1. The patient, a married white female, suffered a left intracerebral hemorrhagic stroke requiring craniotomy. She now exhibits Wernicke's aphasia, memory problems, and partial seizures.
2. On evaluation, she was pleasant but had significant language deficits, poor memory, and limited insight. Previous aggressive behavior was likely due to frustration from aphasia.
3. Recommendations include obtaining prior neuropsychological evaluation records, educating staff and family on the patient's deficits, establishing consistent routines, focusing on communication strategies, and encouraging socialization.
This program includes an innovative outreach program that combines sound business principals with social goals in order to specifically target the largest barrier to early psychosis treatment in Bolivia: the stigma of mental illness.
By utilizing a mobile, multidisciplinary treatment team that emphasizes the roles of trained case managers focused on providing intensive individual and family support in the home, this program will provide culturally appropriate care that will leverage contributions from a limited supply of psychiatrists and shift dependence away from a fragmented medical system
• Attention Deficit Hyperactivity Disorder (ADHD)
• Paranoid Schizophrenia
After clicking a disorder, click the Diagnostic Overview tab in the left column. This will cover the major diagnostic features of the disorder. After that, click the DSM-5 Features tab. You can then go though the Case History, Interview, and Treatment sections on the website. Finally, in the Assessment section, you can complete an optional multiple-choice quiz. You have to write a case report for each case study.
The format for the sample report is as follows:
Your Name
Instructor's Name
Class/Section Number
Background
• Outline the major symptoms of this disorder.
• Briefly outline the client's background (age, race, occupations, etc.).
• Describe any factors in the client's background that might predispose him or her to this disorder.
Observations
• Describe any symptoms that you have observed that support the diagnosis. You can include direct quotes or behaviors that you may have observed.
• Describe any symptoms or behaviors that are inconsistent with the diagnosis.
• Provide any information that you have about the development of this disorder.
Diagnosis
• Did you observe any evidence of general medical conditions that might contribute to the development of this disorder?
• Did you observe any evidence of psychosocial and environmental problems that might contribute to this disorder?
• As per your observations, what is the client’s overall level of safety regarding potential harm to self or others (suicidality or homicidality)?
• What cross-cultural issues, if any, affect the differential diagnosis?
Therapeutic Intervention
• In your opinion, what are the appropriate short-term goals of this intervention?
• In your opinion, what are the appropriate long-term goals of this intervention?
• Which therapeutic strategy seems the most appropriate in this case? Why?
• Which therapeutic modality seems the most appropriate in this case? Why?
APA format
Diagnostic overview
Schizophrenia is the most debilitating form of mental illness . This disorder which can come on quite suddenly distorts a person thoughts , perceptions and mood, and leaves them unable to meet the ordinary demands of life .
There is no single test to determine who suffers from schizophrenia. Instead the diagnoses is made when a person expresses a collection set of symptoms. The symptoms can be divided into three categories. One positive symptoms two negative symptoms and three social dysfunction.
One positive sentence
Positive symptoms include overt behaviors that are unusual and that interferes with the persons ability to interact in a daily life. The Two most common types of positive symptoms include delusional and hallucinations. It is essential to understand the difference between these two.
A delusion is a firmly held beliefs that is not grounded in real life. There are many types of delusions for example when a person vastly overestimate his or her importance we would ...
This program includes an innovative outreach program that combines sound business principals with social goals in order to specifically target the largest barrier to early psychosis treatment in Bolivia: the stigma of mental illness.
By utilizing a mobile, multidisciplinary treatment team that emphasizes the roles of trained case managers focused on providing intensive individual and family support in the home, this program will provide culturally appropriate care that will leverage contributions from a limited supply of psychiatrists and shift dependence away from a fragmented medical system
• Attention Deficit Hyperactivity Disorder (ADHD)
• Paranoid Schizophrenia
After clicking a disorder, click the Diagnostic Overview tab in the left column. This will cover the major diagnostic features of the disorder. After that, click the DSM-5 Features tab. You can then go though the Case History, Interview, and Treatment sections on the website. Finally, in the Assessment section, you can complete an optional multiple-choice quiz. You have to write a case report for each case study.
