Introduction:
Mrs. Fisher being an elderly patient presenting within acute inpatient care environment with mental distress related to delirium; the purpose of this evaluation is to build person-centred treatment strategy for her. Recognising Mrs. Fisher's autonomy as well as dignity while focussing on her present psychological, along with social, as well as physical status is essential towards recovery-focused strategy.
Background Information
A lively as well as gregarious lady, Mrs. Fisher is frequently referred to as life along with soul for party." She has taken a dramatic turn for the worse, isolating herself as well as her husband from society while acting deliriously drowsy along with confused. Her hypertension, along with sciatica, as well as rheumatoid arthritis have all been under control due to modern medicine, and her overall physical condition has remained steady. Her present mental suffering has just begun, along with she has no history about mental disease.
Delirium
Mrs. Fisher is exhibiting symptoms of delirium, including disorientation, along with hallucinations (such as thinking she is a film director), as well as abrupt shifts in mood. She may be experiencing symptoms such as an infection, along with side effects from her medicine (oxycontin), as well as discomfort from conditions like sciatica and arthritis.
Psychological factors:
- Disorganised thinking, delusions (that she is a film director), along with impaired reality testing are symptoms of delirium that Mrs. Fisher suffers from, along with acute confusion along with cognitive impairment (Kunicki et al, 2023).
- Anxiety along with Fear: Her formerly self-assured demeanour has taken a nosedive, and she exhibits symptoms of anxiety and clinginess that are out of character.
- Emotional discomfort: She has been experiencing emotional upheaval due to the abrupt onset of mental discomfort, which has led her towards withdraw from social activities as well as feel even more powerless (Ormonde et al, 2023).
- Mood Alterations: As a result of her madness, Mrs. Fisher's mood shifted from active and gregarious to sluggish, along with distant, as well as disturbed.
- Identity Crisis: Her irrational conviction that she is a film director raises concerns about her possible identity crisis, which is likely exacerbated by her disorientation along with cognitive deterioration as well as adding to her emotional suffering (Rieck et al, 2020).
Family Dynamics
The abrupt changes in his wife have obviously concerned Mr. Fisher, a loving along with supportive husband. He has never seen her in such a vulnerable state, along with his worry might make her illness worse. He must be included in her care plan to guarantee continuity of treatment after release, as well as emotional support is critical for her rehabilitation.
Mrs. Fisher's Care Plan
Goals:
- Resolve the medical issues (such as infection, along with pain, as well as drug review) that are contributing to delirium in order to stabilise her physical condition.
- By creating a comfortable, familiar space, may lessen the effects of cognitive impairment along with disorientation.
- Improve her mental health by gently helping her overcome her fears, anxieties, as well as illusions.
Assist Mr. Fisher on his journey to wellness by educating and supporting him along the way.
Key Components:
Medical Management
- To manage her pain, should look into Mrs. Fisher's usage for oxycodone along with other opioids; these drugs may cause delirium. If necessary, a pain evaluation should be carried out and other options (such as non-opioid analgesics) ought to be investigated (Sampson et al, 2020).
- Underlying Causes identification: It is important to look for physical causes of delirium, such as infections, along with metabolic abnormalities, as well as other medical conditions.
- Hydration along with Nutrition: Her sudden unwillingness to eat as well as drink must be addressed immediately. Insomnia and lack of fluids might exacerbate the symptoms of delirium. It might be possible to address her dietary requirements by consulting a dietician (Lauretani et al, 2020).
- Medicine review: It is important to check Mrs. Fisher's medicines, including painkillers as well as antihypertensives, to find any potential drug interactions as well as adverse effects that might be causing her delirium.
Emotional along with psychological assistance
Reassurance Mrs. Fisher by employing mild reorientation strategies, including gently informing her of her current location along with the current time. To assist her feel more grounded, surround her with familiar things like family photographs.
To stimulate the brain, try using basic puzzles or starting a discussion as a scheduled activity. Cognitive symptoms for delirium may be alleviated along with attention improved in this way.
Environmental Adjustments
Environmental variables such as noise, along with excessive light, as well as well as a new place may exacerbate delirium, thus it's important to minimise these stresses as much as possible. An atmosphere of peace and quiet should be established in an effort to lessen the impact of sensory overload. If she has trouble controlling her sleep-wake cycle, a quiet room with good lighting throughout the day as well as complete darkness at night may be helpful (Poulsen et al, 2021).
Regular Visits from Familiar Faces: Her husband's regular visits may be reassuring along with clear up any uncertainty.
Family and Social Engagement
Education among the Family: Mr. Fisher including his loved ones need to know more about delirium, its symptoms, along with how to deal with it. With this knowledge, he will be able to help Mrs. Fisher out more and feel less overwhelmed. Also, he may find ways to reassure as well as reassuage her (O’Rourke et al, 2021).
Mr. Fisher ought to be urged to take engagement in meetings for care planning along with updates so that he may feel supported as well as interested in understanding his wife's development. This will ensure that he is active in her care. Having him there during visiting hours may help Mrs. Fisher feel more at ease along with less anxious.
Follow-up along with Discharge Planning
Home Care Support: Nurse or home health aide should visit Mrs. Fisher within her residence as part of her care plan since she is at risk of experiencing delirium again. After she leaves the hospital, this will be useful for tracking her mental along with physical well-being.
Plan for Pain Management: It is important to establish a strategy to alleviate her sciatica as well as arthritis pain in the long run. Alternatives to pharmaceutical painkillers, including cognitive-behavioral therapies along with physical therapy, ought to be seriously considered.
Conclusion
Adhering towards Mrs. Fisher's physical, along with cognitive, as well as emotional needs is essential for a person-centred, along with recovery-focused plan for her care. Care plan may improve her chances about a complete recovery while giving her abetterquality living during difficult time by treating the reasons of delirium, offering psychological support, along with including her family throughout recovery process.