Q The case study is about Mrs Walker who has a diagnosis of Alzheimer’s dementia (4 months) and has deteriorated Home, - Care for patient suffering from Alzheimer’s dementia a) The primary sources that can provide information about the Mrs. Walkers medical history are the people who were taking care of her earlier as cited in Alzheimer’s, 2015. According to the case study, it elaborates that those people who were caring Mrs. Walker are the family, medical team and her psychogeriatric. These people must have kept some records concerning medicine Mrs. Walker takes. b) In reference to Burge et al (2014), the case of Mrs. Walker requires adaptive stage of interview. The reason for the adaptive method of the discussion is that the patient, Mrs. Walker, may fail to speak at this moment. Her health has deteriorated. When diagnosing her, one should concentrate on the non-verbal movement she is making this is according to D'onofrio et al (2015). On the other hand, she may also get angry at any moment. There is need to be patient while diagnosing Mrs. Walker. On should acknowledge the feeling of Mrs. Walker in order to get to the cause of what is happening to her. It is what referred to us the adaptive stage of the interview is, where one acknowledges how patient the feels. c) Identifying health problems in older people requires some concentration. The way nurses do assessment to the younger people differs from the older people. There are various reasons why older people need specific assessment tools in reference to Groot et al (2016). The first reason is that older patients have some particular complication that comes because of aging. For instance, the older person may experience walking difficult, due to this, he or she may need diagnosis at home. Another essential thing is that older people may have hearing problems that is why while assessing them one needs to even concentrate on the facial expression of the patient. The vital assessment tools inevitable in the case of Mrs. Walker are the psychological assessment tool and the medical assessment tools as cited in Holthoff et al (2015). a) Mrs. Walker is suffering dementia, which may cause some memory problems this is according to Kentish-Barnes et al (2015). After the unsuccessful effective communication to her, it may be essential to discuss the difficulties a psychiatric nurse. The psychiatric nurse handles both memory and mental issues. The nurse may provide the effective way of treating the patient. After that, it is easy to get the unmet ways that are important to address in referencing to Lee et al (2018). The nurses will assess the situation of Mrs. Walker and give the best direction to go. In addition to, it is good to handle the nurse with an assessment tool. The psychological assessment tool that was earlier elaborated may be given to the nurse for further assessment. b) The nurse that should operate with Mrs. Walker requires maintaining the standards. These standards comprise of ensuring the confidentiality of Mrs. Walker. Another thing is that the nurse should support the policies of the law as stated by Mace & Rabins (2017). On the other hand, the nurse should also ensure that the services are timely and are of quality. Lastly, he or she should maintain good communication. a) Restraints refer to the preventive steps that are applied to a patient to control the movement or behavior of that specific patient. The reason why this limitation is used in the patient is to prevent further injuries that may be reported this is according to Miyajima et al (2014). In addition to that, the boundary also helps to maintain the safety of the people around the patient. The nurse taking care of the patient is the one responsible for deciding on how the restraint is going to take action. b) The type of restriction applicable in the case of Mrs. Walker is the physical restraint. The reason why this is the best restraint is that she had become a stress to both caregivers and the family. Besides that, she burnt herself due to instability in the kitchen. Physical restraint will control her movement hence no more physical injuries. Once this restriction is put in place, there should be only specific people that attend to Mrs. Walker. a) The first reason that causes weight loss in the case of Mrs. Walker is the loss of interest in food. The family states that she is not eating and this may lead to this problem. Food is essential to increase the weight of the body. The second reason that causes weight loss is the unbalanced eating meal. Mrs. Walker has been only consuming food, which cannot maintain the weight of the individual. The balanced diet is the one that makes the body weight to be at a good point. The third point is that dementia causes memory loss. Most probably, she has forgotten to eat most of the moments. The last thing is the stress;Ornstein et al (2015) stated that dementia brings a lot of pressure to the patient and the concentration drops. It is why caregiver is necessary to monitor the eating habit of Mrs. Walker. b) Physical disability makes some complication such as Mrs. Walker cannot cook herself in that case. When one does not prepare, there is no eating and thus leading to loss of weight. In addition to that, Mrs. Walker may experience some problems of taking food to her mouth. This problem persists and many days she can go without food. c) Several health professions can health Mrs. Walker’s family deal with her condition. The general health practitioner has skills to help in the situation. It is essential to discuss changes in Mrs. Walker’s body with the general practitioner. Besides that, the type of medication she has been undergoing is also necessary. The public health practitioner will use all these to give the best healthcare. a) There are various ways in which inadequate oral health care contributes to poor health in older people. The first way is poor chewing of food. The reason that might bring poor chewing is the dental problems. One needs to visit a dentist to ensure that the tooth are right conditions. The second unfortunate care is the inadequate saliva flow. Saliva is the one responsible for good swallowing. If the patient has weak saliva flow, she may develop dry mouth and poor swallowing of food. The other thing is the decay of teeth. Teeth take part in digesting food. If they are worn out, older people do not understand well and thus brings inadequate health care. The other thing may be the lips problem, which may make the older person not to consume hot food. b) Good health is essential for everyone; however, caring the old people who have dementia may be a bit challenging. In this case, Mrs. Walker needs oral health care to maintain good health. The vital things that one should look at while doing oral assessment should comprise the following. The first one is the missing teeth. Teeth are an essential part of the mouth that helps in digesting food, and if one is missing, it is possible to replace. The other thing is the rate of the periodontal