Dementia – Case Study
John, 82, moved into his daughter Lucy’s home three years ago when he was diagnosed with Alzheimer’s disease. Lucy has a husband, three children and a dog. She had to use her savings to build an extension to the family home so that John can have his own private area of the house. John used to be an engineer and ran his own company building parts for nuclear submarines.
John has a very poor short-term memory; he often makes himself a coffee and then forgets he has just made it. He’ll occasionally go out to get a paper, forgetting that he has already been to get one earlier that morning. When he realises he gets upset and frustrated with himself. On a few occasions he also got lost and couldn’t find his way back.
The run-up to Christmas was particularly difficult. John bought Christmas cards almost every day and wrote them out to people, forgetting that he had previously done this. He was also recently targeted by scammers when he was out shopping, and they stole £500 from him. He felt ashamed that this had happened and did not want to admit it to Lucy.
On a few occasions John has struggled with continence when out and about. His mobility is also deteriorating and at times he struggles to keep the balance. A few months ago, John started to have difficulties getting up from his chair and lifting objects such as kettle.
John used to be very outgoing and he used to be a member of different social clubs including bowling, snooker and hillwalking. Unfortunately, due to the progress of dementia he stopped attending these groups. In addition, all his friends do not leave nearby, and he is not able to visit them independently.
Lucy is up before 7am to send business emails; she then takes the children to school and looks after dad and the rest of the family for the rest of the day. At 11pm she finally has ‘me time’ which she uses to run her business, before going to bed between 1am and 2am. She is in poor physical health and has a blood condition which means she has low energy levels despite being on the go for 19 hours a day.
Recently Lucy was so exhausted that she stayed in bed until midday, which is unheard of for her. She used to exercise a lot but has not been able to do much since she started to care for her dad and has put on five stone.
Questions:
1. Identify two of John’s physical needs and explain the impact of dementia on these needs.
2. Identify two of John’s social needs and explain the impact of dementia on these needs.
3. Identify two of John’s emotional needs and explain the impact of dementia on these needs.
4. Identify two of John’s cognitive needs and explain the impact of dementia on these needs.
5. Choose two of the potential behaviours listed below and for each of the behaviours describe a different strategy that could be used to manage the situation and minimise the distress for individuals living dementia:
repeated questions or repeated behaviour
wandering
incontinence and soiling
aggression
sleeplessness
will not go out
lack of movement
no routine or plans
6. Choose two of the potential affairs and routines listed below and for each of the affairs describe a different strategy that could be used to manage the situation and minimise the distress for individuals living dementia:
financial and legal
banking and bills
safety in the home environment
driving a vehicle
coping with hazards outside
7. Identify and describe two skills and two attitudes required to care for John.
8A. Identify and describe two personal difficulties experienced by Lucy as her father’s main carer.
8B. Explain at least two ways to support Lucy with these difficulties.
9. Identify one statutory and one voluntary organisation that could support Lucy. Describe the support that these organisations offer to carers of people with dementia.