The format for the sample report is as follows:
Your Name
Instructor's Name
Class/Section Number
Background
• Outline the major symptoms of this disorder.
• Briefly outline the client's background (age, race, occupations, etc.).
• Describe any factors in the client's background that might predispose him or her to this disorder.
Observations
• Describe any symptoms that you have observed that support the diagnosis. You can include direct quotes or behaviors that you may have observed.
• Describe any symptoms or behaviors that are inconsistent with the diagnosis.
• Provide any information that you have about the development of this disorder.
Diagnosis
• Did you observe any evidence of general medical conditions that might contribute to the development of this disorder?
• Did you observe any evidence of psychosocial and environmental problems that might contribute to this disorder?
• As per your observations, what is the client’s overall level of safety regarding potential harm to self or others (suicidality or homicidality)?
• What cross-cultural issues, if any, affect the differential diagnosis?
Therapeutic Intervention
• In your opinion, what are the appropriate short-term goals of this intervention?
• In your opinion, what are the appropriate long-term goals of this intervention?
• Which therapeutic strategy seems the most appropriate in this case? Why?
• Which therapeutic modality seems the most appropriate in this case? Why?
APA format
Diagnostic overview
Schizophrenia is the most debilitating form of mental illness . This disorder which can come on quite suddenly distorts a person thoughts , perceptions and mood, and leaves them unable to meet the ordinary demands of life .
There is no single test to determine who suffers from schizophrenia. Instead the diagnoses is made when a person expresses a collection set of symptoms. The symptoms can be divided into three categories. One positive symptoms two negative symptoms and three social dysfunction.
One positive sentence
Positive symptoms include overt behaviors that are unusual and that interferes with the persons ability to interact in a daily life. The Two most common types of positive symptoms include delusional and hallucinations. It is essential to understand the difference between these two.
A delusion is a firmly held beliefs that is not grounded in real life. There are many types of delusions for example when a person vastly overestimate his or her importance we would ...
1. When a bat uses echolocation to determine the distance .docxambersalomon88660
1. When a bat uses echolocation to determine the distance to an insect, it sends out a sound
wave and waits to see how long the sound takes to echo back. Suppose now that a bat
hears its echo 0.1 second after it emitted the sound. If the speed of sound is 343 meters per
second, how far away is the insect?
2. Let’s imagine we have two CBRs set up in a line to measure a moving cart situated between
them. Assume that both CBRs emit clicks at the same time, 𝑡 = 0. The two CBRs are
separated by a distance 𝑑, and the cart is a distance 𝑟 from the CBR 1, on the left. If each
CBR clicks once simultaneously, how many sound pulses will CBR 1 record? What distance
will CBR 1 record for each of those “echoes?”
If the CBR only clicks once, it should only record a single position even though in question 2
it is receiving two different sound pulses.
3. Imagine you are designing the software for CBR 1. Create a criteria that you would put into
the CBR software to handle this situation. Note: it is not possible to build a criteria that will
always make the CBR report the correct distance if you only have a single click from the
device. Identify the location(s) of the car where your criteria would result in the CBR
reporting the incorrect distance to the car.
CBR2 CBR1
The Origin and Development of Psychoanalysis[1]
Sigmund Freud (1910)
First published in American Journal of Psychology, 21, 181-218.
FIRST LECTURE
Ladies and Gentlemen: It is a new and somewhat embarrassing experience for me to appear as lecturer before students of the New World. I assume that I owe this honor to the association of my name with the theme of psychoanalysis, and consequently it is of psychoanalysis that I shall aim to speak. I shall attempt to give you in very brief form an historical survey of the origin and further development of this new method of research and cure.
