Case Study on Osteoarthritis and Depression in Elderly Patients

Running head: CASE-STUDY
Case-study
Name of the student
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Author’s name

CASE-STUDY1
Introduction
The following report is a reflection of the case study of Fred who is an 84-year-old man.
This report will discuss symptoms of Osteoarthritis and depression and will describe the life
change experience after shifting to residential care.
Discussion
Osteoarthritis/Physical health
Osteoarthritis is the most frequent form of arthritis which affects millions of individuals
worldwide especially the people above the age group of 50 (Glyn et al. 2015). Evidence suggests
that osteoarthritis occurs when the layer involving the protective cartilage that supports and
covers the ends of the bones starts to disrupt throughout time. Even though having osteoarthritis
can impact any kind of joint, but it especially affects the joints in the wrists, knees, hips and
spine. The term osteoarthritis can be divided into three words osteo – bone; arth – joint; itis –
inflammation (Glyn et al. 2015).
As a matter of fact, the game of cards is played using the palm and the fingers. Thus,
when Fred plays cards, he is likely to face pain in his finger joints along with stiffness in the
affected area.
Pain
The paper by Tekeoglu, Dogan, Ugras and Sag (2017) suggests that during the early
osteoarthritis there is a formation of knobby bony deformity at the smallest joint of the end of the
fingers which is also known as the Heberden's node. The paper also showed that osteoarthritis

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mostly impacts three parts of the hand which are the joint between the thumb and the wrist;
joints which is very much near to the fingertip and the joint in the middle portion of the finger
(Tekeoglu, Dogan, Ugras and Sag 2017).
Evidence has stated that the osteoarthritis and multiple sclerosis have a connection
between them. Thus, when Fred plays cards he needs to move his thumb, fingers, wrist and the
hand, as a result, a stimulus is released which directly goes to the brain and tells that it is hurting
when playing cards or moving the joints (Feinstein, Magalhaes, Richard, Audet and Moore
2014).
Stiffness
Similarly, like the pain, when Fred plays cards, the hand movement gets restricted
because of stiffness. While playing, there is a consciousness running behind the mind which is
unknown to Fred because the brain knows that moving the hand will cause pain and thus, the
brain sends sensory signals to the hand through the central nervous system (CNS) and as a result,
the hand dexterousness, synchronization, and strength gets impacted and get limited and
eventually the hand becomes stiff.
It has also been seen that multiple sclerosis causes limitation of hand movement and
causes stiffness. One of the major indications of the multiple sclerosis is observed as a loss of
hand dexterousness. Fine-motor skills may degenerate or start to fade away. Fred will start
experiencing challenges while doing an occupational performance, for instance, lifting up the
cards or any other object, shuffling the cards, will face difficulty when writing or buttoning
clothing, or may face difficulties when eating using the utensils such as a spoon. Multiple
sclerosis (MS) can also cause pain, weakness in the muscle tissues, tremors, and difficulties with

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hand-eye coordination. Though, when playing the game of cards, Fred may suffer from other
joint pains like in the neck, hip, lower back, knees and other joints.
Depression/Mental health
When a person loses all his abilities to do regular daily activities, it causes a rise in
mental issues. The mental health is described by how a person thinks; feels and acts. Depression
has been considered as the most frequent psychological disorder which hampers the quality of
life (QoL) of several people worldwide. Depression negatively impacted the feelings of Fred thus
he used to miss Albert and eventually it hampered his decision making process and his behavior
(American Psychiatric Association 2015). When people start getting depressed, it makes them
sad and they lose interest from different activities, even from those activities which were their
favorite. Thus, it caused many emotional (moderate depression) and physical challenges
(Osteoarthritis) which limited Fred’s capacity to perform accordingly in the residential care such
as he stopped playing cards and wanted to play the game of cards using his lucky deck of cards
and Albert. Diagnostic and Statistical Manual of Mental Disorders (DSM–5) considers that lack
of energy and reduced activity are the major and most experienced symptoms of depression
(American Psychiatric Association 2015). When the person experiences depression, they start
losing their self-esteem along with which they also feel guilty and lose hope and meaning of life.
As self-confidence gets reduced it eventually decreases self-esteem, decreases inner certainty and
power (Parker 2014).
Lack of energy
Depression can have a serious effect on the quality of life as it disturbs the flow of life
(Sehlo and Kamfar 2015). Because of the lack of energy, Fred was feeling demotivated and lost
all his energy from participating in occupational performance. Due to pain in his joints, his level