Question

Mrs. Williams is a 68 year-old wife and mother who has diabetes, hypertension and is suffering from advanced Alzheimer’s disease. Her 70 year-old husband, a retired pastry chef, is her main caregiver. She has gradually lost weight, often refuses to eat and requires a great deal of assistance to move from bed to chair. Mr. Williams does have the assistance of his daughter, but she has a family with school age children who require her time as well. The physician has suggested that a feeding tube would be a consideration at this time. Mr. Williams is anxious and uncertain as to what to do.

1. If she didn't have Alzheimer's, could Mrs. Williams be experiencing a form of dementia or delirium? Please describe the difference between the two.

2. What additional data would you focus on obtaining when you are assigned this patient?

3. What legal and ethical issues do you need to consider in this situation and how would you be an advocate for the couple?

4. You're realizing a multi-discipline conference is necessary. Which disciplines would you invite to attend?

Answer 1

1. Alzheimer's disease is a chronic neurodegenerative disorder that usually start slowly and worsen over time. Alzheimer's is a type of dementia that causes problems with memory, thinking and behavior. Symptoms usually develop slowly and get worse over time, becoming severe enough to interfere with daily tasks.

Dementia is the progressive decline of memory and other thinking skills due to the gradual dysfunction and loss of brain cells. The most common cause of dementia is Alzheimer's disease.

Delirium is a serious disturbance in mental abilities that results in confused thinking and reduced awareness of your environment. The start of delirium is usually rapid — within hours or a few days.

Delirium can often be traced to one or more contributing factors, such as a severe or chronic medical illness, changes in your metabolic balance, medication, infection, surgery, or alcohol or drug withdrawal.

2.When a nurse is assigning To take care of Mrs. Williams, she should obtain some extra informations from the patient's care giver. Datas include emotional disturbances, problem with thinking, and self care management.

3.The old couple with Alzheimer's and self care deficit are really vnerable group and the require timely care and support. The care giver should provide assistance with daily activities and feeding. Insertion of feeding tube might cause discomfort to patient. As she is mentally disturbed, she needs frequent monitoring for making sure the tube is in place.

4. For a multidisciplinary conference, the disciplines from various department should be included. A neurophysician, nutritionist, phycisian, psychologist and physiotherapist should be there in the conference.