{"id":4609,"date":"2026-02-06T12:01:52","date_gmt":"2026-02-06T12:01:52","guid":{"rendered":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/dementia-the-case-of-alex\/"},"modified":"2026-02-06T12:01:52","modified_gmt":"2026-02-06T12:01:52","slug":"dementia-the-case-of-alex","status":"publish","type":"post","link":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/dementia-the-case-of-alex\/","title":{"rendered":"Dementia: the case of Alex"},"content":{"rendered":"<p><strong>Dementia: the case of Alex<\/strong><\/p>\n<p>Mary Jo has been contacted by her maternal grandmother and asked to<\/p>\n<p>come and visit so that they can talk about her grandmother\u2019s concerns<\/p>\n<p>about her second husband, Alex.<\/p>\n<p>Mary Jo is a little apprehensive as Grandma has asked her at this stage not<\/p>\n<p>to mention anything to her mother or to her two older brothers and their<\/p>\n<p>wives.<\/p>\n<p>[David, 33 years old, is the elder of Mary Jo\u2019s two brothers; his wife is<\/p>\n<p>Maria; they have two children: Jimmy, six years old, and Thomas, four<\/p>\n<p>years old. Barry, the younger brother, is married to Anna; both are 30 and<\/p>\n<p>they have only one child, Leah, three years old. Sadly Anna miscarried last<\/p>\n<p>year but they are optimistic about having more children.]<\/p>\n<p>Mary Jo is also aware that her own mother has not really accepted her<\/p>\n<p>mother\u2019s (Grandma\u2019s) decision to marry Alex, a Mediterranean man, 12<\/p>\n<p>years ago now, and eight years after her grandfather had died suddenly due<\/p>\n<p>to an aortic aneurism. Mary Jo has always liked Alex as he is a jovial person<\/p>\n<p>who clearly loves and respects her grandmother, often buying her jewellery<\/p>\n<p>and other presents and very often fresh flowers. Mary Jo assumed that her<\/p>\n<p>mum was grieving for her own father and that that got in the way of her<\/p>\n<p>accepting her mother\u2019s second marriage. Mary Jo\u2019s mother had emphasised<\/p>\n<p>how different the personalities of the two men were and explained that as<\/p>\n<p>an only child she had always been her father\u2019s \u2018princess\u2019. These thoughts<\/p>\n<p>and more were going through Mary Jo\u2019s mind as she travelled by train to<\/p>\n<p>her grandmother\u2019s home to stay overnight. She knew something was wrong<\/p>\n<p>because Grandma had said, \u2018You will understand because you are a nurse.\u2019<\/p>\n<p>Mary Jo was concerned that Alex\u2019s \u2018memory problems\u2019 were getting worse<\/p>\n<p>and was worried about how she could best help her grandmother.<\/p>\n<p>Grandma met Mary Jo at the door; she was wearing a brace on her left arm<\/p>\n<p>and clearly sporting a healing right \u2018black eye\u2019. Mary Jo couldn\u2019t contain<\/p>\n<p>herself and started quizzing her grandmother about what had happened.<\/p>\n<p>Had Alex hit her This was no good; how could she live with domestic<\/p>\n<p>violence Something had to be done! Mary Jo stopped when she realised<\/p>\n<p>that her grandmother was just sitting softly weeping while she had gone on<\/p>\n<p>and on.<\/p>\n<p>Mary Jo suddenly saw herself as attacking and criticising the woman she<\/p>\n<p>had come to help. She drew her breath and said, \u2018Oh Grandma, I am so<\/p>\n<p>sorry for how I have just behaved! I can see that you\u2019ve been hurt, and<\/p>\n<p>that has upset me because I love you. I\u2019ll put my bag in the spare room,<\/p>\n<p>check on Alex and we\u2019ll meet in the kitchen and have a cuppa. Is that OK\u2019<\/p>\n<p>Mary Jo\u2019s grandmother nodded and took a few breaths to steady her crying.<\/p>\n<p>Mary Jo was cross with herself for being so\u2026 She couldn\u2019t find the words<\/p>\n<p>but knew she would not have behaved that way if she had been at work.<\/p>\n<p><strong>Prompting questions, set 1<\/strong><\/p>\n<ul>\n<li>Can you record a genogram for Mary Jo from the above information<\/li>\n<\/ul>\n<p>If you have been able to do this, share its elements with your fellow<\/p>\n<p>students in the discussion forum.