Jack Richards
Katarina Mayer
Makenzie Nelson
A 78-year-old man comes to your office with his daughter. The
daughter reports that her father, Mark, has been confusing the name of
relatives and is having trouble controlling his emotions. Her father was
once a respected mathematician, but he is now having trouble
completing simple calculations. He even claims that he does not know
how to play the card game they have been playing since she was a little
girl. She tried to get him to shower and put on clean clothes for the
doctor’s visit, but he is adamant about the fact that he is clean. Most
recently, he has had trouble recognizing people he has known for years.
For quite some time, he has had trouble finding items such as his glasses
or keys and his daughter attributed this to the natural aging process. Now
she is not so sure.
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Confusion
Instability of emotions
Trouble doing math
Forgetfulness/Memory Loss
Stubbornness
Inability to find items
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Dementia
 Confusion
 Instability of
emotions
 Forgetfulness/
Memory Loss
 Stubbornness
 Inability to find
items
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Hypothyroidism
Forgetfulness/
Memory loss
 Stubbornness
 Fatigue
 Muscle Weakness
 Depression
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Blood Test
 Test for hypothyroidism
 Detects the hormone levels in
the blood stream and can
then the function of the
thyroid can be determined
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Physical Exam
 Asks about diet and alcohol
use
 Reviews all medications
 Check blood pressure,
temperature, and pulse
 Listen to the heart and lungs
 Perform other procedures to
assess overall health
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Mini-Mental State Exam (MMSE)
 Tests for Alzheimer’s and dementia
 Maximum of 30 points
 20-24 points suggests mild
dementia
 13-20 points suggests moderate
dementia
 Less than 12 points suggests
severe dementia
 With Alzheimer’s, the points
decline two to four points per
year
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Mini-Cog
 Tests for Alzheimer’s and dementia
 Patient is asked to perform two
tasks
 Remember and in a few minutes
repeat the names of three
objects
 Draw a face of a clock and draw
the time instructed by the
professional there
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Blood test was negative for hypothyroidism
Alzheimer’s shared the most symptoms with the patient
Brain scans, such as a MRI and a CT scan, exhibited multiple
signs of a brain with Alzheimer’s
MRI
CT
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In a brain with Alzheimer's, the brain shrivels up, the hippocampus shrinks,
and ventricles become larger.
Cell death and tissue loss in a brain with Alzheimer's contain plaques and
dead/dying nerve cells that have tangles (twisted strands of proteins).
 Plaques are made up of beta-amyloid, a protein, when they clump
together.
 The tangles and plaques block the synapse from cell-to-cell, thus
disrupting the charges that was being transmitted.
 Plaques and tangles spread through the cortex.
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More about Alzheimer’s
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Alzheimer’s will affect the patient’s life in the ways of
Memory loss
 Language deterioration
 Impaired perception and spatial relationships
 Poor judgement
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To make the patient feel long term ease, the thought of a home health
nurse, a family member monitoring the patient, or the admittance to a
nursing home may be few options the family may consider
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Perform mental status exams that may include a 20-30
question test, asking standard questions about daily life or
current events, drawing/counting items, and monitor ability
to perform and complete routine activities
Other exams may test motor reactions, senses, reflexes,
coordination, and the cranial nerves
Visits occur every six months or with any decline in memory
or any other skills
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Help clients in their daily personal tasks, such as bathing or dressing
Provide basic health-related services according to a client’s needs, such as
checking vital signs or administering prescribed medication at scheduled
times
Do light housekeeping, such as laundry, washing dishes, and vacuuming in a
client’s home
Organize a client’s schedule and plan appointments
Arrange transportation to doctors’ offices or for other kinds of outings
Shop for groceries and prepare meals to a client’s dietary specifications
Provide companionship
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There are no known cures, but there are options that
may help symptoms
To help memory loss cholinesterase inhibitors or memantine can be
prescribed
 To aid behavioral abnormalities antidepressants, anxiolytics, or
antipsychotic medications could be taken
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Medical College of Wisconsin. (nd.). Alzheimer’s Disease Treatment and Prognosis. [accessed 9 October
2015]. Retrieved from: http://healthlink.mcw.edu/article/921383587.html.
Alzheimer’s Association. (nd.). Treatments for Alzheimer’s disease. [accessed 13 October 2015].
Retrieved from: http://www.alz.org/alzheimers_disease_treatments.asp
Alzheimer’s Association. (nd.). Treatments for Behavior. [accessed 13 October 2015]. Retrieved from:
http://www.alz.org/alzheimers_disease_treatments_for_behavior.asp
Everyday Health. (nd.). Assembling Your Alzheimer’s Care Team. [accessed 13 October 2015]. Retrieved
from: http://www.everydayhealth.com/alzheimers/alzheimers-care-team.aspx
Alzheimer’s Association. (nd.) Tests for Alzheimer’s Disease and Dementia. [accessed 13 October 2015].
Retrieved from: http://www.alz.org/alzheimers_disease_steps_to_diagnosis.asp
Mayo Clinic. (Dec 1, 2012). Hypothyroidism (underactive thyroid). [accessed 13 October 2015]. Retrieved
from: http://www.mayoclinic.org/diseases-conditions/hypothyroidism/basics/symptoms/con-20021179
Medscape. (Jul 27, 2014). Alzheimer’s Disease Imaging. [accessed 13 October 2015]. Retrieved from:
http://emedicine.medscape.com/article/336281-overview
National Institute on Aging. (June 2015). Alzheimer’s Disease Medications Fact Sheet. [accessed 13
October 2015]. Retrieved from: https://www.nia.nih.gov/alzheimers/publication/alzheimers-diseasemedications-fact-shee