Question

Mr Hartup is living independently in his own home. He has been diagnosed with Alzheimer’s and is becoming increasingly vague and forgetful. His primary carer is his daughter, Janice, who has moved into Mr Hartup’s home to assist him.

You have been supporting Mr Hartup for the past six months, visiting on a daily basis and according to his care plan, under personal care you have been providing medication and assisting with his personal hygiene.

Question: Use a motivational approach to try to help Mr.Hartup understand the dentist and agree to visit the dentist.

Answer 1

Alzheimer's Disease (AD )

It is a chronic progressive degenerative disease of the brain. It is the most common form of dementia, accounting for approximately 60-80% of all causes of dementia.

Home health nursing

Here nurses provide quality care in the convenience at the client's home.They creates care plans to achieve goals based on the client's diagnosis.

Early warning signs

Memory loss

Difficulty in performing familiar tasks

Problem with language

Disorientation to time & place

Poor judgement

Problem with abstract thinking

Misplacing things

Changes in mood & personality

Loss of initiative

In the given scenario;

The nurse has to follow a motivational approach to let Mr.Hartup understand about the Dentist & agree to visit the dentist.

These approach can be followed using 5 steps;

1 ) Understanding about behavioural problems

These include,

a ) repetitiveness ( asking the same questions repetitively.

b ) False believe

c ) Resisting care

So here the Nurse have carefully explain about the dentist, since AD patients have memory loss by cinsconside about the above mentioned points in mind.

They may repeatedly ask the same doubts & disclose false belief about dentist. All the questions should be answered completely to gather co-operation.

It can be done by ;

Redirection Distraction. & Reassurance of the patient

2 ) Loss Of initiatives among AD patient's

Person with AD become & remain uninterested & uninvolved in many of his usual persuit

Nurse should encourage the client to go for a dental check up by pointing the benefs one at a time without confusing him

3 ) Oral care

In the late stage of AD, the patient is unable to perform self oral care which leads to tooth decay. Development of dental caries & tooth abscess can add pain which points to increase in agitation among them.

Here comes the importance of mouth care on daily basis by the care giver.

4 ) Client Teaching

The nurse can motivate the client to visit the Dentist by telling him in simple words.

She can ask the patient about the pain or any type of unpleasant feelings in the mouth.

She can also tell to the patient that she is ready to help him to come out of this pain, if he is ready to come with her for dental consultation.

She can also focus on the halitosis ( bad breath ) & motivate him by telling him that, he will be get off this fowl smell after the visit.

5 ) Communication ( how to start the conversation )

Give simple direction at a time to decrease confusion & frustration.

Limit number of choices patient has to make, so as not to cause anxiety

Through the me mentioned steps, a nurse can encourage & understand the AD patient for dental checkup

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