Granted that it is a merit to have created psychoanalysis, it is not my merit. I was a student, busy with the passing of my last examinations, when another physician of Vienna, Dr. Joseph Breuer,[2] made the first application of, this method to the case of an hysterical girl (1880-82). We must now examine the history of this case and its treatment, which can be found in detail in "Studien über Hysterie," later published by Dr. Breuer and myself.[3]
But first one word. I have noticed, with considerable satisfaction, that the majority of my hearers do not belong to the medical profession. Now do not fear that a medical education is necessary to follow what I shall have to say. We shall now accompany the doctors a little way, but soon we shall take leave of them and follow Dr. Breuer on a way which is quite his own.
Dr. Breuer's patient was a girl of twenty-one, of a high degree of intelligence. She had developed in the course of her two years' illness a series of physical and mental disturbances which well deserved to be taken seriously. She.
This is a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For questions about this blog project or its content please email the teacher Chris Jocham: jocham@fultonschools.org
This is a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For questions about this blog project or its content please email the teacher Chris Jocham: jocham@fultonschools.org
1. When a bat uses echolocation to determine the distance .docxambersalomon88660
1. When a bat uses echolocation to determine the distance to an insect, it sends out a sound
wave and waits to see how long the sound takes to echo back. Suppose now that a bat
hears its echo 0.1 second after it emitted the sound. If the speed of sound is 343 meters per
second, how far away is the insect?
2. Let’s imagine we have two CBRs set up in a line to measure a moving cart situated between
them. Assume that both CBRs emit clicks at the same time, 𝑡 = 0. The two CBRs are
separated by a distance 𝑑, and the cart is a distance 𝑟 from the CBR 1, on the left. If each
CBR clicks once simultaneously, how many sound pulses will CBR 1 record? What distance
will CBR 1 record for each of those “echoes?”
If the CBR only clicks once, it should only record a single position even though in question 2
it is receiving two different sound pulses.
3. Imagine you are designing the software for CBR 1. Create a criteria that you would put into
the CBR software to handle this situation. Note: it is not possible to build a criteria that will
always make the CBR report the correct distance if you only have a single click from the
device. Identify the location(s) of the car where your criteria would result in the CBR
reporting the incorrect distance to the car.
CBR2 CBR1
The Origin and Development of Psychoanalysis[1]
Sigmund Freud (1910)
First published in American Journal of Psychology, 21, 181-218.
FIRST LECTURE
Ladies and Gentlemen: It is a new and somewhat embarrassing experience for me to appear as lecturer before students of the New World. I assume that I owe this honor to the association of my name with the theme of psychoanalysis, and consequently it is of psychoanalysis that I shall aim to speak. I shall attempt to give you in very brief form an historical survey of the origin and further development of this new method of research and cure.
Granted that it is a merit to have created psychoanalysis, it is not my merit. I was a student, busy with the passing of my last examinations, when another physician of Vienna, Dr. Joseph Breuer,[2] made the first application of, this method to the case of an hysterical girl (1880-82). We must now examine the history of this case and its treatment, which can be found in detail in "Studien über Hysterie," later published by Dr. Breuer and myself.[3]
But first one word. I have noticed, with considerable satisfaction, that the majority of my hearers do not belong to the medical profession. Now do not fear that a medical education is necessary to follow what I shall have to say. We shall now accompany the doctors a little way, but soon we shall take leave of them and follow Dr. Breuer on a way which is quite his own.
Dr. Breuer's patient was a girl of twenty-one, of a high degree of intelligence. She had developed in the course of her two years' illness a series of physical and mental disturbances which well deserved to be taken seriously. She.
This is a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For questions about this blog project or its content please email the teacher Chris Jocham: jocham@fultonschools.org
This is a project for a high school AP Psychology course. This is a fictionalized account of having a psychological ailment. For questions about this blog project or its content please email the teacher Chris Jocham: jocham@fultonschools.org
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
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This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
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Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
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Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
New Drug Discovery and Development .....NEHA GUPTA
The "New Drug Discovery and Development" process involves the identification, design, testing, and manufacturing of novel pharmaceutical compounds with the aim of introducing new and improved treatments for various medical conditions. This comprehensive endeavor encompasses various stages, including target identification, preclinical studies, clinical trials, regulatory approval, and post-market surveillance. It involves multidisciplinary collaboration among scientists, researchers, clinicians, regulatory experts, and pharmaceutical companies to bring innovative therapies to market and address unmet medical needs.
