NURS 1005 Assignment 2: Case Study of Marjorie Burns' Healthcare Needs

This case study analyzes the healthcare needs of Marjorie Burns, a 79-year-old patient diagnosed with moderate dementia, as part of a NURS 1005 assignment. The paper outlines the anatomy and physiology of dementia, discussing its impact on the brain and associated symptoms like memory loss and confusion. It also addresses microbiology and infection control precautions relevant to elderly patients with dementia, emphasizing the importance of hygiene. Furthermore, the study identifies and explores two key health issues affecting elderly patients: depression/anxiety and the risk of falls, detailing appropriate nursing interventions such as psychological counseling, cognitive therapy, and physical exercise programs. The paper underscores the significance of comprehensive care, including communication, dietary considerations, and support for elderly patients like Mrs. Burns.

Running head: NURS 1005 1
Nurs 1005
Student’s Name
Institutional Affiliation

NURS 1005 2
Introduction
For the provision of quality and standard healthcare services, nurses and other healthcare
students are always exposed to different real-world healthcare situations in the healthcare setting.
This equips the students with the necessary practical knowledge and skills that they require
during their medical career. Different patient case worlds and case studies are often used by the
students to enhance their practical understanding of patient healthcare issues and problems.
These case studies and case worlds contain essential patient information. Therefore, the students
have to critically analyse the provided information concerning the patient, and come up with the
best solutions for specific problems that patients face as far as healthcare service provision is
concerned.
For instance, in this paper, the selected case world concerns a patient by the name
Marjorie Burns. Being 79 years old, Marjorie and other elderly patients require special medical
attention since they are at a high risk of being infected by chronic diseases. For example,
Marjorie Burns in the provided Caseworld is recently assessed and diagnosed with dementia of
moderate severity, which is a chronic disease. Her previous medical history also indicates that
she was suffering from memory loss, bilateral salpingo-oophorectomy, abdominal hysterectomy,
and recurrent Urinary Tract Infection(UTI).
Therefore, this paper aims at outlining and discussing the anatomy and physiology of
dementia and the microbiology and infection control precautions. Two health issues that affect
elderly patients, such as Burns is also provided in this paper. Furthermore, the most appropriate
nursing precautions for these health issues are discussed.
Anatomy and Physiology of Dementia

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Dementia is a described as a collection of symptoms that caused by damage in the in
parts of the brain (Danilovich, et., al, 2018). The person’s ability to perform daily activities is
affected since the person cannot be able to think or behave normally due to dementia. This
condition is common in most aging patients like Burns in the provided case world, who is 79
years old. Normal working or social life of a person is also interfered with since the functions of
the brain are affected by the condition. When the parts of the brain start to shrink and die,
symptoms such as loss of memory is experienced. Dementia is a collection of diseases that affect
the brain; Alzheimer’s disease is identified as the most common disease that causes dementia
(Birks, 2018). Other diseases such as Vascular disease, Pick's disease, Parkinson's disease, and
multiple sclerosis can also cause dementia in aging patients.
Alzheimer’s disease damages the brain through neurodegeneration (Wyss, 2016). That is
to say; the brain cells are progressively destroyed by the condition. The brain being part of the
nervous system, it has neurons which help in the control and integration of the main activities
performed by different body organs and tissues. Damage to these neurons by dementia is referred
to as neurodegeneration. Over a long period of time, the number of patients who have
Alzheimer's disease and dementia has increased, especially the aging ones. Dementia affects the
brain by breaking down the cerebral cortex, which an essential part of the brain. The cerebral
cortex in the brain is responsible for determining intelligence and personality, language
processing, processing of sensory information, and movement (Dum, 2016). Therefore,
breakdown of cerebral cortex will result in memory loss, which is most commonly associated
with Alzheimer’s disease and dementia in general.
Short-term loss of memory, difficulty during verbal communication, impaired reaction,
and depression are among the symptoms experienced by dementia patients (Tong, et., al, 2015).

