2. Which level of support do you

2. Which level of support do you think Mrs. Brown needs? Why? (3 marks) 3. Her daughter who is her power of personal care, has decided a long term care home would be best for her. What is the next step? (include the assessments that need to be done) (5 marks) Mrs. Brown’s medical history includes Alzheimer’s disease; type II diabetes; hypertension; high cholesterol and osteoarthritis. She was admitted to Hospital following a stroke that resulted in moderate left arm and leg weakness. This admission was the third hospital admission in the past year. Other admissions have been for a urinary tract infection, and a fall due to low blood sugars, both of which were complicated by episodes of delirium. Mrs. Brown was diagnosed with Alzheimer’s disease by Dr Joanne Winters, Geriatrician, in April 2016. At that time, Mrs. Brown scored 21/30 on the Montreal Cognitive Assessment (MoCa). During this admission, Mrs. Brown scored 15/30. There are cognitive deficits, primarily affecting memory, attention and executive function (planning, problem solving, mental flexibility and abstract reasoning). The most recent CT-Brain scan shows generalized atrophy along with evidence of the new stroke affecting the right frontal lobe. The assessments suggest moderate to severe mixed Alzheimer’s and vascular dementia. Financial and legal affairs Mrs. Brown has been living in her house for 30 years. She receives $1413.81 per month from Old age security benefit and the Canada pension Plan. Her home is in extensive need of repairs and is not able to be sold until this work is done. Mrs. Brown states that her daughter is her Substitute Decision Maker. General living circumstances Mrs. Brown acknowledges that she needs some assistance but lacks insight into the type of assistance that she requires, apart from home help for cleaning and shopping. She does not appreciate her risk of falling. She is unable to get in and out of bed without at least one person assisting her. She frequently forgets to use her walker when mobilizing and is not able to describe how she would seek help in the event of falling. She is not able to identify or describe how she would manage her blood sugar levels, and this has not improved with education. SCIENCE HEALTH SCIENCE NURSING LHC 2104

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