1.
Your wife says she has noticed changes over the past year. Have you noticed any of the changes
she mentioned?
Rationale Relevancy
Your
Answer
It
... [Show More] is important to assess the client’s perspective about his own
health. Even though he may not be aware of his cognitive decline
with the same specificity or accuracy of his spouse, it is critical to
gain his input and insight into the chief complaint. Relevant Relevant
Client: You know, there’s really nothing wrong with me other than getting older. Sometimes
it’s hard to remember where I put something or where we are going that day, but that’s the
only thing…and I know that comes from old age!
2.
When you are feeling confused, have you been running a fever?
Rationale Relevancy Your Answer
Fever is associated with episodes of delirium, not
dementia. Irrelevant Irrelevant
Client: I haven’t had any fevers.
3.
Have you noticed that one side of your body is weaker than the other?
Rationale Relevancy Your Answer
Unilateral weakness is association with cerebrovascular
accident (CVA) and transient ischemic attacks (TIA), not
dementia. Irrelevant Irrelevant
Client: No. Both sides seem the same.
4.
You said that sometimes you forget where you are going or where you put something. Are you
able to remember things from long ago, such as your wedding to Mrs. Roberts?
Rationale Relevancy
Your
Answer
Alzheimer’s disease is characterized by memory impairment or
the impaired ability to learn new information or recall previously
learned information. Most clients in the early stages of
Alzheimer’s disease will still have clear recollection of events long
Relevant Relevant
past.
Client: Of course. It was in the middle of February of 1958 with snow up to my knees. How
could I forget that?
5.
Are the hand tremors that you experience while at rest worsening as your memory declines?
Rationale Relevancy
Your
Answer
Hand tremors are associated with Parkinson’s disease, which can
also cause a progressive deficit in memory and cognition.
However, Mr. Roberts’ diagnosis has already been established as
early Alzheimer’s disease, and there are no other issues in the
chief complaint to indicate that this is a new concern. Irrelevant Relevant
Client: I don’t have those.
6.
Do you find that you get upset or frustrated more easily now than you did last year when we
saw you?
Rationale Relevancy
Your
Answer
An increase in a clinically significant behavioral disturbance, such
as wandering or agitation, can accompany a progression in
Alzheimer’s disease. Therefore, it is important to know if Mr.
Roberts has developed further accompanying symptoms as his
wife stated. Relevant Relevant
Client: Well, of course I get more frustrated than normal. Mrs. Roberts here is on me all the
time about forgetting things and it just gets on my nerves. I guess I just get irritated and then
say things that maybe I shouldn’t. It just ticks me off when she keeps asking me about [Show Less]