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
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- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
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The Gram stain is a fundamental technique in microbiology used to classify bacteria based on their cell wall structure. It provides a quick and simple method to distinguish between Gram-positive and Gram-negative bacteria, which have different susceptibilities to antibiotics
Intracerebral Hemorrhage leading to Wernicke's Aphasia and partial seizures
1. 1
Mental Health Consultation
Patient Name: Intracerebral hemorrhage Facility: XXXX
leading to Wernicke's aphasia & partial seizures
Date: x-xx-xx
For the sake of brevity and timeliness, the following sections will not be included in this report:
Background Information: Current Medications: Medical History: That information can be
found elsewhere in this chart.
Reasonfor Referral: Left-handed, xx-year-old, white, married, female… I was asked to
evaluate her in connection with a hemorrhagic stroke. While she was in xxxxx with her husband,
on x-x-xx she suffered a left intracerebral hemorrhage which subsequently required a left
parietal-occipital craniotomy. Later neuroimaging showed a large area of low attenuation in the
left occipital lobe and the posterior left parietal lobe; small vessel disease; a remote old lacunar
infarct; and diffuse cerebral and cerebellar volume loss.
Following her acute stroke care she was sent to the Xxxxx Rehabilitation Xxxxx for a couple of
months then to xxxx Hospital and finally to us. Shortly after the onset of her stroke she was
described as globally aphasic with poor impulse control; “she grabbed a nurse by the throat”
and was described by family members as “narcissistic, irritable, verbally abusive, controlling
and argumentative”. She was initially admitted from xxxxx Hospital on x-xx-xx. More recently
she was admitted to XXXX where she was diagnosed with partial seizures. As far as I can tell,
she has not exhibited any aggressive behavior at XXXX. She is not taking any psychiatric
medications.
Mental Status Exam: I interviewed her with her husband present. She was a well-groomed,
cooperative and pleasant, gray-haired lady with a distinct Wernicke’s type aphasia. Unlike most
Wernicke’s patients she did not take offense when told that much of her speech made no sense.
She responded, “I used to get angry and frustrated about that but not so much anymore”. She
was also able to laugh about it. However, about 50% of her speech was relevant and coherent.
Her affect was full and appropriate. She denied depression and disinhibition. Her husband
confirmed this. However, she did very poorly on my simple tests of speech comprehension using
yes or no questions. She also clearly had severe memory problems. She did not know how many
children she had; what their names were or much at all about them. Her main complaint was she
felt that she has made little progress in rehabilitation and she has had two “severe setbacks”. She
had moderate weakness on the right side. Her orientation was limited to name only. She did not
know the date, the month, year, her own age or her date of birth. Her insight and judgment were
impaired. She exhibited pronounced apraxia and anomia.
Findings and Recommendations: Obviously, based on symptoms, despite her left handedness
and the fact that three of her children are left-handed she is not familial left-handed and therefore
left hemisphere dominant for language. Based on a fairly brief contact and a thorough review of
her history but without any of the important documents from her rehab at Xxxxx, I can offer the
following limited impressions: She evidently had a hemorrhagic stroke. She had an intracerebral
hemorrhage. Bleeding into the substance of the brain and/or the ventricles may cause an
elevation of intracranial pressure which can produce profound lasting deficits like the gross
confusion we see in her presentation. Intracerebral hemorrhage has a predilection for certain sites
in the brain, including the thalamus, putamen, cerebellum, and brainstem; in addition, to the
2. 2
areas of the brain directly injured by the hemorrhage. The surrounding brain tissue can be
damaged by pressure produced by the mass effect of the bleeding. Also a general increase in
intracranial pressure may occur which can lead to damage in wide spread areas of the brain.
