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Running head: Assessing and Treating Clients with Dementia Assessing and Treating Clients with DementiaNURS 6630: Psychopharmacologic Approaches to Treatment of PsychopathologyIntroductionAlzheimer’s disease (AD) is a neurodegenerative disorder marked by a gradual onset of loss in cognition, speech and language, activities of daily living (ADL), and the ability to recognize familiar objects, people and places. Clients might experience significant changes in 1
Managing care for patients with Dementia 2personality, sleep, and behavior (Arcangelo et al, 2017). There are no drugs available to target the underlying disease and santipsychotic agents, benzodiazepines and antidepressants are used for the noncognitive symptoms of AD (Arcangelo et al, 2017).Summary of Patient CasePatient is Mr. Akkad, a 76-year-old Iranian male who is brought to the Psychiatric mentalhealth nurse practitioner (PMHNP) by his eldest son for “strange behavior.” The patient was seen by his family physician who ruled out any organic basis for his behavior. All laboratory anddiagnostic imaging tests (including CT-scan of the head) were normal. According to his son, he has been demonstrating some strange thoughts and behaviors for the past two years, but things seem to be getting worse. Per the client’s son, the family noticed that the patient’s personality began to change a few years ago. He began to lose interest in religious activities with the family and became more “critical” of everyone. They also noticed that things he used to take seriously had become a source of “amusement” and “ridicule.” Over the course of the past two years, the family has noticed that Mr. Akkad has been forgetting things. His son also reports that sometimes he has difficult “finding the right words” in a conversation and then will shift to an entirely different line of conversation.During the clinical interview, Mr. Akkad is pleasant, cooperative and seems to enjoy speaking with you. You notice some confabulation during various aspects of memory testing, so the PMHNP performs a Mini-Mental State Exam. Mr. Akkad scores 18 out of 30 with primary deficits in orientation, registration, attention & calculation, and recall. The score suggests moderate dementia. Mr. Akkad is cooperative with today’s clinical interview. His eye contact is poor. Speech is clear, coherent, but tangential at times. He makes no unusual motor movements and demonstrates no tic. Self-reported mood is euthymic. Affect however is restricted. He deniesvisual or auditory hallucinations. No delusional or paranoid thought processes noted.