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Introduction of the Older Adult
The patient interviewed is a 70-year old African-American man, Robert. At the time of examination, Robert felt and looked well. He was eager to communicate and discuss possible problems and concerns he thought to have. One of the evident challenges Robert had was the pain in his back. Still, the patient supported the idea of eye contact.
It seemed like the patient tried to neglect the fact of his back pain to clarify if it could happen that he had some serious problems with his mental health because he had discovered that the majority of older adults suffered from several health problems at the same time (World Health Organization, 2016). He also mentioned that his wife underlined that his thoughts were not always rational for several times.
Meaning of the Results
The recognition of cognitive impairment is a crucial step that should be taken by all older adults to avoid possible complications in the form of Alzheimer disease or other cognitive deficits (Fitzpatrick & Kazer, 2012). There were five areas of the Mini-Mental State Examination test (MMSE), and the results in each of them have their meanings and importance. The patient demonstrated good results in the orientation section, indicated the date and location correctly, and resulted in ten points. Three points were got in the registration section because the patient succeeded in naming the objects and repeating them.
Attention and calculation is the section where the patient got four points because it was a bit difficult for him to give quick answers. The recall section was not problematic and brought the patient three points. The language area resulted in eight points because some problems took place with copying the design (the patient felt difficulties because of his back pain). In general, Robert got 28 points and reached the normal score. The patient has a normal condition. Still, it is not possible to say that the condition is ideal. Some concerns take place.
Concerns about the Individual
The patient is bothered by his back pain, and it may distract him from other activities. It could happen that this kind of pain could be the source of constant depressions and changes in mental health. He also spends much time on thinking and evaluating the material. He should provide more spontaneous answers regarding his experience and knowledge. More confidence should be developed.
Interventions
One of the possible interventions that could be offered to Robert is to communicate with a psychologist to recognize the reasons for his doubts and inabilities to rely on personal experience and needs. The patient should also address a doctor to decrease the level of pain in his back.
Possible Recognition of Delirium and Mental Illness
Though the results of the MMSE test cannot help to distinguish between acute or potentially reversible decline of cognition due to delirium and other mental illnesses (OKeeffe, Mulkerrin, Nayeem, Varughese, & Pillay, 2005), delirium can be recognized in case the results of the test are lower and reach the point of 23 or lower (mild cognitive impairment). The patient can make mistakes in the identification of his location. Besides, the patient may even ask to repeat the question and take some time to pass the test. Finally, the patient may refuse to continue taking the test and explains his unwillingness due to the lack of time or bad health conditions.
Treatment Goals in the Elderly Patient with CI, Delirium, and Mental Illness Superimposed on Other Chronic Conditions
The goals of treatment differ in the elderly patient with CI, delirium, and mental illness superimposes on other chronic conditions in the following ways: homecare offered by a professional nurse or even hospitalization in a special organization that can provide the patient with the required portion of medications and control of behavior.
References
Fitzpatrick, J.J. & Kazer, M. (2012). Encyclopedia of nursing research. New York, NY: Springer Publishing Company.
OKeeffe, S. T., Mulkerrin, E. C., Nayeem, K., Varughese, M., & Pillay, I. (2005). Use of Serial MiniMental State Examinations to Diagnose and Monitor Delirium in Elderly Hospital Patients. Journal of the American Geriatrics Society, 53(5), 867-870.
World Health Organization. (2016). Mental health and older adults. Web.
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