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1. Cognitive impairment can disrupt the person’s ability to participate in their ADLs. List three examples of specific difficulties with ADL’s that could arise, and then provide one action the PSW could implement to support and assist the client to promote autonomy and dignity with the task. (6 marks) ADL task: Being able to bath or shower oneself PSW Support: Try to allow them as much privacy and independence as possible, allowing them to wash themselves as much as possible, providing privacy with a covering ex(robe or towels ), and allowing time for them to adjust. ADL task: Sudden dizziness and loss of balance, when walking to get food or a drink PSW Support: See if a walker would help when they feel dizzy, bring food to the client or drinks, or ask when they feel dizzy the most (maybe getting up too soon, advise how to slowly get up). Report to supervisor if dizziness persists. ADL task: Getting dressed or putting on shoes PSW Support: Allow the client to dress as much as possible, assisting with buttons that might be hard or zippers to do up, allowing them to slip on their shoes but assist with tying them up. How might Mr. Heron’s personality and past experiences influence the behaviour you witness today? He seems to be suffering from dementia. People with dementia suffer from memory loss and as get confused about their simple routine tasks and get agitated very instantly. Conscientiousness and neuroticism as personality traits are highly linked with dementia. Also he is a person with precise ideas and preferences regarding how things should be done. He was high school principal. So he would want to be independent like he use to b He seems to be suffering from dementia. People with dementia suffer from memory loss and as get confused about their simple routine tasks and get agitated very instantly. Conscientiousness and neuroticism as personality traits are highly linked with dementia. Also he is a person with precise ideas and preferences regarding how things should be done. He was high school principal. So he would want to be independent like he use to b He seems to be suffering from dementia. People with dementia suffer from memory loss and as get confused about their simple routine tasks

and get agitated very instantly. Conscientiousness and neuroticism as personality traits are highly linked with dementia. Also he is a person with precise ideas and preferences regarding how things should be done. He was high school principal. So he would want to be independent like he use to b Mr. Heron seems to be experiencing changes in thinking, remembering, and reasoning in a way that affects his daily life and activities . Because he used to be a person with precise ideas and preferences regarding how things should be done, he has feelings of confusion, agitation not understanding, and upset that he’s going to miss his train. These are all part of Early on in Alzheimer's and related dementia. What actions or verbal direction might you do or suggest in order to make Mr. Heron more comfortable? Remind Mr. Heron of who you are, Listen to the expression of frustration even if the actual words don’t make sense. Maybe say to Mr. Heron there’s no school today , I will help you back to the room. Why is depression often mistaken for dementia? Depression and dementia can both lead to reduced motivation, impaired concentration, and mental slowing. Using the three stages of dementia, explain how you would support your client with their meal times and eating in each of the stages. Mild Stage: Allow the person with dementia to be as independent as possible during meals.Offer just one food at a time instead of filling the

plate or table with too many options. Don't rush. Be patient and give the person enough time to finish the meal. Ask if they need help Allow the patient to be as independent as possible, don’t give a large menu selection have them pick from a few items, and assist if needed with placing utensils in hands or cups to mouth. Moderate Stage: Again, you would want them to be as independent as possible, more care may be needed with utensils and holding items, so allow more time for them, they may be confused as to what they're for, so make sure to explain to them, be patient, and allow more time. Severe Stage: Allow as much independence as possible, and explain what you are doing, giving plenty of time you might have to guide the food to a person more often. Allow more time for chewing and swallowing cutting food into smaller pieces might help, also making food softer. A client you are assigned by your home care agency has been diagnosed with Alzheimer’s Disease – Stage 2. List five safety concerns you would have in the client’s home. (5 marks) List five safety concerns you would have in the client’s home. Avoid the use of extension cords, if possible, by placing lamps and appliances close to electrical outlets. Tack extension cords to the baseboards of a room to avoid tripping. Keep all alcohol in a locked cabinet or out of reach of the person with Alzheimer's . Drinking alcohol can increase confusion.

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Keep all medications (prescription and over-the-counter) locked. Avoid clutter, which can create confusion and danger. Throw out or recycle newspapers and magazines regularly. Keep all areas where people walk free of furniture. Eliminate uneven surfaces or walkways, like rugs that are turned up on corners or that easily trip over. i) What is dementia? Dementia is a general term for loss of memory, language, problem-solving and other thinking abilities that are severe enough to interfere with daily life ii) What is meant by multi-infarct dementia? Multi-infarct dementia (MID) results from a series of small strokes that cause brain damage. It's a type of vascular dementia . iii) How might Mrs. Green’s forgetfulness interfere with her safety needs? She may feel abandoned leading to depression thinking her daughter isn’t seeing her, this can lead to refusal to want to eat. iv) Considering effective communication techniques, how would you respond to Mrs. Green? Listen to Mrs. Green don’t try and convince the person with dementia to see things from your perspective. Instead, try and connect with the person’s emotions. (If not sure how to approach this situation ask the supervisor for some pointers, they will be able to help you). v) Explain this approach would be helpful. Showing Mrs. Green that you understand, rather than saying you are wrong your daughter was in yesterday doesn’t help. She might become agitated, maybe even more confused, and not understanding. 7. “When a resident is cognitively impaired, does it really matter whether he/she is attractively dressed? Are we just trying to make an impression on visitors and other residents? If the confused resident doesn’t know or care how he/she is dressed, why should we? It’s not bothering him/her.” I think in this situation you have to put yourself in their place, how would I feel? I know, I would want to be treated with respect and dignity, so why would you treat this person with less value? It does matter

8. You have been assigned a client with a diagnosis of schizophrenia. At the time of their in-home assessment, the client was well controlled on medication and had excellent outside support from social work and family who live in the area. Desiring to be prepared for any change that could potentially occur from non-compliance with their medication regime, what are three signs that you would take note of that your client may be in mental health crisis? Extremely disorganized or abnormal motor behavior. Threatening to harm themselves or others. Aggression, outburst, Depression 9. “The elderly are not at risk of committing suicide.” Do you agree or disagree? Disagree suicide in older adults is often attributed to the development of depression due to bereavement or loss of physical health and independence . Define & give 1 example : (4 marks) i) Affective disorder: Example: Affective disorders are a set of psychiatric disorders, also called mood disorders. Which can affect the way you feel and act, some can have sad outcomes. Example: Depression ongoing feelings of extreme sadness and hopelessness. ii) Anxiety disorder: Example: An anxiety disorder is a type of mental health condition. If you have an anxiety disorder, you may respond to certain things and situations with fear and dread . Example : People with generalized anxiety disorder worry endlessly over everyday issues—like health, money, or family problems—even if they realize there's little cause for concern. They startle easily, can't relax, and can't concentrate. They find it hard to fall asleep or stay asleep.

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