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Instructions: Assignment 1 (PSW053)
Read the following scenario. Apply critical thinking skills to problem solve and respond to the ensuing questions. Include concepts and strategies you would utilize when relevant, to achieve the best possible outcome. Use the course text book for reference as well as any outside professional source.
Title Page: A separate title page is required which should include assignment name, full course name and number, student name and student number, professor’s name, due date
Format: Word document, ensure you include in-text citations as well as a separate reference page.
Due date: Thursday October 4, 2018
Evaluation: 15% of final mark
Joe is a 71 year old Italian male who moved to Canada with his wife 35 years ago. Joe worked 6 days a week for 35 years to provide for his family. Furthermore he sent money to his sister in Italy every month for years. Together Joe and his wife had 3 children; each moved out of the house in their early 20’s. Joe and his wife had always been traditional Italians who believed that family looks after one another no matter what. Two years ago Joe’s wife suddenly passed away after having a massive heart attack which devastated the entire family especially Joe.
Eight months ago Joe was diagnosed with Dementia with Lewy Bodies. Initially, Joe refused to accept the diagnosis and rejected treatment. He told doctors that he didn’t believe in mental illness and stated that he felt just fine. However his children had noticed several unusual changes in Joe’s behaviour. His speech cadence had changed; it seemed as though he was having difficulty finding the right words. In addition, his daughter had noticed during her last few visits with Joe that he had soiled his pants on more than once occasion.
Joe’s daughter lives an hour away and his 2 sons live in New York. Collectively they attempted to convince Joe that Dementia is an illness just like Cancer. The more they tried to persuade him the more resistant he was to accepting his diagnosis. His children agreed that they would go along with his wish to remain in his home. However, they also noted that if his symptoms worsened they would have to consider moving him to a long-term care facility.
Joe was able to continue living alone in his home for 3 months after his diagnosis. However his condition began to quickly deteriorate which posed a safety risk. As a result, his children agreed that it was time for him to move to a long-term care facility near his home.
Joe was very resistant to moving; he said that if he had to leave his home he would like to live with his daughter and her family. However this was not possible as she worked full-time and would be unable to provide the care he required. His children finally convinced him to move to a long term care facility. Joe felt betrayed and rejected by his kids which caused him to withdraw emotionally.
Within a few weeks of moving to the long term care facility Joe withdrew further. He rarely left his room and complained that it hurt when he walked. He refused to participate in any social activities even the ones he enjoyed with friends prior to becoming ill i.e. bocce ball, bingo, swimming etc. Joe’s English was at best poor but he could make himself understood. His verbal skills continued to deteriorate. A few months after the move Joe stopped speaking English and would only speak Italian, albeit with the same difficulty finding words.
As a result, Joe seldom interacted with any other residents. The nurses stated that Joe was just being difficult and often would avoid working with him. When upset he yelled in Italian and became very frustrated that the support team didn’t understand what he was trying to say. On occasion Joe would throw his food on the floor and refuse to eat. He experienced sleep disturbances therefore did not sleep most nights. Joe would stay awake and wander the halls asking for someone to take him home. Some nights he would ask the nurses to call his wife to come and pick him up.
In the ensuing weeks Joe’s cognitive functioning skills decreased substantially. He suffered substantial memory loss, disorientation, difficulty concentrating, and was often lethargic. Recently he had been experiencing muscle tremors which often prevented him from being able to carry out every day personal tasks/routines such as feeding or dressing himself. This decline in ability only frustrated Joe further which led to statements of despair i.e. ‘I would be better off dead’ or ‘I should just go to sleep and never wake up’.
Joe’s sons were present when he first moved to the facility however had not been able to visit since. They call a few times a month but Joe refuses to take the calls. His daughter and grandchildren visited him 4 times since he moved. The first 2 visits were tense as Joe was angry at his daughter for moving him to a facility. The last 2 visits Joe did not recognize his daughter or grandchildren. Consequently his daughter no longer visits; she stated that it was too upsetting for her and her children because he didn’t recognize them.
When Joe has a moment of clarity he complains that his children don’t call or visit him. The nurses try to explain that his children have called and visited but that his memory issues are causing him to think otherwise. Joe does not believe the nurses and accused them of lying and keeping his children away just like they lied about him having Dementia.
Answer the following questions (number your answers)
1. Identify the key health/mental health illnesses present and if/how they are related to one another (4 marks)
2. Identify possible signs and symptoms of the key health/mental health illnesses (4 marks)
3. How does the illness impact Joe’s thoughts/behaviours? (2 marks)
4. How does the illness impact Joe’s family? (3 marks)
5. Name the cultural influences that are present. How do they impact the situation?
(3 marks)
6. How could you improve Joe’s environment to make him more comfortable? (2 marks)
7. Identify any barriers to communication. How would you effectively communicate with Joe? What resources would you seek? (4 marks)
8. How would you approach the family to emphasize the importance of maintaining a connection with Joe? Identify possible solutions for future calls or visits (ensure the outcome is acceptable for family and Joe) (2 marks)
9. Which strategies could you utilize when encouraging Joe to participate in social activities? Identify the steps you would take (2 marks)
10. How would you approach and respond to the following behaviour/issue?
a) Throwing food and refusing to eat (1 marks)
b) Refusing to leave his room (1 marks)
c) Uttering suicidal ideations (1 marks)
d) Memory loss (1 marks)
Good Luck!
Total 30 marks converts to= /15


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