Module 11 – Cognitive and

Mental Health Issues and Brain

Issues - Assignment

General Direction:

A. The assignment will count for 20% of your final mark in Module 11.

Name: Jashanpreet Kaur

Student id: 030624psw9299

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 1. Cognitive impairment can disrupt the person’s ability to participate in their ADL’s. List
three examples of specific difficulties with ADL’s that could arise, and then provide one
action the PSW could implement to support and assist the client to promote autonomy
and dignity with the task. (6 marks)

i) ADL task: Bathing

PSW support: The PSW can set up the bathing area to ensure safety by using grab bars and
a non-slip mat. They can also assist the client by providing step-by-step guidance while
encouraging the client to wash themselves as much as possible, promoting independence.

ii) ADL task: Dressing

PSW support: The PSW can help the client choose their clothes to encourage personal
choice and dignity. They can assist with putting on clothes but should allow the client to
do as much as they can by themselves, fostering a sense of autonomy.

iii) ADL task: Meal Preparation

PSW support: The PSW can involve the client in meal planning by discussing their favorite
foods and asking for their input. While preparing meals, the PSW can help with simple tasks,
like stirring or setting the table, which allows the client to participate actively and feel valued.

2. Mr. Heron is a 78-year-old client of the agency you are employed with. He lives in a
retirement home but is supported by your agency two mornings each week. He has
been a client of yours for a month. Mr. Heron’s forgetfulness is progressing slowly, but
he remains a person with precise ideas and preferences regarding how things should be
done. Mr. Heron’s occupation was a high school principal. He held that position for over
thirty years. He is married and has two adult children and five grandchildren.

Three times in the last two weeks when you have visited Mr. Heron you have found him
hovering near the elevator in his building. He has appeared slightly agitated and has not
been fully dressed. Today you find him in the same location wearing a suit jacket with
no shirt underneath, and he seems particularly upset. He says to you, “The train is
leaving, and I’ve got to be on it or I will be late for school.”

a. How might Mr. Heron’s personality and past experiences influence the behavior
you witness today? (2 marks)

Mr. Heron was a high school principal for many years, which means he was used
to being in charge and having a schedule. Because of his past, he may feel
anxious or upset when he thinks he is late or missing something important. His
need for structure and routine could make him hover near the elevator,
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 believing he has to catch a "train" to get to work, which is a sign of his confusion.

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 b. What actions or verbal direction might you do or suggest in order to make Mr.
Heron more comfortable? (2 marks)

To help Mr. Heron feel better, you could calmly talk to him and say something
like, “You’re not late for school. Let’s go back to your apartment and relax.”
You can also reassure him that he is safe and that it’s okay to take a moment
to gather himself. This can help him feel more secure and less anxious.

3. Why is depression often mistaken for dementia? (1 mark)

Depression can be mistaken for dementia because both can cause memory
problems and difficulty thinking clearly. People with depression may forget
things, have trouble concentrating, or seem less interested in activities,
which are also signs of dementia. This overlap in symptoms can lead to
confusion between the two conditions.

4. Using the three stages of dementia, explain how you would support your client with
their mealtimes and eating in each of the stages. (3 marks)

Mild Stage: Encourage independence by allowing them to choose their meals and assist them as needed. In this
stage, the person may still be able to eat independently but might need some help. The PSW can encourage the client
to choose what they want to eat, which gives them a sense of control. The PSW should also offer gentle reminders
about using utensils or where to find items on the table.

Moderate Stage: At this stage, the person may struggle with eating and might forget how to use utensils.
The PSW should sit with the client during meals and provide clear prompts, like saying, “It’s time to take
a bite,” or helping them with one step at a time. A calm and quiet environment will help the client focus
on their meal and reduce distractions.

Severe Stage: In the severe stage, the person may need a lot of assistance. The PSW can provide easy-to-eat
finger foods that don’t require utensils, such as sandwiches or fruit. They may need help with feeding, so the PSW
should patiently offer small bites and encourage the client to chew and swallow. Keeping a comforting presence
during meals can help the client feel more at ease and enjoy the experience.

5. A client you are assigned by your home care agency has been diagnosed with
Alzheimer’s Disease – Stage 2. List five safety concerns you would have in the client’s
home. (5 marks)

i) Confusion About Locations: The client may forget where things are in the house, like the
bathroom or kitchen, leading to frustration or wandering.
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ii) Misuse of Appliances: The client might forget how to use the stove, microwave, or other
appliances, which can result in unsafe situations, like leaving the stove on.

iii) Medication Errors: The client may forget if they took their medication or take the wrong dose,
which can harm their health.

iv) Difficulty with Household Hazards: The client may not recognize hazards, such as stairs, rugs,
or electrical cords, increasing the risk of falls or accidents.

v) Wandering Outside: The client may forget where they are and wander outside, which can lead
to getting lost or encountering unsafe situations in the neighborhood.

