Jo is a trim fit looking Maori gentleman looking younger than his stated age. He was tidily dressed in casual attire and when we first met he was playing the piano.He had good social skills and smiled readily. Affect
His affect was reactive initially when talking about his successes and highlights of his life and other neutral subjects he was able to laugh and smile However when talking about the separation from his wife which he does not understand he became quite tearful. He was able in the end to be distracted from that to a degree. Mood
No vegetative symptoms
His speech was clear but he did have word finding problems from time to time. Normal rate. Thought form
At times he did perseverate He did at the end go on at some length about his wish to be with his wife. Thought content
The major content especially towards the end was his desire to be living with his wife He was able to say that he didn’t think he would live forever and he wanted to spend his last days with her .He had no understanding of why he should be where he is. Cognition
He knew the date of his birth but not his age but guessed in the 80s somewhere As noted some difficulty in finding his room He initially misidentified his wife from a photo on the wall as his mother but later self corrected.Whe asked the name of his children he initially gave the names of his siblings but with one prompt subsequently was able to name his children He got 1/10 for orientation, country .Full MMSE not done because of distress Insight/Judgement
Does not understand why he is not at home.
Reason for referral
Joes initial assessment was done by a geriatrician this was due to Joes increasing verbal abuse and aggressive toward his wife his property. Joe was placed in a rest home by his family under a 28 day respite scheme, which the family are paying for privately According to the referrer the family are now considering permanent placement Identifying information (Inclusive of DSM 1V DIAGNOSIS
Presenting problem/and precipitating problems
Joe was diagnosed by a Geriatrician as having problems with Alzheimers disease.At the time Joe was frequently verbally and at times abusive to his wife He had an MSQ of 4/10 which means ?He was commenced on Donepizil up to 10mgs a day with good affect In 2009 he started becoming more verbally aggressive to his family and it was decided to stop the medication as is was thought it was no longer effective In July 2009 Joes was seen by a needs assessor to request getting onto the respite program.In November of 2009 Joe was assessed by the Community Mental Health Nurse. Previous mental health history
Joe has no previous history of mental health issues
Previous Medical history
Joe has Type 11 diabetes that is diet controlled.
In 2006 was diagnosed with left carotid artery aneurysm
Previous drug history
Joe has no previous drug history
Joe is the third child in is family with two older brothers and a younger sister His father was a Methodist minister. Joe is of Nga Puhi descent and was born in Northland. Joe education was done in Hawera, he attended Massey university and got a Bachelor of Agriculture and a Diploma of education. He became a school teacher and was the principle of a high school in Auckland Joe also held a high position within Maoridom Relationship history
Joe first met his wife in Waima and has been married to her for 53 years Joe has written Maori books and in his youth he was an active sportsman and was a Maori All black and a successful rugby coach. Joe...