LOYOLA, TRISHA FAE B.

During aging process, cognitive impairment is common to occur as manifested by

confusion or change in mental status. There are 3 D’s of aging that are associated with these
such as dementia, depression and delirium.

 Dementia is the gradual deterioration of mental status and Alzheimer’s disease is the
common type – over the years the individual experience loss of memory, general
knowledge and is unable to eat or walk (Press, 2013).
 Depression is associated with decreased interest, pleasure to certain activities and
pervasive sadness (Naqvi, 2013)
 Delirium is a disorder of attention and cognition that is accompanied with fluctuating
LOC such as sleepiness/agitation. This may be related to an illness, present
medication or triggers (Malenfant, 2012).

These diseases are not appropriate to be developing as we age. There are certain tools
that we should use to further assess the occurrence and to properly monitor and provide
such interventions.

During our community duty at Ambuklao, we saw and old lady lifting some plastic bottles
in a bag. We approached and helped her until she gets home – and found out that she’s
living alone with all children are living in Baguio already with their own families. With the
knowledge in mind about 3 D’s of aging, I used minicog, GDS and confusion assessment
method (CAM) to assess for dementia, depression and delirium.

The assessment for dementia using minicog, she was able to recall those 3 unrelated
words and categorized as non-demented. But during the drawing of clock, there are some
barriers such as educational attainment since she was unable to read and write and the used
of sundial that uses the position of sun to indicate the time.

For the GDS, she scored 7 points which a suggestive of depression.

 Feels that life is empty

 Not in good spirits most of the time
LOYOLA, TRISHA FAE B.

 Afraid that something is going to happen to herself

 Feels helpless
 Feels that she have more problems with memory than others
 Feels weak
 Thinks that most people are better than her

According to her, since she’s already 80 years old she feels really weak and been telling that
she misses her children very much. She often feels lonely and sad because there is no one
that’s been taking care of her since her children left the house. Despite of these, she
verbalize that she is satisfied what life has to offer and thankful that she’s still alive and been
collecting plastic bottles in the Barangay.

Throughout the assessment and interview there was no confusion as observed.

We should not overlook our clients who are elderly. There may be several factors that
they have been experiencing and complaining that we thought that is normal among them.
The best way to do this is to assess and observe carefully, used the best tools available,
REFER and render necessary health teachings and also necessary interventions as possible
to provide the client centered care.

References:

Malenfant, P. & Voyer, P. (2012). Detecting Delerium in Older Adults Living at Home.
Journal of Community Health Nursing, 29: 121-130

Naqvi, R., Liberman, D., Rosenberg, J., Alston, J., & Straus, S. (2013). Preventing
Cognitive Decline in Healthy Older Adults. Canadian Medical Association Journal, 185 (10),
881- 885.

Press, D. & Alexander, M. (2013). Treatment of Dementia. Found at:

www.uptodate.com on 10/28/13. Randolph, C. (2013). Frontotemporal Dementia: Clinical
Features and Diagnosis. Found at www.uptodate.com on 10/25/13.