Seizures are more common in hemorrhagic stroke than in ischemic stroke and occur in 28%
of cases of hemorrhagic stroke. We know that she is one of the 28%. On the whole, the lasting
effects of hemorrhagic stroke are much worse than they are for ischemic stroke. In her case, the
pressure was high enough to require a left parietal-occipital craniotomy. Typical lasting
symptoms and consequences of hemorrhagic stroke include the following: decreased social
interaction, decreased ability to function or care for oneself, decreased life span, difficulty
communicating, joint contractures, muscle spasticity, permanent loss of cognitive or other
brain functions (dementia), permanent loss of movement or sensation of one or more parts of
the body, pressure sores due to lack of movement, urinary and respiratory tract infections.
She appears to have a Wernicke's type aphasia which is a language disorder that impacts language
comprehension and the production of meaningful language. Individuals with Wernicke's aphasia
have difficulty understanding spoken language but are fluent and able to produce sounds, phrases,
and word sequences. While these utterances have the same rhythm as normal speech, they are
mostly not language and empty of meaning. Receptive aphasia involves damage to the area of the
cortex known as Wernicke’s area in the posterior area of the cerebral cortex. A patient with
receptive aphasia is usually unaware of the deficits and can become angry with others for not
understanding their incoherent utterances. Spontaneous improvement in speech for stroke victims
generally occurs during the first ten weeks post CVA. Some spontaneous improvement will be
seen up to 18 months after a CVA.
Her previous aggressive behavior may have been driven by frustration associated with expressive
aphasia and the consequent inability to express anger and other emotions in words. Her family
seemed to describe her as having a premorbid personality disorder. Much of the data suggests
that she had a premorbid mild vascular dementia.
1. Psychotropic medication is not likely to be of much benefit in this situation.
2. Quite a bit of historical material was available in her chart but none of it appeared to be
from Xxxx. I presume a thorough neuropsychological evaluation was done there and we
need the results of that evaluation. The couple seemed uninformed about nature and
consequences of her stroke. It will fall to us explain this to them.
3. Staff should help her compensate for memory loss by:
a. Assisting her with the creation of a memory log which includes:
1) Autobiographical information
2) Facts about the facility
3) A detailed daily schedule
4) A calendar with scheduled appointments, activities, therapies etc.
5) A things to do list
6) A list of names of frequently encountered people with identifying
information.
b. Repeat important information/instructions many times each day. Try to use
the same simple words and phrases each time.
3. 3
4. Avoid complex demands or tasks which can lead to frustration and use praise liberally
when her behavior is appropriate.
5. Staff should always try to communicate important information using the same language.
Staff might consider creating a list of sentences to use when responding to her questions.
6. To improve awareness of deficits, tell her about her speech and language deficits and
how they impact her daily life. This must be presented in a non-judgmental fashion.
7. Avoid ambiguity, and do not present her with unnecessary choices or decisions. Use
statements such as “Now it is time to take a shower”.
8. Be sure to allow her enough time to communicate when she is struggling to speak and
offer cues when necessary.
9. When interacting with her:
Limit the use of questions but when you must ask a question keep to the here and now
and word your questions so they can be answered yes or no.
Give one direction or ask one question at a time.
Start each conversation by identifying yourself and use short, simple sentences with
familiar words. Smile and use gentile touch.
Avoid presenting her with decisions by using no choice instructions.
Avoid “why” questions.
Look directly at her, speak slowly and distinctly.
Point and use gesture. Encourage her to point and use gesture.
Use touch and eye contact to calm her.
Announce any physical contact before touching her.
Always approach her from the front.
When she is agitated, tell her you understand that she frustrated because others cannot
understand her.
10. Establish a predictable and consistent daily routine for her. Keep her busy with simple tasks
but not excessively stimulated. Track her daily fluctuations in arousal and schedule the
most demanding activities when she is typically at peak arousal levels. Schedule frequent
rest periods but no naps throughout the day.
11. Have her practice the following:
Trying to get her point across no matter what anybody says or thinks.
Asking people to slow down when they speak.
Engaging in more one-on-one conversations.
When talking with a new person say, “I had a stroke…can you understand me?”
Go out more often and interact with many people, socialize.
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Drew Chenelly, Psy.D. This document was created using voice recognition software.
Clinical Neuropsychologist