<\/p>\n<p>page 1<\/p>\n<p>What other information would be informative What are the benefits of a<\/p>\n<p>genogram in aged care<\/p>\n<ul>\n<li>What significance can be placed on the family dynamics<\/li>\n<li>If Mary Jo wants to let her mother know about her concerns, how should<\/li>\n<\/ul>\n<p>she deal with the fact that she has promised not to talk to other family<\/p>\n<p>members<\/p>\n<ul>\n<li>What might account for Mary Jo\u2019s response to seeing her grandmother\u2019s<\/li>\n<\/ul>\n<p>injuries<\/p>\n<ul>\n<li>How prevalent is aggressive behaviour between people with dementia and<\/li>\n<\/ul>\n<p>their carers<\/p>\n<ul>\n<li>What advice can be provided to help prevent and minimise aggressive<\/li>\n<\/ul>\n<p>behaviour<\/p>\n<p>In the kitchen<\/p>\n<p>Mary Jo informed her grandmother (Matilda) that Alex was asleep in his<\/p>\n<p>recliner.<\/p>\n<p>Mary Jo and Matilda did have a cuppa, with Mary Jo listening to what<\/p>\n<p>Matilda said and allowing her to tell the story as she had experienced it.<\/p>\n<p>Mary Jo also learnt that Matilda had put off approaching her granddaughter,<\/p>\n<p>as she was still embarrassed that Alex had hit her and twisted her arm. It<\/p>\n<p>was so out of character for him but it really had scared her, and she still<\/p>\n<p>felt a bit on edge because it might happen again. She thought that it<\/p>\n<p>related to his wanting a cigarette and her saying no because she didn\u2019t<\/p>\n<p>want to bother at the time. She was not able to distract him from the idea.<\/p>\n<p>Her grandmother continued, \u2018He got up to look for his smokes and spotted<\/p>\n<p>them and then went to light one. But in his agitation, he tried to put the<\/p>\n<p>match in his pyjama pocket when it was still alight. I was trying to stop him<\/p>\n<p>from burning himself\u2014thank God they were good cotton and not synthetic\u2014<\/p>\n<p>and God knows what he thought but he hit out at me and grabbed my arm.<\/p>\n<p>Then when he saw me crying he was all \u2018lovey dovey\u2019 and not aware of<\/p>\n<p>what had just happened!\u2019<\/p>\n<p>Mary Jo thought about the number of smokers who are admitted to hospital<\/p>\n<p>but don\u2019t get to smoke while they are there. She quietly wondered how<\/p>\n<p>much crankiness and worse could be attributed to nicotine withdrawal.<\/p>\n<p><strong>Prompting questions, set 2<\/strong><\/p>\n<ul>\n<li>How might you as a health professional respond to this story<\/li>\n<li>Why is Alex\u2019s wife feeling guilty and embarrassed<\/li>\n<li>What problem-solving techniques could be employed to assist with the<\/li>\n<\/ul>\n<p>issue of unsafe smoking<\/p>\n<ul>\n<li>If one of the options selected were for Alex to undertake a quit smoking<\/li>\n<\/ul>\n<p>program what would be required<\/p>\n<p>Further disclosure<\/p>\n<p>Mary Jo and Matilda got into the flow of interacting and maintaining the<\/p>\n<p>routine that had been pretty well established between Matilda and her<\/p>\n<p>husband. Mary Jo was pleased to be able to prepare the meal her<\/p>\n<p>grandmother had planned and observed her grandparents holding hands<\/p>\n<p>while watching the TV together. Although Mary Jo offered, Matilda did not<\/p>\n<p>accept any assistance with toileting or caring for Alex. Mary Jo was<\/p>\n<p>page 2<\/p>\n<p>mpressed with her grandmother\u2019s ability to help Alex maintain the skills he<\/p>\n<p>did have; she seemed to wind into her conversation with him the<\/p>\n<p>suggestions and cues about what needed to be done or focused on. There<\/p>\n<p>wasn\u2019t that babying approach that Mary Jo had so often seen and<\/p>\n<p>sometimes knew she resorted to at the hospital just to get the task done.<\/p>\n<p>Later that evening Mary Jo and Matilda were able to spend time together<\/p>\n<p>again.<\/p>\n<p>At this time Matilda revealed that their GP had suggested that she needed<\/p>\n<p>to start thinking about putting Alex into residential care. This was her worst<\/p>\n<p>fear as they had in fact made part of their marriage vows to care for each<\/p>\n<p>other in their latter years. She did not deny that he had hit her but felt that<\/p>\n<p>with more help and information she could do better.<\/p>\n<p>The doctor had given Alex a definite diagnosis of dementia, and probably<\/p>\n<p>Alzheimer\u2019s disease. Matilda wanted to know whether the type of dementia<\/p>\n<p>made any difference to what she should do. The doctor was also reluctant<\/p>\n<p>to discuss how long this might go on for. Matilda understood that no one<\/p>\n<p>had a crystal ball but felt that it would help her if she knew some of what<\/p>\n<p>was in store and had some timeframe to work from. She was thinking of<\/p>\n<p>visiting relatives in Holland before she got too old to manage such a trip but<\/p>\n<p>didn\u2019t know what was best to do.