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Mr. H
Korea
Mr. H case study
What is the client's most prominent presenting issues (that is, what seems to take priority as being wrong)?
Mr. H has shown a sharp decline in cognitive functioning. He has quit his job without warning and without consulting with his spouse (who is economically as well as emotionally affected by this decision), has shown difficulty remembering basic tasks and words that a man of his education and background should be able to retrieve easily, and is exhibiting signs of disorientation. Despite being an accomplished outdoorsman he has gotten lost while hiking; has difficulty reading; and although he was a science teacher has difficulty doing basic math. He also has trouble performing basic acts of self-care and memory exercises.
Q2. What else do you feel you need to know (or, what might be some areas you may ask about in order to determine what is going on and how severe the problem may be)?
Alzheimer's disease can have a genetic component, so inquiring into the history of Mr. H's family might be useful, particularly if the dementia of the family members was early-onset in nature (early -- onset Alzheimer's disease is defined as occurring before the age of 65 and tends to have a stronger heritable component than other forms of Alzheimer's). Also, other disorders need to be eliminated as the source of his dementia -- both psychological and physical --...
Further tests would be needed to perform a conclusive diagnosis, and the patient would need to be interviewed to a greater extent, given that most of the available information has been given by the patient's spouse.
Q3. What do you think may be your initial diagnosis based on the information given in the case study? Why?
The criteria for diagnosing Alzheimer's disease according to the DSM include the following factors: memory impairment; language disturbance; difficulty in carrying out motor activities "despite intact motor function" the "failure to recognize or identify objects despite intact sensory function" and "disturbance in executive functioning (i.e., planning, organizing, sequencing, abstracting" (Diagnostic criteria for dementia of the Alzheimer's type, 2013, BehaveNet). Mr. H exhibits signs of all of these problems with the possible exception of physical apraxia. However, according to the DSM other possible causes should be eliminated such as "cerebrovascular disease, Parkinson's disease, Huntington's disease;" or brain traumas or tumors; medications; or other conditions known to cause dementia (Diagnostic criteria for dementia of the Alzheimer's type, 2013, BehaveNet).
Q4. What, if any, psychospiritual factors might be present and maintaining the presenting issue?
Although Mr.…
References
Alzheimer's disease: Treatment and drugs. (2013). Mayo Clinic. Retrieved from:
http://www.mayoclinic.com/health/alzheimers-disease/DS00161/DSECTION=treatments-and-drugs
Diagnostic criteria for dementia of the Alzheimer's type. (2013). BehaveNet. Retrieved from:
http://behavenet.com/node/21508
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