Behavioral Disturbances in Dementia

 

Behavioral and psychological disorders commonly occur in dementia. Symptoms can include depression, agitation, psychosis, anxiety, aggression, disinhibition, and sleep disturbances.
Choose two of the symptoms associated with dementia listed above, and:
1. Describe these symptoms and the clinical manifestations seen with the symptoms that you have chosen.
2. Use evidence-based references to explain how you would manage these symptoms.
3. Address both nonpharmacological and pharmacological considerations for management.
Delirium and agitated depression can occur with dementia. The syndromes may look alike. How do you differentiate among delirium, dementia, and depression?

 

 

Sample Solution

Somerset’s misguided focus on his foreign policy enabled domestic tension to evolve which threatened state stability and thus pushed England into a state of ‘crisis’. Williams (1995) asserts that Somerset’s “policy had cost an immense sum… [yet] achieved nothing at all.” Williams assertion is supported by Sir William Paget‘s letter to the Duke; warning Somerset of the confusion and chaos that had been created by his policies. Paget explains that as a result of English victory at the Battle of Pinkie (1547), which was precipitated by Somerset, “Scotland” was left “desir[ing] revenge” whilst “France [saw] a most propitious time to fall out with [Somerset] and ally with Scotland.” Despite creating the conditions to start a war, Somerset appeared “ready to have the Emperor [Charles V] to fall out with [him]”. Indeed, the Scottish Council had offered a marriage union between Mary Queen of Scots and Henry II’s son in exchange for further French aid. Additionally, Somerset’s failure to negotiate an Anglo-Scottish union, through the marriage of Edward VI and Mary Queen of Scots, only resulted in alienating Charles V. Thus, the source reliably conveys that Somerset’s foreign policy was misguided, suggesting Williams view is convincing as Somerset switched between aggression and negotiation yet “achieving nothing” positive. The source further supports Williams view as Somerset’s policy had quite literally spent an “immense sum” to fund his war with Scotland, spending £580,000 in his war with Scotland, debasing the coinage to fund the war which exacerbated inflation, and debased the coinage to fund the garrisons in the Firth of Tay (also exacerbating inflation). Thus Paget’s claim that Somerset had left England “in beggary, in debt” is also reliable. One should also recognise the significance of Paget himself writing such a letter to Somerset. Sir William Paget was one of the few major politicians who rose to power under Henry VIII, who in 1543 was appointed one of the two principal secretaries of state, and became comptroller of the household in 1547 under Edward VI’s reign. Furthermore, Paget was a personal friend of Somerset’s, playing an important role in the establishment of Somerset’s protectorate, and had written the letter on the night of Christmas. Therefore, Paget’s letter is a very useful source with regards to understanding how damaging Somerset’s foreign policy was, as even his close friend, who was knowledgeable in foreign affairs and management of the country, felt compelled to warn his superior at a time of celebration. Consequently, Somerset’s protectorate period can be labelled a ‘crisis’ as the Duke proved to be an incompetent leader, pursuing a damaging foreign policy which enabled instability domestically, and ultimately gave the opportunity for an

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