HPI & CC
How does Francis do on the Mini-Cog test in Part 1?
Clock drawing is normal. Remembers 2 out of 3 words
In Part 1, does Francis still enjoy the things they've always enjoyed?
Not as much. They don't find their hobbies as fun anymore. They no longer invite friends over because they can't always remember their names or how they know each other.
In Part 1, how does Francis feel about their memory issues?
A little defensive and they try to brush off the seriousness of the issue. However, they do get frustrated when they can't remember things and they worry about the future.
How much time has passed between Part 1 and Part 2?
Roughly one year
In Part 2, is Francis safe in their home?
No. Although Alex loves Francis and isn't abusive to them, Francis is no longer safe in their current situation.
In Part 2: How is Francis' diet or interest in food?
Alex gets frustrated because Francis often won't eat. Francis has lost 10 lbs in the past 3 months.
What about Simon?
Simon doesn't visit much and is not providing support to Francis or Alex. He thinks Francis should be placed in a care facility.
What should you do if the Participants try to talk to you separately?
Find an excuse not to let them! It's hard for us to hear when multiple conversations are happening.
In Part 1: What are some of the things Francis forgets?
What they had for breakfast (but it was probably the same thing they always eat)
Doctor appointments and Paying bills on time
Blowing out candles or turning off the oven
What to get at the store or where they put their lists
What has Francis' mood been like leading up to Part 2?
Francis is having behavior changes, cries frequently and seems depressed
In Part 1, when might Alex try to speak for or contradict Francis?
When Francis tries to minimize or brush off their memory issues. Alex doesn't want to hurt their feelings, but they are worried, and they want the nurses to understand the scope of the problem.
How does Part 1 end?
Dentist’s office calls to confirm an appointment that Francis has forgotten all about. Francis and Alex rush to get ready to leave.
What is Francis' behavior like in Part 2?
Francis no longer communicates clearly and cannot participate in the encounter in a meaningful way. They are either unresponsive (in their own world) or cannot answer questions appropriately. They misunderstand objects. Example: May think a lemon is a ball because it’s round. Likes to rhyme words “ball, tall, fall, fall down.”
In Part 2: How does Alex respond to the Caregiver Strain Index?
Yes to every question. Alex is exhausted, overwhelmed and stressed.
In Part 2, why does Alex feel guilty?
Leaving to go to work
Francis’ unkempt appearance and poor hygiene
Not being able to care for Francis well
Not being able to keep Francis safe when they aren’t there
The thought of putting Francis in a home
What is one learning objective from Part 1 and one learning objective from Part 2?
Part 1:
1. Communication: adjusting techniques to match ability of client
2. Assess mental and emotional status of a client with dementia using the mini-cognition assessment tool
3. Demonstrate use of the following tools: geriatric depression screen, caregiver stress index
Part 2:
1. Therapeutic communication
2. Provide support to family/caregiver experiencing strain
3. Determine need for use of assessment tools: Mini-cog, Geriatric Depression Scale, Modified Caregiver Strain Index
4. Identify and intervene in potential client safety issue