Mental Health Nursing for Older Adults

Assessment 2: Case Study Analysis

In this assessment, you will demonstrate understanding of how older adults can develop mental health issues linked to cognitive decline, potentially leading to dementia-related impairment. Use the provided clinical scenario to guide your response.

As a Registered Mental Health Nurse, a local GP has referred Mr. McFarlane, an older adult experiencing mental distress from cognitive decline, for a comprehensive assessment and person-centred recovery-focused care plan. The GP saw him the day before, and you meet him at the practice accompanied by his wife.

Assessment Task

1. Discuss the presenting problems and formulate potential evolving problems for Mr. McFarlane.
2. Identify and describe appropriate assessment tools for a comprehensive assessment of Mr. McFarlane.
3. Discuss physical and psychological factors that may impact the assessment.
4. Identify two Theoretical Models of Successful Ageing and critically analyse their application to Mr. McFarlane.
5. Discuss potential psychiatric diagnoses for Mr. McFarlane.
6. Discuss the most appropriate treatment and management plan for Mr. McFarlane.
7. Reference your assignment using APA 7th edition.

Case Study

Mr. McFarlane, 58, lives at home with his wife in Anytown, New South Wales. They have two adult children: Tom, 20, studying engineering at TAFE while living at home, and Sam, 30, pursuing music in Brisbane. Mr. McFarlane runs a plumbing business inherited from his father 20 years ago.

Born and raised in Anytown, he enjoys community involvement as a plumber, knows local roads well, and is liked by residents. He participates in the local bowls club and plays cricket, generally appearing happy and sociable.

Presenting Problem

Mr. McFarlane presented at the GP after release from police custody for driving his ute on the wrong side of the road, confused by a new road system. He claims familiarity with all local roads and avoids maps or navigation.

Recently, he struggles with comprehension and social interactions. His wife reports anger after a bowls game dispute over scores, accusing cheating. He forgets plumbing appointments, feeling guilty. Incidents include forgetting house keys, losing tools, locking keys in his ute, and the driving mishap.

He rarely visits the GP, priding himself on good health, with no prior mental illness history.

Submission Guidelines

• Word count: 2500-3000 words (excluding references)
• Format: Double-spaced, 12-point Arial font, 2.5 cm margins
• Submit via the online portal by the due date
• Include a cover page with student details and declaration

Marking Criteria

Criteria 1: Discussion of presenting and potential evolving problems (5 marks)

High Distinction (4.3-5): Perceptive discussion and exceptional formulation.

Criteria 2: Identification and description of assessment tools (10 marks)

High Distinction (8.5-10): Exceptional identification supported by high-quality literature.

Criteria 3: Discussion of physical and psychological factors (10 marks)

High Distinction (8.5-10): Outstanding discussion supported by literature.

Criteria 4: Evaluation of Theoretical Models of Successful Ageing (10 marks)

High Distinction (8.5-10): Outstanding critical evaluation and analysis.

Criteria 5: Discussion of potential diagnoses (10 marks)

High Distinction (8.5-10): Outstanding discussion supported by literature.

Criteria 6: Treatment and management plan (10 marks)

High Distinction (8.5-10): Outstanding and insightful discussion.

Academic writing and expression (5 marks)

High Distinction (4.3-5): Exemplary writing with authenticity.

Literacy sources and referencing (5 marks)

High Distinction (4.3-5): Outstanding relevant sources with perfect APA 7.

Presenting problems for Mr. McFarlane include confusion with familiar roads and social conflicts at the bowls club. Potential evolving issues may involve increased isolation if memory lapses worsen client relationships. Assessment tools like the Mini-Mental State Examination help evaluate cognitive function comprehensively. Physical factors such as fatigue from work could influence assessment accuracy while psychological stress from guilt affects responses. Models like Rowe and Kahn’s successful ageing emphasize engagement which Mr. McFarlane maintains through community activities. Application to his case supports interventions preserving social connections amid decline. van der Steen et al. review symptoms in advanced dementia informing tailored management plans. van der Steen, J.T., Radbruch, L., Hertogh, C.M., de Boer, M.E., Hughes, J.C., Larkin, P., Francke, A.L., Jünger, S., Gove, D., Firth, P. and Koopmans, R.T., 2014. White paper defining optimal palliative care in older people with dementia: a Delphi study and recommendations from the European Association for Palliative Care. Palliative medicine, 28(3), pp.197-209. Treatment focuses on cognitive therapies and family support to enhance quality of life.

References

• van der Steen, J.T., Radbruch, L., Hertogh, C.M., de Boer, M.E., Hughes, J.C., Larkin, P., Francke, A.L., Jünger, S., Gove, D., Firth, P. and Koopmans, R.T., 2014. White paper defining optimal palliative care in older people with dementia: a Delphi study and recommendations from the European Association for Palliative Care. Palliative medicine, 28(3), pp.197-209. Available at: https://doi.org/10.1177/0269216313493685
• Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C. and Costafreda, S.G., 2020. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396(10248), pp.413-446. DOI: 10.1016/S0140-6736(20)30367-6
• Prince, M.J., Wimo, A., Guerchet, M.M., Ali, G.C., Wu, Y.T. and Prina, M., 2018. World Alzheimer Report 2015 – The Global Impact of Dementia: An analysis of prevalence, incidence, cost and trends. Alzheimer’s Disease International. Available at: https://www.alz.co.uk/research/WorldAlzheimerReport2015.pdf
• Spector, A., Orrell, M. and Goyder, J., 2019. A systematic review of staff training interventions to reduce the behavioural and psychological symptoms of dementia. Ageing research reviews, 12(1), pp.354-364. DOI: 10.1016/j.arr.2012.06.005
• Watt, J.A., Lane, N.E., Veroniki, A.A., Vyas, M.V., Williams, C., Ramkistensigh, R., Tadrous, M., Rochon, P.A. and Straus, S.E., 2021. Comparative efficacy of interventions for aggressive and agitated behaviors in dementia: a systematic review and network meta-analysis. Annals of internal medicine, 174(9), pp.1245-1256. Available at: https://doi.org/10.7326/M21-1501