No heading? That is part of the assignment and page numbers if you do not know how to do this ask someone to help you out.  I sent a your tube that explained how to do this. It also to be in double space.  13/15

Case Study 17.2
Caprice Hudson
Lakeview College of Nursing
N 309
March 24, 2012

Case Study 17.2
1.	Based on Claudine’s symptoms I would say she has stage 3, mild cognitive decline. Stage 3 is when family, friends and coworkers notice a differences and this stage can sometimes be diagnosed for some people but not all (Stages of Alzheimer’s, 2010). some of the common difficulties in this stage that Claudine exhibits include: difficulty organizing and planning, losing or misplacing valuable objects (Stages of Alzheimer’s, 2010).  Other symptoms of this stage includes difficulty remembering names when introduced to new people; problems coming up with the right words, and having great difficulties performing task in social or work settings  and forgetting material that one has just read, this could be similar to Claudine not being able to remember her recipes (Stages of Alzheimer’s, 2010).
2.	According to Fletcher (2008), dementia is a clinical syndrome of cognitive that involves memory impairment and a disturbance in one of the cognitive areas (aphasia, apraxia, and agnosia) (Fletcher, 2008). Aphasia is language deficit; apraxia, is the inability to carry out motor activities and agnosia, is failure to recognize sensory stimuli (Mauk, 2010). Lastly there is a disturbance in executive functioning (Fletcher, 2008). Dementia is commonly associated with changes in behavior and function (Fletcher, 2008). Dementia affects about 5% of individuals 65 years of age and older (Fletcher, 2008). 4-5 million Americans have Alzheimer’s disease (AD) (Fletcher, 2008). 13.2 million people are expected to have AD by 2050 (Fletcher, 2008). The global prevalence of AD is about 24. 3 million and 6 million new cases yearly (Fletcher, 2008).
3.	Claudine’s family can obtain information about Alzheimer’s disease at the following websites: 1) ADEAR. Alzheimer’s Disease Education and Referral Center. U.S. National Institute on Aging. 2) Alzheimer’s Disease Centers (ADCs) Directory. National Institutes of Health. 3) Mayo Clinic Alzheimer’s Disease Center.
4.	The ten warning signs that Claudine’s family will find on the Alzheimer’s Association Web site include the following: Memory loss that disrupts daily life; challenges in planning or solving problems, Difficulty completing familiar task at home or work,  at leisure; confusion with time or place, trouble understanding visual images or spatial relationships; new problems with words in speaking and writing, misplacing things and losing inability to retrace steps, decrease or poor judgment; withdrawal from work or social activities; lastly, changes in mood and personality (10Signs of Alzheimers, 2012).
5.	Claudine should visit a Neurologist doctor; one who specializes in the study of the brain, the physician will closely evaluate the person problems that may signal brain disorders other than AD (Steps to diagnosis, 2010). Also maybe a general physician, who will review medical and family history for dementia, and perform physical exam and diagnostic test (Steps to diagnosis, 2010).
6.	Cholinesterase and Memantine are the only 2 drugs that have been approved by the FDA for treatment of AD (Standard treatments, 2010). Cholinesterase drugs inhibit the breakdown of acetylcholine, which is important in learning and memory (Steps to diagnosis, 2010). Donepezil, treats all stages of AD; rivastigmine, tacrine,and galantamine treats  mild to moderate stages of AD (Steps to diagnosis, 2010). Memantine is used to treat moderate to severe AD; it regulates the activity of glutamate, which is a chemical messenger involved in learning and memory (Steps to diagnosis, 2010).
7.	Respite care service provides a temporary break from daily care giving responsibilities (Respite care, 2007). The family could seek home care services which include: companion service, a person who oversees activities; home health aide, they assist hygiene care and exercises; homemaker or maid to help with meals and cleaning, and skilled care services to help with medications (Respite care, 2007). Also the family could consider an adult day care, which provides a safe environment transportation, meals and activities for people with AD (Respite care, 2007).
8.	A nurse may recommend a n adult day care center as a potential option for Mr. Everett because it will give him a break from his care giving responsibilities (Respite care, 2007). Adult day cares are aware of the exhaustion that may occur from care giving duties and will allow care givers a break, which will allow them to refresh and return to duties. I think if caregivers do not take a break they will be more likely to abandon their loved one. Most adult day cares follow a sliding scale to cover cost, which is based on income and ability to pay. The day care provides transportation, food, and activities, while allowing a person with AD to be social (Respite care, 2007). These are some of the reasons a nurse may recommend an adult day care.  
9.	I would advise the family to consider the following questions: Does she recognize a dangerous situation, such as a fire? Does she show signs of agitation, depression or withdrawal when left alone for any period of time? Lastly, does she stay content within the home? (Home safety for people with Alzheimer’s disease, 2010). These are some of the questions that will assist the family in making decisions about Claudine being home alone.
10.	 2 actions Claudine’s family can do to promote safety in the homes entryway, is leave emergency numbers and address posted near all telephones. Secondly installing carbon monoxide and smoke detectors and checking them periodically. In the case of a fire this would alert Claudine to a problem (Respite care, 2007).
11.	 I think that it is important to inform Claudine of the truth regardless of her cognitive decline. Dementia patients are obligated to the truth and providing realistic information and reorientation are important. 

References
Fletcher, K. (2008). Nursing standard of practice protocol: Recognition and management of dementia. Hartford Institute of Geriatric Nursing. Retrieved from 	http://consutlgerirn.org/topics/dementia/want_to_know_more
Home safety for people with Alzheimer’s disease (2010). National Institute on Aging. (NIH 	Publication No.02-5179). Retrieved from 	http://nia.nih.gob/Alzheimers/Publication/homesafety.htm#safe
Mauk, K. L. (2010). Gerontological nursing: Competencies for care. (2nd ed.) Sudbury, MA: 	Jones and Bartlett
Respite care. (2007). Alzheimer’s Association. Retrieved from 	http://www.alz.org/living_with_alzheimers_respite_care.asp
Stages of Alzheimer’s (2010). Alzheimer’s Association. Retrieved from			 http://www.alz.org/alzheimers_disease_stages_of _Alzheimers.asp>
Standard treatments. (2010). Alzheimer’s Association. Retrieved from 	http://www.alz.org/alzheimers_disease_standard_prescriptions.asp
Steps to diagnosis. (2010). Alzheimer’s Association. Retrieved from http:// 		www.alz.org/alzheimers_disease_steps_to_diagnosis.asp
10 Signs of Alzheimer’s. (2012). Alzheimer’s Association. Retrieved from 		http://www.alz.org/alzheimers_disease_know_the_10_signs.asp