence based literature to support all answers expect for Q2. For each answer you must demonstrate person centred care by including reference to Ediths circumstances where required. Question 1 Edith requires a physical assessment in the ED. Provide evidence based person centred (ie Edith) rationales for each assessment provided below. ECG Respiratory Ax Skin Ax Mini cognitive assessment (suggest 150-200 words) Question 2 Edith has presented with dementia, most likely in the context of Alzheimers Disease. List six 6 signs and symptoms of early Alzheimers disease which Edith is experiencing. For each sign and symptom provide detailed data from scenario to support your answer. Provide your answer in a table below. Do not apply your answer to the ED setting.
