Depression—The Case of Antonia Maurice - Medical Science Assignment Help

Assignment Task:

Task:

Delirium, Dementia and Depression: Continuing education course

PBL 3: Depression—the case of Antonia Maurice

Mary Jo is the primary nurse for Antonia Maurice, who has been on the medical ward for five days. Antonia has been admitted by her GP because of weight loss (7 kg over six months) and for stabilisation of her non-insulin dependent diabetes, diagnosed two years ago. Mary Jo has got to know Antonia and her family well and Antonia has increasingly confided her concerns to Mary Jo. Antonia is concerned that she is forgetful and losing her concentration and is fearful that she is ‘losing her mind’. She complains that her concentration is no good and that she can’t remember the names of things in English or gets them wrong. Antonia also has an above-the-knee amputation of her left leg following a car accident 15 years ago. Antonia mobilised independently with the aid of a prosthesis until four months ago and now uses a walking frame as well. She reported that she had lost confidence in her ability to walk; she felt weak and her usual active social life had declined because of this. Antonia is 74 years old, a retired (14 years ago) hairdresser. She lives in her own home and is married to Pat, 71 years old. They have three children and four grandchildren. Their two daughters live overseas and their son, his wife and their 9-year-old son live close by. Pat and Antonia own their home, receive the aged pension and are financially secure. However, Pat reports that Antonia is uncharacteristically worried and anxious about bills and the cost of living and is unwilling to spend any money on her own needs, such as better fitting clothes, saying she is not ‘worthy’. Mary Jo considers that although Antonia’s blood sugars have been stabilised with regular dietary input and a change in oral anti-hypoglycaemic medication she in fact seems worse in herself, feeling anxious and lacking confidence in general. Mary Jo feels that Antonia is not ready for discharge. Antonia is requiring more assistance than her usual functional level would indicate, such as assistance with showering and waiting for help and direction with ADLs. She is also complaining of headaches and stump pain, tiredness and not being able to sleep. There is no evidence of injury or poor skin integrity to her stump. She is overly concerned about her bowel movements and being dirty and is anxious that she will soil herself. Prompting questions, set 1

• What are the key words and information of most concern to you?\

• What do you think may be Antonia’s problem(s)?

• What other issues need to be addressed?\

Meeting with Pat

Mary Jo has arranged a meeting to talk with Pat to gain more history and about Antonia’s problems. She has allowed about 40 minutes and booked the interview room. Pat is pleased to meet with Mary Jo as he has always felt that the doctor was too busy to give him time and did not seem concerned about whether Antonia’s diabetes was under control. Antonia was present at the beginning of the discussion but excused herself shortly after, saying that she would ‘leave it to you – you know best’, and returned to her bed. Mary Jo learnt that Antonia was born in Switzerland, is an only child and had migrated to England in her early twenties. She and Pat had married when she was 24 and migrated to Australia shortly after. All of their children had been born in Australia. Antonia had maintained her career as a hairdresser while also raising the children. Pat described their marriage as a good one and happy. He described Antonia as a very capable woman who had managed her own business affairs and was generally happy with her lot. She had maintained lifelong friendships, had strong links to the church community and until four years ago was still playing bowls.

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