Mrs. Ellyn Townsend is an 87-one year-used widow who lives alone alongside with her cat in a modest apartment in the center of a dapper metropolis. She has lived alone for two decades, following the death of her husband of 40 years from a lethal stroke. She has lived in this neighborhood since she and Mr. Townsend first married. They raised four formative years in the apartment Mrs. Townsend aloof occupies. The neighborhood isn’t very as safe as it once was, nevertheless many older people have stayed in the website attributable to of its convenient proximity to the downtown shopping website. Fair nowadays, the neighbors called Mrs. Townsend’s daughter, Theresa, to expose her that Mrs. Townsend was wandering spherical the neighborhood making an strive to search out her husband. Mrs. Townsend expressed scenario that he was late getting dwelling from work. When reminded that Mr. Townsend died two decades ago, she was very agitated and argumentative. She accused the neighbors of bewilderment her and making an strive to create stress-free of her. Despite the incontrovertible fact that her scenario about the rising crime rate in her neighborhood is warranted, she has become hypervigilant about locking doors and windows.
Mrs. Townsend has various smartly being problems, alongside with coronary heart disease and circulation problems attributed to her late-onset diabetes. She is on nearly a dozen pretty a couple of prescription medicines, though it’s obvious to Theresa that she does not trace when and secure out how to draw shut them. She becomes irritated when Theresa asks her about her drugs, insisting she is taking them as required and can describe it. Mrs. Townsend is a retired nurse and till currently was very expert in monitoring her blood sugar and giving herself insulin. She wishes to be reminded secure out how to construct this now.
Theresa has observed currently that the apartment smells of urine and feces, and she has came upon soiled dresses stuffed in drawers and below the mattress. Her mother denies there is a say, refusing to assign in mind she might possibly possibly want an adult hygiene product. The cat runs away assuredly, and Theresa suspects that right here’s attributable to her mother is either not feeding the cat or has become abusive.
1. What signs does Ellyn Townsend level to that suggest she will have depression dementia, or delirium? Which signs are clearly a alternate from what her daughter has viewed in her mother over the years?
2. What rapid components ought to the social worker take care of for Ellyn’s safety and smartly-being?
3. What’s going to be the subsequent step in creating an intervention for her? Who else does the social worker need to involve in the diagnostic process?
Case 5.2 Mr. Charles Curry
Charles Curry is a 78-one year-used widowed man who has lived alone for the previous 2 years, following the death of his wife of fifty years. His suburban dwelling is in right condition though wanting minor repairs and painting. The in discovering site has taken on a cluttered gaze since his wife’s death, with dishes piled in the sink, flower beds overrun with weeds, and papers scattered about the lounge. Mr. Curry served as his wife’s caretaker forward of her death and did an superb job, primarily primarily based totally on Tom Curry, his eldest son. Mrs. Curry had a prolonged sickness from cancer nevertheless was ready to assign at dwelling with hospice give a enhance to till the time of her death. Hospice maintained contact with Mr. Curry for about a one year after her death, nevertheless then he requested that they not plod to him.
Mr. Curry customary to be energetic in the local men’s club, the Sons of Hibernia, a social and repair organization for those of Irish descent. He went to the club three times a week to play cards with pretty a couple of retirees. His mates at the club describe him as having been a jovial, outgoing, friendly man since his retirement at age 65. He’s a retired postal provider, so he knew everyone alongside his route and looked as if it can possibly possibly revel in visiting with lifelong mates and neighbors. He stopped going to the club when his wife was sick and has not indicated any ardour in returning there since her death. He says the club is too some distance-off and that he’s too tired to encourage any social actions.
Tom Curry has expressed scenario about his father’s unwillingness to secure out of mattress. Mr. Curry says he’s persistently tired after not snoozing thoroughly. As a consequence, he spends important of the day going from the sofa to the mattress, snoozing on and off. At night, he goes to mattress at 7:00 p.m. and is up wandering spherical the apartment or making an strive to gaze television from boring night on. Tom claims his father appears to be like to be very lethargic and preoccupied. He has effort remembering whether or not or not he has eaten nevertheless does not explicit hunger or thirst. He answers “I don’t know” to many questions, not seeming to draw shut the time to take into chronicle the solution. He assuredly expresses a want to die and join his wife, though he has not indicated he has any particular plans to draw shut his existence. Tom does not think his father has viewed a smartly being-care provider for over 2 years, nevertheless Mr. Curry refuses to plod attributable to he feels sufficient. He has lost weight since his wife’s death; he does not revel in cooking and prefers to snack on comfort meals. He has not engaged in any snide habits, and when he concentrates, he appears to be like to be oriented to time, residing, and particular particular person.
