Running Head: TREATMENT CARE PLAN 1

Treatment Care Plan

Brittany Robinson
Calvin College














TREATMENT CARE PLAN 2

Case Study
Emma is a 65 year old African American female who is in the moderate stage of
Alzheimers. She lives in Chicago under the care of her daughter Sarah. Emma is still somewhat
in the early stages of the disease, so she is still able to do a lot of things on her own, like get
dressed on her own, make up her bed, etc. Her daughter Sarah is her sole caregiver but Emma
has six other children who come to visit her frequently. Emma has short term memory loss, and
difficulty recognizing friends and relatives. She often will start a task and then stop and become
confused as to what to do next. She gets confused between day and night especially if she takes
a nap during the day. She often wanders around not knowing where it is she wants to go. She
becomes agitated and defensive very often and it gets difficult for her daughter Sarah to take
care of her.
Emma enjoys going on walks, reading, cooking, card games, and talking about her life.
Emma meets with a therapeutic specialist twice a week, Tuesdays and Thursdays. On Tuesdays
Emma meets with the therapeutic specialist at an adult daycare and together they play card
games, go for a walk around the indoor track or outside. On Thursdays Emma meets with the
specialist at her home where they read together and do daily chores.
Treatment Plan
Who:
Emma Morris
Why Referred:
Becoming difficult to take care of, expresses some agitation and irritation. She
is starting to show some aggressive and defensive behaviors.
Subjective:
Emma states that she feels tired and depressed. She constantly fights with her
daughter Sarah because Sarah doesnt listen to her or understand. She says that she is tired of
being in the house daily and wishes that she can get out more. She complains about being stiff
all the time, due to her lack of getting out of the house. She says that she gets frustrated with
her daughter, especially when she rushes her or gets angry or frustrated. Emma wants to do
things for herself sometimes, but her daughter wont allow her to.
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Objective:
Emma has prescribed medication that she has to take morning, noon, and
evening, to help slow down the disease. She also has eye medicine for her glaucoma and a
special medicated ointment for her feet. When observing Emma during the interview, she often
puts her hand to her forehead in an attempt to get her thoughts together. It takes her a little
longer to walk from place to place she has very slow weak movement.

