Case Study 1

Mrs Walker is a 72 year old lady who lives alone and until recently was in her own home with a care package.

Mrs Walker has a diagnosis of Alzheimer's dementia (4 months) and has deteriorated both physically and mentally over the last 8 weeks, she habitually paces up and down even though she has very poor balance and appears very pale and tired.

Mrs Walker has been deemed to have 'lost capacity' by her Psychogeriatrcian and the Enduring Power of Attorney has been enacted.

Mrs Walker's family and the health team caring for her have all agreed that she is a danger to herself and others, a decision has been made to place her in a residential facility within a secure environment.

Mrs Walker has had to be physically escorted into the residential facility and is very distressed.

Mrs Walker has a severe contracture of her right hand caused by burns received in her kitchen 11 months ago, her noncompliance with physiotherapy have rendered that hand useless.

Mrs Walker weighed 62kgs a year ago, today she weighs 34.5kgs. Her family advise you that she is refusing to eat and that they often find Mrs Walkers dentures in bizarre places around the house, they tell you that Mrs Walker is still drinking plenty.

7a) You are discussing the diagnosis of Alzheimer's disease with Mrs Walker's son, he tells you he doesn't understand what dementia means and asks you if there is a cure. Provide a definition of dementia with particular reference to what Alzheimer's disease is.

7b) Mr Walker asks you if his mother will die soon, discuss the difference between palliative and end of life care

8a) After 2 weeks of residing in the facility, Mrs Walker has not engaged in any activities and continues to pace the corridor, although not with the same level of anxiety. You discuss your concerns with the activity officer, what therapies might she suggest for Mrs Walker?