Residential Care-Home: A Case Study

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Pain is a universal experience; to which we all have different levels of tolerance. However; we can recognise its’ effect; and can alleviate these symptoms with appropriate treatment and accessing health care services. The symptoms of pain can only be defined by the individual, thus making assessment and treatment complicated (MCCaffery,1968).
James is an 87 year old gentleman with a diagnosis of Alzheimer’s; living in a residential care-home (RCH). I was conducting a medication review as part of his 6 monthly memory monitoring usually consisting of; a Mini Mental State Examination (MMSE); in accordance with the National Institute for Health and Clinical Excellence (NICE) guidelines; and general conversation to ascertain any concerns around physiological; side effects or changes in presentation. (Folstein et al., 1975) (NICE, 2006).
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They identified; physical aggression towards staff during his personal care; where James repeatedly shouts; “No!” They also advised; he appears to be disorientated to time, place and person; but often wanders around the unit independently. James is not currently prescribed any mood stabilizers i.e. anti-depressants or anti-psychotics. His only prescribed medications; are for constipation and pain relief; which have not been administered/dispensed. I enquired as to his physical health as a possible infection may result in changes in behaviour. The GP; visited 2 days prior to my assessment; had ruled-out any physical health causes; claiming these behaviours were directly relating to his dementia i.e. opposed to any infections causing delirium. (Alzheimer’s

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