Mental Health for Older People

Using a recovery focused approach, undertake a psychosocial assessment and develop a person-centred care plan for an Older Adult presenting with mental distress associated with Delirium within the context of an acute inpatient care setting. You must use the clinical scenario provided below. In your capacity as a Registered Mental Health Nurse, you have been asked to conduct a psychosocial assessment and develop a person-centred care plan for Mrs Fisher, an Older Adult presenting with mental distress associated with delirium in the Local Emergency Department (ED). You must access, read and use high-quality contemporary literature to support the ideas that you present in this written assessment. Assessment Task Provide a brief description of Mrs Fisher’s current clinical presentation, issues and provide a brief description of Mrs Fisher’s history. Identify the type of delirium that Mrs Fisher is presenting with and discuss the physical, psychological and social needs associated with the type of delirium. Describe the main issues; risks and needs that need to be addressed and discuss how you will manage the issues that you have identified. Critically discuss the best assessments and tool/s that can be used to address Mrs Fisher’s presenting problems associated with delirium. Reference your work using APA 7th Referencing System. Word Limit - 1000 words Case Study Presenting Problem Mrs Fisher is a 72-year-old-lady who is presenting with acute confusion, anxiety and restlessness. She is accompanied by her husband Mr Fisher, and they have been married for 45 years. They have 2 adult children who have moved away from home and now live in Victoria. Mrs Fisher is a retired Principal for a Local Primary School. She is an active member of her local community, and she enjoys supporting local After School Clubs that are provided by the Local District Council for Children and Young People. Mrs Fisher was rushed into the ED during the early hours of the morning. Mrs Fisher had woken up to use the toilet during the night. As she was walking back to her bedroom, she fell, bumped her head and became temporarily unconscious. Mr Fisher found her on the floor, and he called for an ambulance. When the Paramedic Team arrived at the home, Mrs Fisher was very confused and she was complaining of pain in her head, chest and her left arm. Mrs Fisher was agitated, and she did not want her husband to leave her side. She believed that she was a Director on the set of an Action Movie. She kept asking her husband why there were so many strangers on her movie set. The Paramedic Team observed that Mrs Fisher was confused, disoriented and she was very angry with them for invading her house. When the Paramedic Team were transferring Mrs Fisher into the ambulance, she became increasingly distressed. She became progressively more agitated and appeared to be struggling to find the words to verbally express herself. At times, she behaved in a manner that was combative and uncooperative towards the Paramedic Team. Mr Fisher gave a brief description of the events leading up to Mrs Fisher’s admission to the ED. He said that generally, Mrs Fisher’s health is stable. She enjoys being around people and she is often described as ‘the life and soul of the party’. However, during the last 5 days, she has been reluctant to go out of the house, she has been refusing to engage in social activities that she usually enjoys. Instead, she has become increasingly lethargic. In the last 3 days, he stated that Mrs Fisher has been complaining of feeling physically unwell. She started to become more socially withdrawn and she would sleep during the day. When Mr Fisher offered her food, she ate very little, she told him that she did not feel like eating much. Mrs Fisher told Mr Fisher not to make such a fuss, she thought that she might just be under the weather. Mrs Fisher did not feel the need to disturb her GP Dr Lee. Mr Fisher is distressed about his wife’s presentation. He said that he had never seen his wife so clingy before. Generally his wife is a strong, confident woman and he is shocked at how agitated, scared and anxious she has suddenly become. He reported that he was worried about his wife’s idea that she is the Director of an Action Movie, and she didn’t understand why these strange people had taken her away from her movie set. Previous History In the past, Mrs Fisher has been diagnosed with rheumatoid arthritis which affects her hands, feet and knees. The pain in her knees and feet has occasionally left Mrs Fisher unsteady on her feet. She also experiences pain associated with sciatica which she manages using prescribed opioid medication Oxycodone. Mrs Fisher has a history of high blood pressure which is well managed. Mrs Fisher does not have a history of mental illness.