Mental Health Nursing: Dementia Care Plan & Communication Strategies

This case study focuses on the mental health nursing care of a 69-year-old Italian man, Phillip Lusk, recently diagnosed with early-stage dementia and residing in a low-care facility. The study details his behavioral and psychological symptoms, including reluctance towards personal hygiene, incontinence, agitation, and communication difficulties. It outlines prioritized nursing interventions such as verbal and non-verbal communication techniques and environmental modifications to reduce agitation. The care plan involves a multidisciplinary team including nurses, pharmacists, doctors, and family caregivers, emphasizing a therapeutic relationship with the patient, reducing stigma, and promoting community participation. The study also documents observations before and after hospitalization, noting improvements in aggression, communication, and personal care, alongside medication management using Risperidone. The interventions aim to enhance Phillip's well-being and dignity, with follow-up strategies to ensure medication adherence and continuous improvement in his care.

Running head: MENTAL HEALTH NURSING 1
Mental Health Nursing
Name
Institution

MENTAL HEALTH NURSING 2
Question 1
Prioritised nursing intervention Rational
Verbal Communication:
This is done by firstly identifying yourself as a
nurse and calling Phillip by his name. It is also
important to speak slowly clearly by simplifying
words and making statements instead of asking
questions ("Verbal and non-verbal
communication tips for dementia caregivers |
Samvedna Senior Care", 2019). It would further
be necessary to encourage Phillip when he is
finding trouble expressing himself.
Decrease agitation shown by Philip when he has
difficulty understanding verbal communication
Non Verbal Communication:
Firstly, it is important to make and maintain eye
contact during conversations. It is additionally
important that the RN avoids body languages that
would imply that they are frustrated ("Verbal and
non-verbal communication tips for dementia
caregivers | Samvedna Senior Care", 2019). A
handshake, hug or physical touch could
additionally be important.
Decrease agitation shown by Philip when he has
difficulty with understanding simple tasks.
Environment changes:
Move to a quieter spot to sit down and chat with
him. It may also be important to move away from
busy areas and look for more calm locations to
relax with him (Brooker & Latham, 2015).
Decrease agitation shown by Philip when he becomes
overwhelmed with what is going on around him

MENTAL HEALTH NURSING 3
Question 2
Other individuals who should be involved in implementing, knowing and understanding the
above care plan include the registered nurse, pharmacist, doctor, and family caregiver (Gulanick
& Myers, 2016). This multidisciplinary team assesses all the available treatment and care options
before coming up with one care plan in that is in the best interests of the patient.
Question 3
Firstly, it would be important that the multidisciplinary team develops a therapeutic relationship
with Phillip. This relationship must be respectful of the choices, experiences, and circumstances
in the life of the patient. It may involve building on Phillip’s strengths and enhancing his
resilience to improve the recovery process ("Standards of Practice", 2019). Secondly, the
multidisciplinary team must continuously and actively pursue opportunities that would help in
reducing stigma and promote community participation and inclusion ("Standards of Practice",
2019). Having a sense of belonging improves wellness and maintains the dignity of the patient.
Question 4
Observations Prior to Hospital
Phillip has no motivation to perform personal hygiene and most of the times he suffers from
incontinence. He is easily agitated and may react in an aggressive manner if he does not
understand the things happening around him. He also becomes repetitive in speech when he is
paranoid about his surroundings. He, however, responds to non-verbal cues and body language
from other people
Observations a Week Later

MENTAL HEALTH NURSING 4
There is a massive reduction in aggression. Communication is now more consistent and orderly.
He can even attend to personal care and maintain his personal hygiene. Speaks English even in a
normal state and responds effectively to communicate. Occasional incontinence is still present.
He can now even take his own medication albeit with encouragement occasionally.
Documentation of Changes
Phillip’s aggression has been massively reduced and he can now communicate consistently and
in an orderly manner. He is now more motivated to attend to personal care and maintain personal
hygiene. The incontinence is still there but not as frequent as it had been before being taken to
the hospital. He can now even take his own medication albeit with encouragement occasionally.
Question 5
i) The attending nurse may ask Phillip and his wife to give an account of the
instructions he/she has given them regarding Risperidone.
ii) Follow-ups to ensure appropriate use of medication.
iii) Writing down the prescriptions on a piece of paper.
iv) Insisting on the importance of drug adherence.

MENTAL HEALTH NURSING 5
Reference
Brooker, D., & Latham, I. (2015). Person-centred dementia care: Making services better with
the VIPS framework. Jessica Kingsley Publishers.
Gulanick, M., & Myers, J. L. (2016). Nursing care plans: diagnoses, interventions, and
outcomes. Elsevier Health Sciences.
Standards of Practice. (2019). Retrieved from http://www.acmhn.org/publications/standards-of-
practice
Verbal and non-verbal communication tips for dementia caregivers | Samvedna Senior Care.
(2019). Retrieved from http://www.samvednacare.com/blog/2016/08/26/verbal-and-non-
verbal-communication-tips-for-dementia-caregivers/
.