Cognitive impairment can disrupt the person’s ability to participate in their ADL’s. List three examples of specific difficulties with ADL’s that could arise, and then provide one action the PSW could implement to support and assist the client to promote autonomy and dignity with the task.  (6 marks)

i) ADL task: __________________________________________________

PSW support:  ______________________________________________

ii) ADL task: __________________________________________________

PSW support: _______________________________________________

iii) ADL task: __________________________________________________

PSW support:  ______________________________________________

2. Mr. Heron is a 78-year-old client of the agency you are employed with. He lives in a retirement home but is supported by your agency two mornings each week. He has been a client of yours for a month. Mr. Heron’s forgetfulness is progressing slowly, but he remains a person with precise ideas and preferences regarding how things should be done.

Mr. Heron’s occupation was a high school principal. He held that position for over thirty years. He is married and has two adult children and five grandchildren.

Three times in the last two weeks when you have visited Mr. Heron you have found him hovering near the elevator in his building. He has appeared slightly agitated and has not been fully dressed. Today you find him in the same location wearing a suit jacket with no shirt underneath, and he seems particularly upset.

He says to you, “The train is leaving and I’ve got to be on it or I will be late for school.”

a. How might Mr. Heron’s personality and past experiences influence the behaviour you witness today?  (2 marks)

______________________________________________________________

______________________________________________________________

______________________________________________________________

b. What actions or verbal direction might you do or suggest in order to make Mr.
Heron more comfortable?  (2 marks)
______________________________________________________________

______________________________________________________________

3. Why is depression often mistaken for dementia?  (1 mark)
________________________________________________________________

4. Using the three stages of dementia, explain how you would support your client with their meal times and eating in each of the stages.  (3 marks)

Mild Stage:  ______________________________________________________

Moderate Stage: __________________________________________________

Severe Stage:  ____________________________________________________

5. A client you are assigned by your home care agency has been diagnosed with Alzheimer’s Disease – Stage 2.  List five safety concerns you would have in the client’s home.  (5 marks)

i) _________________________________________________________

ii) _________________________________________________________

iii) _________________________________________________________

iv) _________________________________________________________

v) ________________________________________________________

6. Mrs. Green is a client of your agency. She has been diagnosed with multi-infarct (vascular) dementia. She has been assessed to be in the first stage and is only mildly forgetful the majority of the time. She is most comfortable when she gets the answers she needs, although she may forget them in a short period of time. Today she asks you, “Have you seen my daughter? I haven’t seen her in a very long time.

” You know that Mrs. Green’s daughter visits on a regular basis but you are unsure as to when she was last in. (5 marks)

i) What is dementia?  __________________________________________________

_____________________________________________________________________

ii) What is meant by multi-infarct dementia?________________________________

_____________________________________________________________________

iii) How might Mrs. Green’s forgetfulness interfere with her safety needs?

____________________________________________________________________

iv) Considering effective communication techniques, how would you respond to Mrs. Green?
____________________________________________________________________

____________________________________________________________________

v) Explain how this approach would be helpful._____________________________

____________________________________________________________________

7. ” When a resident is cognitively impaired, does it really matter whether he/she is attractively dressed? Are we just trying to make an impression on visitors and other residents? If the confused resident doesn’t know or care how he/she is dressed, why should we?  It’s not bothering him/her.” (2 marks)

__________________________________________________________________

__________________________________________________________________

__________________________________________________________________

8. You have been assigned a client with a diagnosis of schizophrenia. At the time of their in-home assessment, the client was well controlled on medication and had excellent outside support from social work and family who live in the area. Desiring to be prepared for any change that could potentially occur from non-compliance with their medication regime, what are three signs that you would take note of that your client may be in mental health crisis? (3 marks)

___________________, _____________________, _____________________

9. “The elderly are not at risk of committing suicide.” Do you agree or disagree?

_______________

Explain your answer: (2 marks)  ______________________________________

________________________________________________________________

________________________________________________________________

10. Define: (4 marks)

i) Affective disorder:
__________________________________________________________

Give one example:
__________________________________________________________

ii) Anxiety disorder:
__________________________________________________________

Give one example: