Martha Kendel, 82 years old, has AD. She lives with her husband, who has been trying to care for her in their home. Mrs. Kendel is having trouble dressing. She has put her blouse on backward and sometimes puts her bra on over her blouse. She often forgets where things are. She makes an effort to cook but has recently attempted to “put out” the electric burners of the stove with pitchers of water. Once in a while, she cannot find the bathroom in time, often mistaking it for a closet. Sometimes she cries because she is aware that she is losing her sense of her place in the world. She and her husband have always been loving companions, and he wants to keep her at home as long as possible.

a. Help Mr. Kendel by writing out a list of suggestions that he can try at home that might help facilitate (a) communication, (b) activities of daily living, and (c) maintenance of a safe home environment.

b. Identify at least three interventions appropriate to this situation for each of the areas previously cited.

c. Identify resources available for maintaining Ms. Kendel in her home for as long as possible. Provide the name of a self-help group that you would urge Mr. Kendel to join.

2. Mr. Beech is undergoing surgery for a broken leg. He is suspicious of the staff and believes that the intravenous medication he is receiving for hydration and pre-anesthesia will be used for harmful purposes. He keeps his eyes closed and refuses to answer or look at his family, who describe him as odd. He has schizotypal personality disorder.

a. Explain how being friendly and outgoing may be threatening to Mr. Beech.

b. Explain how being matter-of-fact and neutral and sticking to the facts would be effective to Mr. Beech.

c. What could be done to give Mr. Beech some control over his situation as a hospitalized patient?

d. How could you best handle his beliefs and lack of interpersonal comfort with caregivers so that both you and he would feel most comfortable?