Question

74-year-old male, retired accountant, with a long-standing history of hypertension and atherosclerosis, begins to exhibit some personality changes, deterioration in grooming, trouble understanding news events, and difficulty managing personal finances. He also stopped attending social events and dropped out of his chess club. His wife of 50 years becomes concerned and schedules an appointment with his healthcare provider, who diagnoses him with Vascular Dementia, Alzheimer’s type. Arrangements have been made for a visiting RN to come to the house once weekly. 

Initial Discussion Post:

Address the following:

In what stage of Alzheimer’s disease is this client? What criteria did you use to determine this?
What are 3 priority RN assessments when home visits are made?
What are some anticipated caregiver issues that this client’s spouse will personally experience?
List and describe 3 intercollaborative referrals that may be needed for this client within the next year or so. 

Answer 1

1.The client is diagnosed with pre-clinical Alzheimer's disease, during which the patient he faces trouble remembering things and challenges in performing tasks. In this case, morphological examination of brian is performed by CT(Computed Tomography) scan and the initial diagnosis of Vascular Dementia is diagnosed based on NINDS-AIREN( National Institute of Neurological Disorders and Stroke criteria, Association Internationale pour la Recherche et l'Enseignement en Neurosciences) criteria and the Alzheimer's disease is diagnosed based on NINCDS-ADRDA(National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association) criteria.

2. 3 priority RN assessments during home visits include: Mental Status assessment, BPV(Blood Pressure Variability test) for hypertension and blood test for athersclerosis.

3. The common caregiver issues the client's spouse will personally experience are stress, depression, anxiety, irritability, sleeplessness and other health problems.

4. An intercollaborative approach might be required for this client within next year or so, in this case a trained transdisciplinary care team consisting of a neurologist, nurse practitioner, social worker and health educator are required to deliver care to patient, to perform diagnostic evaluations, and offer phsychosocial services & counseling.