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 6. Mrs. Green is a client of your agency. She has been diagnosed with multi-infarct
(vascular) dementia. She has been assessed to be in the first stage and is only mildly
forgetful the majority of the time. She is most comfortable when she gets the answers
she needs, although she may forget them in a short period of time. Today she asks you,
“Have you seen my daughter? I haven’t seen her in a very long time.” You know that
Mrs. Green’s daughter visits on a regular basis, but you are unsure as to when she was
last in. (5 marks)

i) What is dementia?
Dementia is a decline in mental ability that affects daily life, including
memory, thinking, and communication skills.

ii) What is meant by multi-infarct dementia?

Multi-infarct dementia is caused by multiple small strokes that affect
blood flow to the brain, leading to memory and thinking problems.

iii) How might Mrs. Green’s forgetfulness interfere with her safety needs?

Mrs. Green’s forgetfulness may make her unsafe because she might not remember where
she is or may forget to follow safety routines, like locking doors.

iv) Considering effective communication techniques, how would you respond to Mrs.
Green?
To respond to Mrs. Green, you could say, “Your daughter visits often.
I can check the schedule and find out when she’ll be here next.”

v) Explain how this approach would be helpful.

This approach is helpful because it acknowledges her feelings, provides
reassurance, and keeps her engaged in a positive conversation.

7. “When a resident is cognitively impaired, does it really matter whether he/she is

attractively dressed? Are we just trying to make an impression on visitors and other
residents? If the confused resident doesn’t know or care how he/she is dressed, why
should we? It’s not bothering him/her.” (2 marks)

It is important for cognitively impaired residents to be well-dressed even if they

don’t seem to notice because it affects or maintain their self-esteem and dignity.
Being dressed well can help them feel more like themselves and improve their
mood, even if they don’t always notice it. It shows respect and care for their well-
being. When a person is dressed neatly, it can also make them feel more
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 comfortable and confident, even if they can’t express it.

This is not just about making a good impression on visitors or other residents; it’s
about showing respect to the individual. Dressing someone in a thoughtful and
respectful way shows that we care about their well-being, and it also helps to
maintain a sense of normalcy and routine in their life, which can be comforting.
Even if they don’t know how they are dressed, it still matters because it supports
their dignity.

8. You have been assigned a client with a diagnosis of schizophrenia. At the time of their
in-home assessment, the client was well controlled on medication and had excellent
outside support from social work and family who live in the area. Desiring to be
prepared for any change that could potentially occur from non-compliance with their
medication regime, what are three signs that you would take note of that your client
may be in mental health crisis? (3 marks)

 Hallucinations or delusions: The client may start seeing or hearing things that aren’t there
(hallucinations) or believe things that aren’t true (delusions), such as thinking someone is
out to harm them.
 Increased agitation or irritability: The client might become more easily upset, angry, or
anxious, and may have sudden mood changes.
 Withdrawal from others: The client may start isolating themselves, avoiding family,
friends, or social activities, which can be a sign that they are struggling emotionally.
 Neglecting personal hygiene: In a crisis, the client might stop caring for themselves,
forgetting to shower, brush their teeth, change clothes, or take care of their physical
health regularly because they are overwhelmed or confused by their symptoms.

9. “The elderly are not at risk of committing suicide.” Do you agree or disagree? Explain your
answer: (2 marks)

I disagree with the statement that the elderly are not at risk of committing suicide. Many
older adults face significant challenges, such as health issues, loneliness, or loss of loved
ones, or feeling lonely and isolated which can lead to feelings of hopelessness or
depression. It’s essential to recognize and address these risks.
Sometimes, older people may not talk about their feelings, so it’s important to pay
attention to warning signs like withdrawing from others, talking about death, or changes
in mood. We should take their emotional health seriously because depression and other
mental health issues in the elderly can increase the risk of suicide.

10. Define: (4 marks)

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i) Affective disorder:
An affective disorder is a type of mental health condition that affects a person’s mood or emotions.
People with these disorders may feel very sad, anxious, or experience mood swings.

Example: One example of an affective disorder is Major Depressive Disorder. This condition
causes deep feelings of sadness, loss of interest in activities, and can make it hard for someone to
function in daily life.

ii) Anxiety disorder:

An anxiety disorder is a mental health condition where a person feels excessive worry, fear, or
nervousness. These feelings can interfere with daily activities and can make it difficult to relax or
focus.

Example: One example of an anxiety disorder is Generalized Anxiety Disorder (GAD). This
condition causes a person to feel worried about many different things, such as health, work, or family,
even when there is no real reason to be worried.

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