ISBAR template IDENTIFY I My name is Kirsty and I am the OT working at this facility It’s my role to ensure residents feel orientated, safe and cared for in their environment Mr Y is a 78yo Korean male with presenting early onset Alzheimer’s dementia. SITUATION S Mr Y has recently transitioned to the long-term care facility three weeks ago. He presents with worsening confusion, disorientation and wandering behaviours overnight. Mr Y enters other residents rooms, paces the halls and is often found awake, wondering outside his bedroom, asking staff repetitive orientation questions. Mr Y appears distressed over concerns that he is “missing the bus” as a result of his confusion and dementia symptoms. Mr Y is not engaging in daytime activities and his wife is concerned about his engagement and personality changes BACKGROUND B Prior to admission, Mr Y lived with his wife, Mrs Y, running a floristry business for over 40yrs. Mr Y has a history of OA, frequent UTIs, falls at home and is supported to take medication to manage these. Mr and Mrs Y have a son who is supportive, engaged in his father’s care and was actively involved in encouraging his parents to seek healthcare providers. Mr Y was 60yo at onset of symptoms that progressively worsened and included coordination difficulties, waking overnight and poor memory, such as forgetting important floral pick-ups. These symptoms progressively worsened, severely impacting Mrs Ys ability to sustain care through frequent disturbed sleep, increasing confusion and subsequent distress. The physical care demands also exceeded what Mrs Y could provide given declining strength, coordination and increasing falls With support from community providers, Mr Y was transitioned to the current facility when it became apparent Mrs Y could not longer manage Mr Ys care. ASSESSMENT A Mr Y appears to be presenting with sundowning and worsening confusion overnight. He appears to have difficulties adjusting to the new environment. He is struggling to conceptualise his wife not being present and has not yet built relationships with other residents. Mr Y is extremely fatigued and is therefore unable to stay awake during daytime hours due to his reversed sleep-wake cycle. He is low of mood. Mrs Y is also presenting with some emotional challenges both adjusting to the change in care arrangements and in seeing the changes in her husband RECOMMENDATION / REQUEST R Medical review for overnight medication and sleeping assist Review by OT for liaison with RN and overnight staff for bedtime routine and strategies to reduce confusion Support to Mrs Y regarding the transition, including a clear schedule for visits and more frequent information updates OT to support Mr Y to find activities he enjoyed (?related to floristry) to support engagement and improve moods