Cognitive assessments are useful tools for diagnosing neurological problems that involve memory loss and changes in the ability of the patient to orient themselves to time, place, and space. During this assessment, the Mini-Cog Test was conducted, which consists of a 3-item recall and a clock drawing (Alzheimer’s Association, 2013). This is a standard assessment for patients who have suspected Alzheimer’s as it is an accurate triage tool for identifying patients that may need a future assessment of their neurologic system (Zhang et al., 2013).

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Other tests are also useful for assessing the non-mental aspects of a suspected Alzheimer’s case. Here, the patient was notably irritable and argued with her husband. Alzheimer’s is often associated with changes in mood and behavior, which as observed here (Zhang et al., 2013). This type of assessment can be conducted simply by observing how the patient reacts and noting their reactions to certain conversational elements.

There are several other ways to assess the neurological system function of a patient. The Mini-Mental State Exam is a 30-point questionnaire that measures the level of cognitive impairment in a patient (Alzheimer’s Association, 2013). It is commonly used to identify patients who have dementia as it incorporates elements of registration, recall, and language, which are all processes that are affected by Alzheimer’s and other forms of dementia (Fisher et al., 2014). In this case, there are also informant tools which could be used by the patient’s husband, such as the eight-item Informant Interview to Differentiate Aging and Dementia (Fisher et al., 2014). The husband can also give a history of the patient which is likely to be more accurate than the patient’s own, and can also give insight into the patient’s non-memory issues at home. These should all be noted on the medical record in detail, including numerical values of memory testing where applicable.

There is no cure for Alzheimer’s and thus the plan of care for this patient should incorporate elements of palliative care. The patient should be encouraged to exercise and keep her mind as busy as possible, using tools like crosswords to keep it active (Fisher et al., 2014). The patient can also take a cholinesterase inhibitor, which works to slow the decline of cognitive function (Fisher et al., 2014). The patient should also be cared for by a carer or her husband until this gets to be too difficult. The patient may begin to get increasingly confused and angry and could put herself in danger, so needs to be closely watched.

Patient education for Lydia should consist of telling her the ways in which she can slow the decline of her cognitive function. This includes a focus on keeping healthy and active where possible. It may also be useful to provide Lydia with access to a carer or information in Filipino, as this is her native language. As her disease progresses, she may find it easier to communicate in Filipino rather than English (Zhang et al., 2013). Her husband should receive patient education on the likely changes that he will see in his wife and how best to deal with them. It may also be useful to prepare him for the possibility that Lydia must go into a care home at a later stage (Zhang et al., 2013). Support can also be provided by groups who are experiencing the same thing.

Caregiver strain is a common issue for individuals who are caring for someone with Alzheimer’s. The Caregiver Strain Index is a useful tool that can measure the level of strain on Dr. Ocampo. It has been shown that perceived caregiver burden is a major cause of unnecessary or early institutionalization and can lead to the patient having needs that are unmet, so it is important that Dr. Ocampo is aware of the pressure of caregiving for his wife.