Aged Perrsons Mental Health Nursing
Using the clinical scenario provided (see below), develop a care plan for Mrs B which incorporates a thorough
nursing-focused assessment.
Review the information available for Mrs B and develop a care plan that captures the relevant information
required for Mrs B to ensure a positive person-centered outcome in the acute care setting with supportive highquality contemporary literature.
Outline Mrs B’s current presentation/issues; and briefly describe Mrs B’s history
Identify and discuss Mrs B’s physical, psychological and social needs
Describe the main issues/risks/needs that need to be addressed and how will you manage these issues
Critically discuss the assessments and tool/s best used for Mrs B
References: using APA 7th Style
Case Study
Mrs. B, an 85-year-old woman, who lives in a assisted living facility presented to the Emergency Department
with her son. She is experiencing an increase in paranoia, visual hallucinations, and agitation. Her son had taken
her to her GP when facility staff reported concerns about these symptoms. Mrs B. angrily accused the GP of
trying to euthanise her when the discussion progressed to treatments that may alleviate her current complaint.
The GP, concerned, encouraged the son to take her to ED and he would fax a referral.
Mrs B had been living in an aged care facility for approximately 3 years. She initially was doing well in the
facility until she was hospitalized 2 years ago with agitation. At that time, she was diagnosed with moderate
degree of Alzheimer’s type dementia with delusions, depressed mood, and behavioural disturbance. She returned
to the aged care facility and had been 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. This episode was treated through titration of DESVENLAFAXINE 200 mg PO MANE,
MIRTAZAPINE 30 mg PO NOCTE and OLANZAPINE 2.5 mg PO NOCTE. A period of supplemental
DIAZEPAM 2 mg PO PRN QID was employed to assist with “behaviour management” and was advised to be
ceased after one month.
Mrs. B then moved to the assisted living facility and did well there until she was hospitalized two years later
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 presentation. The staff had noticed gradually worsening paranoid ideation, with
concerns that they may be of delusional intensity, visual hallucinations, severe restlessness, and difficulty in
being redirected.
The son reports that Mrs B had no significant medical history previously and was not taking any regular
psychotropic medication. She has experienced some pain that has been managed through Paracetamol XR 665
mg PO TDS, breathlessness managed with Ventolin – PRN. Medications choices for symptom control of
Alzheimer’s were being explored with a specialist, however, not finalised before the deterioration in
presentation. Mrs. B enjoys hydrotherapy at the “Water Winged Women of the West” pool. Mrs. B’s son is now
living locally and is supportive of his mother.
