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CEJN 144 Intro To Blogging

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Blog 2 Case Study

Mrs. B, an 85-year-old woman, presented to the Emergency Department with her son with increased paranoia, visual hallucinations, and agitation. Her son had taken her to her GP when facility staff reported the symptoms, but Mrs B. angrily accused the GP of trying to euthanase her. The GP encouraged the son to take her to ED and he would fax a referral.

She moved to an assisted living facility and did well there until she was hospitalized 2 years ago with agitation. At that time, she was diagnosed with late onset Alzheimer’s type dementia with delusions, depressed mood, and behavioural disturbance. She returned to the assisted living facility and was stable until a few months before her current hospitalization, which was precipitated by gradually worsening paranoid delusions, visual hallucinations, severe restlessness, and difficulty in being redirected.

According to her son, Mrs. B had had "strange thoughts" for as long as he could remember. For example, for a time, Mrs. B would eat only foods that were white. Still, in her adult life, she had actively participated in developing and running a successful family business with her husband and had raised two sons. When her husband died 5 years ago, Mrs. B developed a major depressive disorder, single episode, severe with psychotic features.

1. After reviewing the information available, what other information needs to be gathered at this point?
 
2. What are the important immediate issues?

3. With this minimal information, what do you think may be happening with Mrs B.?
 
4. How should the health service respond?
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