1. What signs does Mr. Curry level to that suggest he has depression, dementia, or delirium?
2. What wretchedness components give a enhance to a diagnosis of a form of prerequisites?
3. How can the social worker secure Mr. Curry, his son, and pretty a couple of collaterals occupied with a understanding to take care of the condition? May possibly possibly well this require hospitalization?
Case 5.3 Ms. Rosa Mateo
Karen Kline works for Elder Products and companies in a midsize metropolis in the southwestern a part of the usa. She has been working with Rosa Mateo, age 80, for 5 years, helping her to create mild housekeeping assistance and trusty a visiting nurse to video display blood stress and drugs, as smartly as offering pretty a couple of ingredients of customary case management. Karen has not viewed Rosa in 2 weeks, nevertheless when she involves her apartment, Rosa refuses to let her in, accusing her of making an strive to take her Social Security compare. Karen soothes her fears, reminding Rosa that she is her case manager and not the actual particular person that has been victimizing older adults in the neighborhood. Rosa appears to be like to icy down and lets her in. For nearly an hour, they focus on Rosa’s scenario about a newest respiratory ailment and the spiraling rate of antibiotics. Karen suspects that Rosa supplements her treatment with a wholesome dose of vodka assuredly and most seemingly chooses to buy alcohol in preference to food alongside with her exiguous income. At the new time, Karen notices Rosa appears to be like unusually distracted and agitated. She will be able to get up and walks spherical, glancing furtively out the window each time she passes it. When Karen asks her what she is having a stare upon, Rosa begins to command and expresses concerns about some man who has been having a gaze in her window. She begs Karen to draw shut her out of the apartment and website her somewhere where the actual person can’t secure her. When Karen goes to comfort Rosa, she becomes verbally and physically abusive.
1. What signs does Ms. Mateo level to that suggest she has depression, dementia, or delirium?
2. What wretchedness components give a enhance to a diagnosis of a form of prerequisites?
3. What’s the subsequent step for the social worker in this case?
Table 5.2 Differentiating Characteristics of Depression, Dementia, and Delirium
Depression
Dementia
Delifium
Presenting Symptoms
Melancholy temper, negative self focus on, lethargy, appetite and sleep disturbances
Difficultly with reminiscence; disorientation to time, website, and particular particular person; disturbances in mental reasoning and thinkings
Disorientation, mental confusion, emotional liability, manic-love habits, hallucinations
Onset
Leisurely; might possibly possibly even be connected to onset of bodily sickness, lack of family or mates, changes in monetary or residing scenario
Leisurely; progressive lack of mental functioning, increasing confusion, incapacity to originate acquainted duties
Unexpected; might possibly possibly also happen following sickness or surgical treatment; deterioration in functioning progresses in a temporary time
Cognitive facets
Loss of cognitive functioning is uncommon, nevertheless older adult has scenario concentrating and making choices and will experience minor reminiscence loss
Whisper of affairs remembering newest events, learning contemporary duties, and speaking; becomes at a loss for phrases effortlessly about directions and interior most residing even in acquainted website
Mental confusion and disorientation occurs with out discover; fluctuating ranges of awareness with severe difficulties preserving attention
Emotional facets
Loss of ardour or pleasure in favourite actions; power disappointment, irritability, guilt, and hopelessness; appears to be like lethargic and apathetic or intensely panicked
Passive and withdrawn as the older adult loses touch with the rapid atmosphere; might possibly possibly also become agitated when confronted about cognitive losses
Agitated, erratic temper swings, anxious, uncooperative; might possibly possibly also become aggressive physically and verbally toward others
Physical facets
Appetite and sleep disturbances; vague somatic complaints that construct not answer to scientific treatment; appears to be like to be like very sad
Appears to be like “lost” and at a loss for phrases; might possibly possibly also gown inappropriately or level to signs of lack of self-care
May possibly possibly well in fact have a “wild-eyed” gaze and appear very disoriented, and bodily look might possibly possibly even be matted
Wretchedness components
Family history of depression, social isolation, bodily sickness, low income, stoning up identified for aspect delight in of depression
Family history of Alzheimer’s disease or Down syndrome; evolved age
Taking a pair of drugs, history of drug or alcohol expend, wretched food regimen and hydration, newest diseases or surgical treatment, presence of Parkinson’s disease or a pair of sclerosis, or in most cases having wretched smartly being
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