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Mr. M is an elderly man living in a facility who lately has been raising concerns among the medical staff. A few months ago, despite some difficulties with physical activities, Mr. M was able to take care of himself. He could get dressed, bathe, and feed himself without any assistants. Currently, Mr. M is displaying disturbing behaviors: firstly, he appears to be suffering from memory losses. He no longer recalls the names of his family members, forgets his room number, and repeats the information that he has just read. Aside from that, Mr. M has become more irritable and aggressive as well as more fearful and agitated. These days, Mr. M is found wandering the facility and appearing completely lost. The rapid decline in Mr. M’s abilities to maintain his normal life requires a thorough medical investigation.
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Based on the information presented in the case scenario, primary and secondary diagnoses would be Alzheimer’s and hypertension. The behavior described above fits the criteria for Alzheimer described in the DSM-5: confusion, disorientation, aggression, memory lapses (American Psychiatric Association, 2015). One would expect the CT head to show changes characteristic for this condition. However, the lack thereof might be explained by the early stages of the diseases. As for hypertension, the medical history of Mr. M suggests that he has been suffering from high blood pressure. Aside from that, based on the patient’s heart rate, he appears to have tachycardias.
Another potential diagnosis for Mr. M would be diabetes: when this condition is poorly controlled, it can lead to delirium (Lopes & Pereira, 2018). This delirium is characterized by the same concerning behaviors displayed by Mr. M: fever, memory loss, fearfulness, and inability to clearly communicate and function independently. However, Mr. M’s blood test results are not exactly indicative of diabetes: one would expect protein in his urine and excessive blood sugar, which is not the case. Apart from that, Mr. M is not overweight while obesity is one of the predisposing factors for diabetes.
Physically, Alheimer’s syndrome can manifest itself through the loss of balance or coordination and muscle stiffness. When Mr. M walks, he is likely to shuffle or drag his feet; on top of that, he might have trouble standing or sitting up in a chair. Alzheimer’s syndrome is characterized with such physical symptoms as weak muscles and fatigue, disturbed sleep, trouble controlling one’s bladder or bowels, seizures, and uncontrollable twitches (Budson & Solomon, 2015). With his new health status, Mr. M is likely to be experiencing such neuropsychiatric symptoms as depression, apathy, aggression, and psychosis, which constitute the core of Alzheimer’s disease (Budson & Solomon, 2015). Emotionally, people with dementia start feeling confused more and more often (Budson & Solomon, 2015). When they cannot make sense of the world around them, they feel frustrated and angry with themselves.
Mr. M’s family may be experiencing the adverse impact of having a relative with Alzheimer’s, even though he is living in a facility and does not require constant supervision. Since Mr. M’s has only recently deteriorated, his relatives might have a difficult time adjusting to his new status. The patient’s family remembers him as an able man who was able to take care of himself and communicate, which might not soon be the case anymore. Overall, it is only natural that Mr. M’s family would feel distraught and frustrated and be unsure about how to proceed. Now they will have to learn how to deal with Mr. M’s cognitive decline, disturbing behaviors, and volatile emotional states in a way that they could still have bonding experiences when visiting him..
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