Biophysical and Psychosocial Processes in Dementia Patients

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NUR104 Assessment Task 3: Case study 40%
Case study 1.
Read Rob’s story, outlined on page 325-326 of your course textbook (Scoot, Shannon & Davies,
2017, p. 325-326).
Discuss the biophysical and psychosocial processes pertinent to the case.
Mr. Rob has mild dementia according to his wife's research and the diagnosis by the GP.
The condition has developed due to biophysical and psychosocial processes in the life of
the patients. The client has a medical history of hypertension which is a risk factor for
dementia. Hypertension is the leading cause of vascular dementia. (Iadecola et al., 2016)
The case study also indicates that the patient likes working independently and building
structures without the help of anyone. Independent working leads to both physical and
mental stress; this can lead to memory loss. (Best, 2014) The depression due to the
separation from his first marriage is also a possible cause of dementia. Depressive
disorder is a mental complication that can make the victim to experience both short-term
and long-term memory loss. The caregivers should manage the hypertension and
depression to lower the symptoms of dementia. Additionally, the family members should
assist Mr. Rob to run his daily chores to avoid independent working. However, the
dementia is still at the mild stage and the caregivers should take measures to prevent its
advancement.
Identify an assessment tool appropriate for use in this case and discuss key elements of the tool.
The ideal assessment tool for Mr. Rob’s mild dementia is MoCA. The Montreal
Assessment tool is suitable for mild mental conditions. (Cheung et al., 2015) The tool
assesses the memory status of the patient in the short-term. Additionally, the screening
technique evaluates the working memory, the levels of concentration, and attention of
the patients. Mr. Rob has memory problems as he forgot his tools outside after his
activities. Furthermore, dementia has interfered with his concentration levels; thus
leading to the car accident due to distraction. The MoCA examination contains thirty
questions that the patient should answer in ten minutes.
Discuss 3 priorities of care for this person.
The three priority areas of care include short memory, distraction, and hypertension. Mr. Rob
forgot his tools outside making them get damaged due to the rains. Dementia interferes with both
the working and short-term memory. (Faulkner et al., 2017) The second priority area is a
distraction which led to the car accident. The caregivers can prescribe medications like Exelon to
boost memory and eliminate mental distractions. Hypertension is a risk factor for dementia and
failure to treat it worsens the symptoms of the condition. Therefore, appropriate nursing
attention for the priority areas reduces the severe effects of dementia in patients.
Discuss any equity, rights and access issues relevant to the case.
Patients of dementia have equity, rights, and access issues due to their condition. The clients
deserve equal treatment like others with disabilities. Members of the society tend to stigmatize
the victims of dementia making the patients shy away from seeking medical attention. The family

of the patients also complains about the difficulty in accessing the relevant information on
dementia. Caregivers have the duty of availing sufficient and accurate information about the
condition to the patients and their relatives. (Beck et al., 2017) Additionally, the care providers
should conduct awareness campaigns to eliminate the stigmatization on dementia patients by the
public.
Case study 2.
Read Dulcie’s story, outlined on page 370 of your course textbook (Samuelson, Crawford &
Alexander, 2017, p. 370.
Discuss the biophysical and psychosocial processes pertinent to the case.
The Doctor diagnoses Dulcie with the early phase dementia. The first biophysical cause of
her condition is the change in her cooking and eating routine. The patient changed from
the busy and raucous meal time to quiet and straightforward times. Taking meals close to
her daughter and her family creates a social connection that boosts appetite. However,
back at her house, she feels lonely and her interest in food declines. Dulcie also returns to
the unhealthy diet that she warned her family about in the past. The brain depends on
the glucose from meals for energy to run functions like memory retention. (Walsh et al.,
2017) The patient’s grief is also a risk factor for dementia. (Jones, & Miesen, 2014) The
changes in the physical perspective of Dulcie’s life have affected her mental health. An
alteration in the eating and cooking routine can make one to lose interest in meals.
Therefore, lack of proper feeding leads to frequent memory loss due to energy deficiency
in the brain. The family should monitor the patient to ensure that she takes her meals
regularly.
Identify an assessment tool appropriate for use in this case and discuss key elements of the tool.
The ideal assessment tool for the patient is the MMSE. The Folstein test contains thirty
points in a questionnaire that caregivers use to gauge the level of the patient's cognitive
impairment. (Callow et al., 2015) The care provider requires between five to ten minutes
completing the rational assessment of the client. Dulcie has trouble remembering family
names and also tend to forget family events. She also forgets her location on numerous
occasions. Her presenting symptoms make MMSE ideal as it gauges the levels of
concentration and memory. Furthermore, the screening method is ideal for assessing
patients of advanced ages.
Discuss 3 priorities of care for this person.
The three areas of priority for the patient are the nutrition aspect, lack of concentration,
and memory loss. Reverting to her home changed her meal routine and also made her
lose interest in food. Therefore, the daughter's family should live with the mother to
boost her appetite and improve the interest in meals. The patient has concentration
issues as she forgets her location. She also forgets the names of the members of the
family and events. The daughter should encourage the mother to keep a calendar. The
calendar can assist the patient to remember medication schedules. (Read, Toye, and
Wynaden, 2017)
Discuss any equity, rights and access issues relevant to the case.