<\/p>\n<p>Matilda said that she hadn\u2019t properly answered the doctor\u2019s questions about<\/p>\n<p>Alex\u2018s incontinence because that would have just made things worse. She<\/p>\n<p>explained that Alex had had some urinary incontinence for a year or more<\/p>\n<p>but this had been mostly at night or he had just used the wrong place or<\/p>\n<p>thing to urinate in. But over the past month he had been wetting himself<\/p>\n<p>and was now occasionally incontinent of faeces as well.<\/p>\n<p>Again Mary Jo disciplined herself from jumping in and answering the parts<\/p>\n<p>of the questions she could answer. She was feeling that her grandmother<\/p>\n<p>had a new level of trust in her and she wanted to live up to that trust.<\/p>\n<p>Somehow it also really mattered to understand what her grandmother was<\/p>\n<p>experiencing.<\/p>\n<p>Their conversation extended beyond \u2018Alex\u2019s problems\u2019 to Mary Jo\u2019s learning<\/p>\n<p>more about her own (and Alex\u2019s) extended family in Europe and some<\/p>\n<p>catching up about what Mary Jo was up to at work and in her rather inactive<\/p>\n<p>social life.<\/p>\n<p>Towards the end of the evening Mary Jo said that she felt that the<\/p>\n<p>Alzheimer\u2019s Association was the best source of information for her<\/p>\n<p>grandmother and that she would be happy to go along with her and support<\/p>\n<p>any steps or stages she chose along the way. When her grandma was ready<\/p>\n<p>Mary Jo was also willing to approach the social worker and get the full<\/p>\n<p>information about nursing home assessment and admission and what that<\/p>\n<p>entailed.<\/p>\n<p><strong>Prompting questions, set 3<\/strong><\/p>\n<ul>\n<li>What influence does the type of dementia have on the onset, progression<\/li>\n<\/ul>\n<p>and prognosis of the condition<\/p>\n<ul>\n<li>What factors contribute to the likelihood of aggressive behaviour in people<\/li>\n<\/ul>\n<p>experiencing dementia<\/p>\n<ul>\n<li>Identify what community resources are available in your community to<\/li>\n<\/ul>\n<p>answer Matilda\u2019s questions.<\/p>\n<ul>\n<li>What could account for the changes in Alex\u2019s continence issues<\/li>\n<\/ul>\n<p>page 3<\/p>\n<p>What resources and advice could be made available to Alex in his own<\/p>\n<p>home<\/p>\n<ul>\n<li>How would you as a health professional support Matilda\u2019s plans to travel to<\/li>\n<\/ul>\n<p>Europe<\/p>\n<p>Epilogue<\/p>\n<p>Matilda did explore the information and community resources available to<\/p>\n<p>her and Alex. She found that the carers\u2019 support group was very welcoming<\/p>\n<p>and good at sharing helpful information.<\/p>\n<p>The continence nurse specialist did an assessment and Alex was found to be<\/p>\n<p>constipated, with some faecal overflow, and his dietary habits and exercise<\/p>\n<p>regime were adjusted under her supervision.<\/p>\n<p>Mary Jo became a regular visitor and support to her grandmother. The<\/p>\n<p>range of topics that they discussed together expanded and sometimes even<\/p>\n<p>surprised Mary Jo.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p><strong>What you need to do to meet your learning outcomes<\/strong><\/p>\n<p>\uf0d8 Explore these websites<\/p>\n<p>Explore the following websites, which provide information about dementia.<\/p>\n<p>Australian Government Department of Health and Ageing 2007, Dementia,<\/p>\n<p><a href=\"http:\/\/https:\/\/essays.homeworkacetutors.com\" rel=\"follow\">https:\/\/essays.homeworkacetutors.com\/write-my-essay\/health.gov.au\/dementia<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<p>AIHW 2007, Dementia in Australia: national data analysis and development,<\/p>\n<p>AIHW Cat. No. AGE 53, AIHW, Canberra,<\/p>\n<p><a href=\"http:\/\/https:\/\/essays.homeworkacetutors.com\" rel=\"follow\">https:\/\/essays.homeworkacetutors.com\/write-my-essay\/aihw.gov.au\/publications\/index.cfm\/title\/10368<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<p>Dementia Training Study Centres: <a href=\"http:\/\/https:\/\/essays.homeworkacetutors.com\" rel=\"follow\">https:\/\/essays.homeworkacetutors.com\/write-my-essay\/dtsc.com.au\/<\/a><\/p>\n<p>&nbsp;<\/p>\n<p>Bridges-Webb, C &amp; Wolk, J 2003, Care