HLT54115 Diploma of Nursing

HLTENN013 Implement and monitor care of the older person

Learning outcomes

For successful completion of this assessment students must demonstrate that they can:

Identify strategies relating to the progressive and variable nature of dementia
Prioritise an older person’s needs based on the potential impacts of dual diagnoses
Identify support services and complementary therapies to assist a client living with dementia and their families or carers
Implement strategies for companionship and social inclusion and activities appropriate for a client living with dementia

Develop strategies to deal with challenging behaviours.

Assessment instructions and criteria

Case Study (Total marks – 40)

Review the case study below and answer the questions that follow.

Case Study

Margaret is a 70-year-old resident who was recently moved into the aged care facility that you work in as a nurse. Margaret was diagnosed with Alzheimer’s disease two years ago, Her husband,Frank, decided Margaret needed full-time care as her symptoms of Alzheimer’s disease worsened.

Margaret and Frank have been married for 40 years, and have three adult children and multiple grandchildren with whom they have always been very close. Although Frank visits Margaret for a few hours every day, Margaret is not coping well with the move into the residential aged care facility and is exhibiting signs of depression. She often stays in her room and doesn’t make contact with any of the other residents or staff in the facility. She also has difficulty eating meals. Frank tells you this behaviour is out of character for her, as his wife has always been very chirpy, sociable and loves to cook and eat.

1.	Question: Provide a brief definition of dementia, including the areas of function that may be affected by the condition.
		Marks - 3

2.	Question: Describe the specific characteristics associated with each of the following types of dementia: a) Alzheimer’s disease
		Marks - 4

	b) Vascular dementia

	c) Dementia with Lewy bodies

	d) Fronto-temporal lobar degeneration

3.	Question: What factors increase a person’s risk of being diagnosed with dementia?
		Marks - 3
		4.	Question: Is dementia a normal part of the ageing process? Explain your response.
		Marks - 3

5.	Question: Describe three types of appropriate treatments or nursing interventions that can be applied when working with clients living with dementia.
		Marks - 3

6.	Question: As well as living with Alzheimer’s disease, Margaret has been exhibiting signs of depression since moving into the residential aged care facility. a) List two nursing assessment tools that could be used to determine if Margaret is experiencing depression.
		Marks - 4

	b) When planning nursing interventions and care strategies for Margaret, what diagnosis should be prioritised – Alzheimer’s disease or depression? Explain your response.

	c) Explain how multiple diagnoses in a client influences the identification and prioritisation of the client’s needs

	d) Identify the types of primary health care services you could get involved in helping treat Margaret’s depression

7.	Question: a) Describe three types of support services that could be offered to Margaret and Frank to assist with Margaret’s transition into residential aged care.
		Marks 3

	b) Identify the types of external factors that could adversely affect Margaret’s transition into aged care.

Case Study (continued)

Margaret’s husband, Frank, tells you that Margaret’s favourite activities are reading stories to her grandchildren, playing cards, gardening and dancing. He expresses concern about Margaret’s social isolation since moving into the facility, because she has always loved meeting new people and making new friends.

8.	Question: Describe three strategies you could implement to ensure Margaret experiences companionship and social inclusion in the residential aged care facility. How could you encourage Margaret to participate?
		Marks - 3

Case Study (continued)

A month after entering the residential care facility, Margaret’s symptoms of depression have improved. She has begun to adjust to her new daily routine and socialise with other residents.

Margaret’s symptoms of dementia can vary from day-to-day. Some days she is alert and functional. Other days Margaret can be confused, with poor memory function and language skills. When she experiences this, she becomes stressed easily and forgets where she is. She is prone to yelling profanities at anyone who talks to her, including her husband Frank. Margaret also experiences incontinence when she is distressed.

9.	Question: Describe at least one strategy you could implement to help relieve Margaret’s dementia-related stress and agitation. List three complementary therapies.
		Marks - 3
		10.	Question: When Margaret is distressed she has continence issues. How can you assist Margaret with continence care when required?
		Marks - 3
		11.	Question: The severity of Margaret’s symptoms of dementia has worsened, and a colleague suggests the use of a restraint. Describe each of the following types of restraints, and explain the limitations and legal ramifications of using each. a) Chemical restraints
		Marks 3

	b) Physical restraints
	c) Psychological restraints

12	Question: Describe the elements involved in creating a safe caring environment for Margaret. Why is it important to provide this type of environment to clients, particularly those with dementia?
		Marks – 3

13	References:
		Marks – 2