Module 23: Concept of Cognition Case Study: Parts 1,
2, and 3 .
MODULE 23: CONCEPT OF COGNITION
Case Study: Parts 1, 2, and 3
Victor Wallace is a 74-year-old Caucasian male who was
diagnosed with moderate Alzheimer disease 2 years ago. Mr.
Wallace lives with his 50- year-old daughter, Anne Marie,
who is his primary caretaker. His wife of 52 years died of
pancreatic cancer 18 months ago.
Mr. Wallace presents at his gerontologist’s office at 9:30 on
Thursday morning. Ms. Wallace requested the appointment
because she is concerned about the changes she has seen in
her father over the past month. As the nurse working with
Mr. Wallace’s gerontologist, you conduct an initial
assessment and interview with Mr. Wallace and Ms. Wallace.
Ms. Wallace reports that Mr.
Wallace has exhibited increased confusion and anxiety at
home and at the adult day care center he attends each day
while she is at work.
In the past, Mr. Wallace only had these problems in
unfamiliar settings. He is also experiencing a decline in
language, increasingly using the wrong words to describe
common objects and relying on scanning speech to find
words. However, Ms.
Wallace’s main concern is her father’s refusal to carry out the
basic activities of daily living (ADLs) he is still capable of
performing. When you ask Mr. Wallace about the ADLs, he
pg. 1
,says, “There’s no point in trying because I won’t be able to
do them much longer.” As you observe Mr. Wallace, you note
that he seems agitated. He is sitting on the
pg. 2
, edge of his chair, tapping his foot and rapping his hands on
his knees. When you ask him basic questions, he has a hard time
coming up with answers. When he can’t find the words he
wants, he just repeats the phrase “That’s how it is.”
Mr. Wallace’s vital signs and weight are normal, and his
physical condition is good for a man his age. You administer
the Cornell Scale for Depression in Dementia and his score is
17, indicating high probability of depression. The
gerontologist maintains Mr. Wallace’s current dose of 28 mg
of memantine (Namenda) per day to slow the progression of
his Alzheimer symptoms.
She then adds sertraline (Zoloft), an SSRI, to treat his
depression symptoms. Mr. Wallace is to start out taking 50 mg
of sertraline per day, gradually working up to 150 mg per day
over a 6-week period.
Question 1
pg. 3
2, and 3 .
MODULE 23: CONCEPT OF COGNITION
Case Study: Parts 1, 2, and 3
Victor Wallace is a 74-year-old Caucasian male who was
diagnosed with moderate Alzheimer disease 2 years ago. Mr.
Wallace lives with his 50- year-old daughter, Anne Marie,
who is his primary caretaker. His wife of 52 years died of
pancreatic cancer 18 months ago.
Mr. Wallace presents at his gerontologist’s office at 9:30 on
Thursday morning. Ms. Wallace requested the appointment
because she is concerned about the changes she has seen in
her father over the past month. As the nurse working with
Mr. Wallace’s gerontologist, you conduct an initial
assessment and interview with Mr. Wallace and Ms. Wallace.
Ms. Wallace reports that Mr.
Wallace has exhibited increased confusion and anxiety at
home and at the adult day care center he attends each day
while she is at work.
In the past, Mr. Wallace only had these problems in
unfamiliar settings. He is also experiencing a decline in
language, increasingly using the wrong words to describe
common objects and relying on scanning speech to find
words. However, Ms.
Wallace’s main concern is her father’s refusal to carry out the
basic activities of daily living (ADLs) he is still capable of
performing. When you ask Mr. Wallace about the ADLs, he
pg. 1
,says, “There’s no point in trying because I won’t be able to
do them much longer.” As you observe Mr. Wallace, you note
that he seems agitated. He is sitting on the
pg. 2
, edge of his chair, tapping his foot and rapping his hands on
his knees. When you ask him basic questions, he has a hard time
coming up with answers. When he can’t find the words he
wants, he just repeats the phrase “That’s how it is.”
Mr. Wallace’s vital signs and weight are normal, and his
physical condition is good for a man his age. You administer
the Cornell Scale for Depression in Dementia and his score is
17, indicating high probability of depression. The
gerontologist maintains Mr. Wallace’s current dose of 28 mg
of memantine (Namenda) per day to slow the progression of
his Alzheimer symptoms.
She then adds sertraline (Zoloft), an SSRI, to treat his
depression symptoms. Mr. Wallace is to start out taking 50 mg
of sertraline per day, gradually working up to 150 mg per day
over a 6-week period.
Question 1
pg. 3
