Assessing and Treating Clients with Dementia
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Assessing and Treating Clients with Dementia
Mental illness or mental disorders are complex conditions that affect how an individual functions and carry out his or her day to day activities. Mental illness of any type affects the relationship that one has with those around them due to the issue of inconsistency, outbursts overreacting, and other incidences caused by mental disorder. When treating mental illness, it is essential to use the evidence-based method of treatment to help the victim maintain and manage the conditions (Folch et al., 2016). Ensure that a diagnosis is made before formulating a treatment plan or starting treatment. Always make sure that the prescribed medication works on the patient and if it does not find alternatives to make the patient better to prevent the adverse impact of their condition.
Case Study
The case that requires assessment and treatment is a case of Mr. Akkad, a citizen of Iran who is 76 years old who is brought in by his son with claims of strange behaviors. Mr. Akkad’s family had initially consulted their family physician, and a few laboratory tests and diagnostics have been done on him, and the results indicated that he was sane. His son claims that the strange behavior and thoughts started two years ago, and things started getting worse with time. The signs of Mr. Akkad’s strange behaviors began when he started losing interest in religious activities and became critical of every. The things that were serious to him started to being sources of his amusement. The issue of him forgetting things and not finding the right words made the PMHNP subject him to a test, which resulted in showed he had moderate dementia or Alzheimer’s disease.
Decision Point One
In this case, I would prescribe Exelon (Rivastigmine) 1.5 mg orally BID with an increase to 3 mg BID in 2 weeks, Aricept (donepezil) 5 mg at Bedtime, and Razadyne (galantamine) 4 mg orally BID. The reason behind this prescription was to deal with the patient’s dementia issues by ensuring that his memory, awareness, and ability to perform his daily duties are improved (Khoury et al., 2018). The Aricept (donepezil) 5 mg is meant to reduce the speed in which the symptoms progresses. This type of treatment was meant to control his Alzheimer’s disease or dementia to make him more productive and able to maintain his condition. The expectation after the prescription was that he would get better, but his condition worsened, and there was no change in his behavior. This warranted the administration of MMSE, which he scored 18 out of 30.
Decision Point Two
In this scenario, I would increase his prescription of Exelon to 4.5 mg to see if there will be any change in his condition, assuming that the first prescription had low quantity, which was not able to deal with his situation effectively. The increase of Exelon from 1.5 mg to 4.5 mg was done to increase the intensity of how the drug functioned in managing his condition and making him better (Heneka et al., 2015). Even after increasing the medication quantity, which was aimed at improving his behavior, but it turned out that it did not make any change as Mr. Akkad was still behaving the same as he did before.
Decision Point Three
In this case, I would discontinue Aricept and begin Namenda (memantine) extended-release, 28 mg orally daily. The reason behind the discontinuation of Aricept is because it is not functioning as it was expected to as the patient’s condition is not improving. Begin Namenda (memantine) extended-release, 28 mg orally daily, was meant to look for another alternative drug to deal with the situation, and prescribing it in 28mg is enhance the intensity of the drug to try and maintain the patient’s condition. Due to the lack of effectiveness towards treating this condition, I would discontinue Razadyne and begin Aricept (donepezil) 10 mg orally daily (Hara & Kawabe, 2019). To increase the content of Aricept to 10 mg is to enhance the effectiveness of the drug towards dealing with dementia.
Conclusion
Dementia caused by Alzheimer’s disease is a complicated mental disorder that is accused by brain cells degenerating and dying. This causes complications in the way a person thinks and how they relate with others. Due to the complexity of this condition, it is difficult to detect and treat it because it affects brain cells. It is essential to ensure that patients receive the best care from those around them and their healthcare providers. It is necessary to reduce stigma towards those that are suffering from mental illness to help them recover and maintain their condition.
References
Folch, J., Petrov, D., Ettcheto, M., Abad, S., Sánchez-López, E., García, M. L., … & Camins, A. (2016). Current research therapeutic strategies for Alzheimer’s disease treatment. Neural plasticity, 2016.
Hara, Y., & Kawabe, H. (2019). Donepezil (Aricept). In Drug Discovery in Japan (pp. 183-205). Springer, Singapore.
Heneka, M. T., Carson, M. J., El Khoury, J., Landreth, G. E., Brosseron, F., Feinstein, D. L., … & Herrup, K. (2015). Neuroinflammation in Alzheimer’s disease. The Lancet Neurology, 14(4), 388-405.
Khoury, R., Rajamanickam, J., & Grossberg, G. T. (2018). An update on the safety of current therapies for Alzheimer’s disease: focus on rivastigmine. Therapeutic advances in drug safety, 9(3), 171-178.
Lei, T. T., Wang, J. H., & Du, G. H. (2018). Galantamine. In Natural Small Molecule Drugs from Plants (pp. 253-258). Springer, Singapore.