Summary of case study
A 70-year-old man presents strange behaviors and thoughts, which led to changes in his personality. He lost interest in many family activities including religious functions; hence, everything became a source of amusement and ridicule. Additionally, he could not remember recent events and often lacked the right words to express himself during a conversation. A mini-mental state examination of the memory revealed that he had a confabulation and had deficits in orientation, registration, and attention; hence, the inability to remember recent circumstances (Anonymous, n.d). Although he speaks clearly, his mood is euthymic and both auditory and visual hallucinations are evident. However, he had never had any suicidal thoughts although his insight and judgment had been impaired.
The first decision is to recommend Acetylcholinesterase (AChE) inhibitors medications to increase the level of acetylcholine to help brain nerve cells to communicate effectively with each other. Consequently, the patient will be able to recall recent events. The second decision involves prescribing antidepressants to lessen depression that is the major contributor to anxiety. Thirdly, I recommended cognitive stimulation therapy, which includes a range of activities and yoga exercises that are appropriate for improving memory and enhancing problem-solving capabilities (NHS, 2018).
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How the decisions are supported by evidence-based literature
Khan, Corbett & Ballard (2014) assert that the cognitive stimulation theory is effective in the pharmacological treatment of neuropsychological symptoms of Alzheimer’s disease (AD). The therapy can be combined with medications like the cholinesterase inhibitors, which are effective for people with mild to moderate severity of the disease. Therefore, the clinical recommendation of cognitive stimulation therapy improves the overall memory and thinking skills of AD victims. The first recommendation aimed to achieve improved memory. The antidepressants were intended to attain mood improvement to ensure effective communication while cognitive stimulation theory intended to improve the patient’s reasoning abilities (NHS, 2018). Interestingly, there was no much deviation in the decisions and the expected results.
References
Anonymous. (n.d). Alzheimer’s Disease: 76-year-old Iranian Male. Retrieved from http://cdnfiles.laureate.net/2dett4d/Walden/NURS/6521/05/mm/decision_trees/week_10/index.html
Khan, Z., Corbett, A. & Ballard, C. (2014). Cognitive stimulation therapy: training, maintenance and implementation in clinical trials. Pragmatic and Observational Research, 5, 15–19. Dove Medical Press Ltd. Retrieved from https://www.dovepress.com/getfile.php?fileID=19569
NHS. (2018). Treatment - Alzheimer's disease. NHS. Retrieved from https://www.nhs.uk/conditions/alzheimers-disease/treatment/
