February, 18, 2008University: Previous Medical and Social HistoryJoseph Williams an old age adult was admitted in our hospital for treatment of his agitation behavior. In this paper we shall discuss briefly the previous medical and social history of Joseph and his major health issues. The care received by Joseph and appropriate decisions that were made during his care period will be presented. At the end we shall discuss the overall care received by Joseph and will suggest the measures aimed at improving the case that Joseph received. In Joseph’s case one of the major impacts on his quality of life and for his family was the existence of agitation behavior right in the middle stage of his disease.
He exhibited some particular type of agitation behavior for the last few years. Moreover he was also a patient of psychosis or depression. Medical experts suggested the best way for managing his disease was through atmosphere and environmental changes instead of medication which was termed as last resort. (Allen MH. 2007)All the proper changes in the environment and circumstances were made to provide proper care and cure to Joseph.
Agitation some times occurs with the patient of dementia. Related behavior includes combativeness, hyperactivity and aggressions. Along with behavioral problems the initial step for treatment is to recognize the precipitants. Evaluations for Joseph included assessment for common type of systemic causes, for example dehydration, constipation, infection and types of illnesses. (Enida. 2000)Family of Joseph was well informed about the probable causes of agitation like excessive stimulation along with the need to execute educated guesses regarding environment that provoke inadequate behavior. As Joseph was initially the patient of dementia, he often became agitated when he was rushed, as such time-critical events were avoided that proved useful to some extent.
His daily activities were re-structured to provide such a routine that was predictable to him. (Janicki, M.P, 2000)Orientation materials such as clock, family pictures and calendars were prominently displayed in his room and his living environment was well lit, even when there was daytime, for the purpose of avoiding misperception and misconception of stimuli. Behaviors that are mostly disruptive but not considered as harmful must be tolerated.
Physical restraint is hardly necessary and generally serves to provoke the degree of agitation. (Gandelman K. 2007) Major Health Issues of JosephBehavioral problems mostly occur in the early stage of disease event before a care provider is aware that person like Joseph in the old age is afflicted. For example patients such as Joseph may become angered easily when there is a mistake made because of memory loss. (Gandelman K. 2007) Joseph could have lash out verbally at the care provider when he was pointed about the loss of memory.
He mostly became angry when he inquired about the reason of non-visit by any relative and was told that the visit was made just a day before. (Enida. 2000)With the progression of disease, behavioral problems became more severe and frequent. He was transformed and became suspicious and paranoid, accusing family members with different allegations like being faithful or stealing his personal things. He also had sleep disturbances and started wandering from home. Later on, as the disease developed, he yelled or screamed inappropriately and even resisted the attempts of family members for helping in his daily routine like dressing and other kind of personal care.
(Janicki, M.P, 2000)