of patients with dementia in general<\/p>\n<p>practice: guidelines, NSW Department of Health, Sydney,<\/p>\n<p><a href=\"http:\/\/https:\/\/essays.homeworkacetutors.com\" rel=\"follow\">https:\/\/essays.homeworkacetutors.com\/write-my-essay\/health.nsw.gov.au\/pubs\/2003\/pdf\/care_dementia_guide.pdf<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<p>Dementia Care Australia: <a href=\"http:\/\/https:\/\/essays.homeworkacetutors.com\" rel=\"follow\">https:\/\/essays.homeworkacetutors.com\/write-my-essay\/dementiacareaustralia.com<\/a><\/p>\n<p>&nbsp;<\/p>\n<p>Alzheimer\u2019s Australia: <a href=\"http:\/\/https:\/\/essays.homeworkacetutors.com\" rel=\"follow\">https:\/\/essays.homeworkacetutors.com\/write-my-essay\/alzheimers.org.au<\/a><\/p>\n<p>Simons, LA, Simons, J, McCallum, J &amp; Friedland, Y 2006 &#8211; Write a paper; Professional research paper writing service &#8211; Best essay writers, \u2018Lifestyle factors and<\/p>\n<p>risk of dementia: Dubbo study of elderly\u2019, Medical Journal of Australia,<\/p>\n<p>vol. 184, no. 2, January, pp. 68-70,<\/p>\n<p><a href=\"http:\/\/https:\/\/essays.homeworkacetutors.com\" rel=\"follow\">https:\/\/essays.homeworkacetutors.com\/write-my-essay\/mja.com.au\/public\/issues\/184_02_160106\/sim10682_fm.pdf<\/a><\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>Department of Human Services, Victorian Government Health Information 2004,<\/p>\n<p>A guide for assessing older people in hospitals, developed by the Centre for<\/p>\n<p>Applied Gerontology, Bundoora Extended Care Centre, Northern Health,<\/p>\n<p><a href=\"http:\/\/https:\/\/essays.homeworkacetutors.com\" rel=\"follow\">https:\/\/essays.homeworkacetutors.com\/write-my-essay\/health.vic.gov.au\/acute-agedcare\/assessing-older-people.pdf<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<p>This guide provides one of the major discussions in the field regarding the<\/p>\n<p>pros and cons of assessments and other tools that are available.<\/p>\n<p>Tameside Council, The single assessment process for older people, frequently<\/p>\n<p>asked questions, <a href=\"http:\/\/https:\/\/essays.homeworkacetutors.com\" rel=\"follow\">https:\/\/essays.homeworkacetutors.com\/write-my-essay\/tameside.gov.uk\/sap<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<p>This web resource about the single assessment process (SAP) was developed<\/p>\n<p>by the Department of Health in the UK. It discusses different types of<\/p>\n<p>assessment scales and social problems facing the older person.<\/p>\n<p>Ministry of Health [NZ] and New Zealand Guidelines Group 2003, Best practice<\/p>\n<p>evidence-based guideline summary, \u2018Assessment of older people with complex<\/p>\n<p>needs\u2019, New Zealand Government,<\/p>\n<p><a href=\"http:\/\/https:\/\/essays.homeworkacetutors.com\" rel=\"follow\">https:\/\/essays.homeworkacetutors.com\/write-my-essay\/nzgg.org.nz\/guidelines\/0030\/Specialist_summary.pdf<\/a>.<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<p>&nbsp;&#8211; Online Homework Help Service By Expert Research Writers<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Dementia: the case of Alex Mary Jo has been contacted by her maternal grandmother and asked to come and visit so that they can talk about her grandmother\u2019s [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"pagelayer_contact_templates":[],"_pagelayer_content":"","footnotes":""},"categories":[1302],"tags":[1832,1879,1875,1877],"class_list":["post-4609","post","type-post","status-publish","format-standard","hentry","category-top-nursing-papers","tag-healthcare-dissertations","tag-online-nursing-papers","tag-health-care-essays","tag-nursing-assessment"],"_links":{"self":[{"href":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/wp-json\/wp\/v2\/posts\/4609","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/wp-json\/wp\/v2\/comments?post=4609"}],"version-history":[{"count":0,"href":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/wp-json\/wp\/v2\/posts\/4609\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/wp-json\/wp\/v2\/media?parent=4609"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/wp-json\/wp\/v2\/categories?post=4609"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.homeworkacetutors.com\/acemyhomework\/wp-json\/wp\/v2\/tags?post=4609"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}