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In the provided case world, Mrs. Burns also experiences memory loss and confusion, which
clearly indicated that the neurons and neurotransmitters in her brain had been affected by
dementia, which slows down the ability of the brain to process information. For instance, Mrs.
Burns had forgotten that she had left pots boiling dry on the stove. Her personality also changes
since she didn’t want anyone around her, including her daughter Trish. Depression is also
caused by a decline in the number of neurotransmitters in the brain, and their receptors
(McKINNEY, et., al, 2016). All the brain damage occurs according to the stage of dementia. The
stages include mild, moderate, and severe. Since Mrs. Burns has relatively mild dementia,
reasoning, judgment, behavior, and personality will be impaired as a result of brain cell damage
during this stage of dementia.
Microbiology and Infection control precautions for elderly patients with dementia.
For elderly patients especially those suffering from dementia, like Mrs. Burns, provision
of safe and proper personal hygiene is the best nursing consideration during the provision of
quality healthcare services to them (Gil, et., al, 2017). The reason why these patients should be
provided with safe and proper personal hygiene is that the symptoms of dementia such as loss of
memory and confusion impair the ability of such patients to maintain excellent and reliable
general body hygiene. Cleanliness is maintained by regular hand cleaning, bathing, and regular
tooth brushing. For a normal and healthy life, proper hygiene guidelines should always be
adhered to. With proper hygiene, cases of Health Care-Associated Infections among elderly
patients will be reduced or eradicated.
If proper personal hygiene is not provided to these elderly patients, they will be at a high
risk of being infected with Health Care-Associated Infections. These are infections which
develop during the course of treatment or provision of healthcare services, and they cause a lot of

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illnesses and deaths. These infections bare a negative implication to the quality of healthcare
services provided since they prolong the time or duration of hospital stays by these elderly
patients (Arefian, et., al, 2016). The additional diagnosis and therapeutic intervention lead to
increased costs and wastage of too much time that would otherwise be channeled to other critical
patient-care services.
These infections are transmitted by microorganisms, such as fungi, viruses, and bacteria
(Clack, 2018). These microorganisms can be obtained from visitors, other patients in the
hospital, or from the healthcare personnel. Therefore, everyone in the healthcare facility should
always maintain clean body hygiene to avoid the spread of infections from one person to the
other, within the healthcare setting. For elderly patients such as Mrs. Burns, maintaining regular
health on their own is difficult. Therefore, healthcare providers and close relatives such as Trish
should always ensure that elderly patients maintain good hygiene by physically helping them
clean themselves up and change their clothes.
Health Issues and their Nursing Interventions
Getting older is often associated with many health issues and problems. An elderly
patient, such as Mrs. Burns are at a higher risk of being affected by many health complications.
These patients also need consistent care and monitoring since most of them are disabled, while
some use different types of medications. Listed below are the two main health issues and
problems that elderly patients face:
 First, most elderly patients suffer from depression, anxiety, other mental illnesses
(Andreas, et., al, 2017). The main factors that contribute to depression and other mental illnesses
among the elderly patients include retirement, declining health, and isolation. Other typical and
social issues such as family, work, and financial status can lead to anxiety among elderly

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patients. For instance, Mr. Burns tells Dr. Mc Cleary that sometimes her thoughts make her feel
confused and scared. This is evident that she is mentally disturbed and depressed. If left
untreated, depression and mental illnesses can lead to other negative health implications such as
substance abuse or death. Suicides are the most common deaths caused by mental illnesses such
as depression (Wilson, et., al, 2016) Therefore, psychological counseling, cognitive therapy and
other forms of training can should be imposed by the healthcare providers as a nursing
intervention for mental illnesses, anxiety and depression among elderly patients such as Mrs.
Burns.
 Another health issue that elderly patients face is the issue of falls and trips
(Lauretani, et., al, 2018). Falling has been the most common mechanism that causes injury
among the elderly population. These injuries can either be major or minor injuries. The main
minor injuries that are caused by falls include lacerations, bruises, and abrasions. On the other
hand, the significant injuries include fractures and Intracranial Injuries. These injuries caused by
trips and falls are dangerous since they can lead to chronic conditions such as brain tumor or
even cause death. The best nursing strategy to prevent falls and trips among elderly patient is to
design various programs and policies that involve leg and bone-strengthening through physical
exercises (Shier, 2016). Nutritional measures such as the provision of vitamin D supplements
will also help reduce falls by strengthening the bones of the elderly patients.
Conclusion
In conclusion, nurses and other healthcare providers should always ensure that they give
elderly patients the right medical attention they require. During the provision of healthcare
services, medical practitioners should also communicate and relate with elderly patients such as

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Mrs. Burns in a friendly manner. Lastly, elderly patients should also be supported by ensuring
that they adhere to the right nutritional and dietary procedures for a healthy living.

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Birks, J. S., & Harvey, R. J. (2018). Donepezil for dementia due to Alzheimer's disease.
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