infection that is affecting Mrs. Walker. Moreover, tooth decay is another aspect that determines oral assessment. Lastly, the lips need to be checked whether they have cracked or not. c) There are many ways in which Mrs. Walker’s daughter can assist her to maintain good teeth. There are behaviors that the two should adapt to achieve the best result. The first thing is that, if Mrs. Walker is feeling pain on the gums while using the toothbrush, her daughter can use cotton instead to do the cleanliness of the mouth. The other guidance is that the daughter should do the tooth cleaning when Mrs. Walker is calm and able to cooperate with her. If Mrs. Walker develops a tendency of swallowing the toothpaste, the doctor can try the homemade once to avoid other complications. On the other hand, they can seek professions to clean the dentures. Most importantly, after every meal, the daughter should clean the dentures to prevent entry of bacteria. Some dentures may not fit well, and it is advisable that you wait over time. If the problem persists, they should see a dentist to correct the situation. Lastly, the daughter should remove the dentures when Mrs. Walker wants to go and sleep. She can even soak the dentures. The best assessment of this case is the functional assessment. In this assessment, it elaborates on the status of the patient and the environment may affect the situation. The nurse responsible for Mrs. Walker should use the functional assessment tools to establish on how Mrs. Walker can help herself. In addition, if support is necessary, she should be provided. a) Dementia is a disorder that causes fall in the capability of the brain of a person to carry out daily activities. In this case, of Mrs. Walker, the type of dementia that is affecting her is the Alzheimer. It is the most prevalent type of dementia. This type of infection leads to several defects in the affected individual in reference to Stroebe et al (2017). The problems include memory loss, poor perception and reasoning, communication problems and inability to pay attention to a particular thing. The signs and symptoms of dementia start at a low pace in the patient and slowly grows to worsen situations. The brain cells of the affected person are usually interfered with at all moment. Because of that, the brain experiences challenges to communicate with other parts of the body. When you have any member of the family showing the signs, one should not ignore but report to a doctor. Early treatment helps in managing the disease. b) The difference between the end of life care and palliative care is a nightmare for many people. Palliative care takes into account care and treatment of people who are under severe complication this is according to Poblador-Plou et al (2014). In many cases, the cure of the disorder may be painful. The signs and symptoms of the illness are put under control in this care. Palliative care does not focus only on the life of the patient undergoing treatment, but also the people providing care to that patient. Apparently, the way the caregiver lives cares even. It involves the consideration across the board including spiritual, psychological and social responsibility. On the other hand, end of life care is part of the palliative care. This portion of palliative care looks at the health of individuals who are near to end life. When the patient dies, it should be a death of dignity rather than regretful death. Another essential part of the end of life care is the incorporation of legal issues while providing care to the patient as stated by Winblad et al (2016). a) After the two weeks of medication, Mrs. Walker still has deteriorated health. The worse health status brings the need to discuss the situation with a general health officer concerned with dementia. The medical officer suggests that the first thing her daughter can do is to change the medicine used to control the memory loss problem. However, before doing this, a doctor must be consulted according to Peters et al (2015). Another option suggested by the officer is to take Mrs. Walker to surgery to check for the brain tumor. In addition to the above, the officer indicates some other medication that the daughter can buy for her. The medicine includes vitamins that can rectify lack of vitamin B12 in her body. The other drug is the one that treats the depression problem. Lastly, the additional step that the daughter should take is to visit a psychiatrist to give further advice continuously. b) There are benefits if Mrs. Walker feels that her environment is physically and emotionally relaxed. The first impact is that it provides ample time for her daughter to give her the drugs. When she follows the dose prescribed, the effect of the disease reduces. The second importance is that she will eat very comfortably and gain weight. For proper digestion of food to happen in the body, it also requires peace of mind. Feeling positive in her emotion and physical state will allow her to socialize with others this is in reference to Prince et al (2016). Socializing reduces the lousy feeling now and then. On the other part, people around her will feel free to interact with her. It is evident that everyone had feared her because of some physical problems she may cause. When Mrs. Walker is cold, she will last longer than expected. 1. The reason why carer recognition act was implemented is to educate more people on roles of carer in ensuring that there are support and care for people with mental challenges, disability or too old as stated by Wiener et al (2015). 2. The carer recognition act of 2010 provides the way the person caring the patient and the patient himself should be considered. The following three consideration provides ways in which legal act care for the two people. a) The person caring the patient has the right to confidentiality. b) The patient and the carer have right to complain. c) The two people have right to be recognized. 3. When caring for a deceased patient, there are the different aspect that still needs consideration. The first thing is that there should be the continuous support to the family. The second thing is that the offices where the deceased might have work should also take a step in ensuring the deceased fare well. Lastly, another thing that is considered is the donation of tissues. 4. Romero et al (2014) stated that, there are things that one should take caution while caring for the deceased. The first thing is that you must prepare the family members before they come to view the body. Secondly, you should always remain calm. Do not express any anger or attempt of violence in the scene. In case the deceased died in another environment, do not remove anything from the body until the body is identified. 5. The first way is to contact the bereaving family as soon as possible and establish any need required. The second thing is to leave the family to express themselves. Expression gives the opportunity to do away with all the anger as illustrated in Wright et al (2016).