Patient Presentation of Dementia, Delirium, and Depression.With the prevalence of dementia, delirium, and depression in the growing geriatric population, you will likely care for elderly patients with these disorders.

Patient Presentation of Dementia, Delirium, and Depression.With the prevalence of dementia, delirium, and depression in the growing geriatric population, you will likely care for elderly patients with these disorders.
Patient Presentation of Dementia, Delirium, and Depression
With the prevalence of dementia, delirium, and depression in the growing geriatric population, you will likely care for elderly patients with these disorders.
While many symptoms of dementia, delirium, and depression are similar, it is important that you are able to identify those that are different and properly diagnose patients.
A diagnosis of one of these disorders is often difficult for patients and their families.
In your role as the advanced practice nurse, you must help patients and their families manage the disorder by facilitating necessary treatments, assessments, and follow-up care.
Consider the patient presentations in the following case studies.
What distinct symptoms or factors would lead you to a diagnosis of dementia, delirium, or depression?
Consider the following case studies:
Case Study 1:
Mrs. Mayfield is a 75-year-old woman who is brought to the emergency room by the police at 11 p.m. She was found wandering and confused in a local neighborhood. The police were called when Mrs. Mayfield tried to use her key on a neighbor’s door. When confronted by the police she became abusive, confused, and frightened and looked very pale and agitated. The police could not establish her correct address and they subsequently brought her to the emergency room. During the examination, it takes several attempts to gain Mrs. Mayfield’s attention to answer any questions at all, but once focused on the question, she rambles on in a disorganized way. Her speech is sometimes incoherent; at times she becomes drowsy and falls asleep. Once awake she seems to be talking about things that are in the room with her, but is unable to describe where she is or where she lives. Her pulse is 96 and regular and her blood pressure is 150/90. Axillary temperature is 99°F. She is at times agitated and at other times quiet and withdrawn. Examination reveals no focal neurological signs, but she is only intermittently cooperative, and her mental status fluctuates. She appears clean, well nourished, and not self-neglected. There is no sign of injury and no sign that she has fallen.
Case Study 2:
Mrs. White, a 78-year-old married woman, is brought to the office of her primary care provider by her husband because she has become “irritable and forgetful†over the past 3 months. Mr. White claims that his wife has had problems for several years now, but has just gotten “worse in her memory†in the past few months. She recently misplaced her purse and accused her son of stealing it. On three occasions, she left the stove on and boiled a pot dry, nearly causing a fire. She recently put a container of ice cream into the washing machine instead of into the freezer and her husband did not discover it for more than a week. Mrs. White claims her family wants to take her money and leave her with nothing. “No matter what they say, there is nothing wrong with me,†she states. Her past medical history includes hypothyroidism, treated with Synthroid, and successful treatment of breast cancer approximately 15 years prior. She also takes over-the-counter ibuprofen for chronic low back pain and occasional Benadryl to help her sleep at night. Her physical examination is within normal limits.
Case Study 3:

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