Assessment:
Emma has definite characteristics of Alzheimers and seems to be in moderate
stages. She is slow to follow instructions, she jumps from topic to topic when talking and she
has significant memory loss.
Strengths:
1. She can get dressed and feed herself.
2. She knows how to initiate and hold conversations
3. She is willing to follow instructions.
Needs:
1. She has very slow, weak movements
2. She cant stay on topic when talking
3. She shows some verbal aggressive behaviors
Long term goals
1. Inactivity: increase daily activity
2. Depression: decrease depression
3. Aggressive behavior: decrease aggressive behavior
4. Conversation skills: work on staying on topic
Specific Objectives
Over the course of the treatment plan Emma will;
1. Inactivity
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a. Increase physical activity
b. Increase muscle movement
c. Decrease stiffness in muscles
2. Depression
a. Decrease depression
b. Feel better about one self
c. Do more relaxing activities
d. Talk about things that are upsetting or cause frustration
3. Aggressive behavior
a. Decrease verbal aggressive behavior
b. Decrease frustration toward daughter
4. Conversation skills
a. Staying on topic
b. Listen to the other person before responding
c. Initiate conversations
d. Verbalize the things that she wants without agitation
Plans:
Interventions
Emma will attend a one on one session with therapist twice a week and go for a 30
minute walk for 4 weeks
Emma will do daily chores and routines with therapist once a week for 1 hour for 2
weeks.
Emma will play a game with therapist or with daughter Sarah once a week, for 1 hour
for 4 weeks.
Emma will read a book with therapist twice a week for 1 hour for 2 weeks.
Emma will engage play a card or board game with someone from adult daycare for 1-2
hours twice a week for 4 weeks.
Therapeutic Approaches
1. Inactivity
a. Encourage client to move around
b. Engage in physical activity with client
2. Depression
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a. Have the client express verbally what is bothering them
b. Have the client say positive or uplifting things about themselves
c. Engage in positive relaxing activities
3. Aggressive behavior
a. Have client take deep breaths when feeling frustrated
b. Have the client verbally state their concern or why they want to do something
specific.
c. Try to help the client calm down when they express feelings of frustration and
agitations.
4. Conversation skills
a. Help bring the client back on topic when they drift off.
b. Ask questions that relate to the topic the client was on before they drifted off
onto another topic.
Research Evidence related to the Intervention
Exercising/ walking
Although Alzheimers is a disease that has no cure and cannot be reversed, through
therapy and good care, a patient with this disease can learn to cope and live with it. It is
important that a patient with Alzheimers remains active and do daily physical activities
whether that consists of walking, riding a bike, dancing etc. According to an article done by
researchers at a medical center in Spain a growing number of studies have linked Alzheimers
and dementia with physical deterioration and reduced muscle mass, resulting in higher risks of
falls and fractures, decline in mobility or poorer quality of life and further loss of independence
(Sosa, Barriopedro, Majores, Perez, Lucia, 2008). Studies show that Alzheimers patients benefit
greatly from activities (Sosa et al., 2008). They enjoy a happier daily life, they have increased
feelings of self -worth, enhance and maintain general health. Physical activities also reduce
nervous tensions and behaviors and decrease pacing and restlessness. Doing these activities
can help Emma decrease the agitation and depression she feels. They can also help her to
maintain her motor skills.
Playing Games
Alzheimers is thought to be caused by an accumulation of particular protein called
amyloid in the brain ( Halazun,2012 ). This particular, abnormal protein is usually produced by
cells in the bone marrow. It is believed to be accumulated as plaques on the outside of the
nerve cells (Halazun, 2012). A buildup of this in ones lifetime may result in the disease
(Halazun, 2012). In a study done by researches for the Archives of Neurology (Halazun, 2012),
they interviewed 65 healthy people about their reading, writing and game playing activities
Treatment Care Plan 6
when they were children and throughout their life. While being interviewed they were being
scanned on a brain scanner to detect the amount of amyloid in their brain (Halazun 2012). This
study found that people who did more reading, writing, and game playing during their lifetime
had less amyloid and therefore less likely to develop Alzheimers.
Emma will do a one on one session with therapist and together they will play a game of
cards or board games. This will help Emma to reduce stress, and agitation. In this session Emma
will be able to relax and feel better. Also during this session, the therapist will try to get Emma
to talk about her past life and things that she did during the week in order to help her maintain
her memory.
Daily Chores
Emma is still able to do a lot of things, for example make her bed, sweep, and mop,
wash dishes, get dressed on her own, bathe, etc. By doing these simple task with Alzheimers
patients it can make them feel important and like they are doing something. It increases their
self-worth and help to maintain their motor skills. As a caregiver and provider its important
that you reinforce these skills with the patient. Its helpful to make a daily planner and keep a
scheduled routine so that the patient can remember what to do on a daily basis. Together with
a therapist and also with her daughter Sarah, Emma will do her daily activities and chores on
regular daily schedule.
Theoretical Foundations
The theory in which this treatment plan was based off of is the social cognitive theory.
In this theory self-efficacy, is highly influenced. This theory incorporates the environment into a
framework for understanding human behavior (Shank & Coyle, 2002). Under this theory Emma
will be able to improve her self-esteem and self-worth. The social cognitive theory attempts to
understand the environment and the influence it has on an individuals beliefs and behaviors. It
seeks to understand how the person interprets the environment and its surroundings.
Self-efficacy is the basis of the social cognitive theory (Shank & Coyle, 2002). It provides
an individual with conviction that they can successfully perform the behavior needed to
produce an outcome. Through this theory the therapist can provide the client with positive,
encouraging, motivational feedback, and this in time makes the client feel competent that they
can perform a certain activity well. This treatment plan is based off of the needs of Emma.
Alzheimers is such a debilitating disease. It can really make a person forget who they really
truly are. With the help of the specialist, her daughter Sarah, and other family members, Emma
will not totally lose her sense of self.
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Works Cited

Activities for People with Alzheimer's Disease. (n.d.). In AARP.org. Retrieved November 14,
2012, from
http://assets.aarp.org/external_sites/caregiving/homeCare/engaging_activities.html

AGIS staff, AGIS network. (n.d.). Top ten reasons why Alzheimer's patients need activities .
In AGIS: AssistGuide Informations Systems. Retrieved November 14, 2012, from
http://www.agis.com/Document/4496/top-ten-reasons-why-alzheimers-patients-need-
activities.aspx
Hagan, C. (2012, July 19). New research offers tips for Alzheimer's caregivers. In CNN Health.
Retrieved November 14, 2012, from http://www.cnn.com/2012/07/19/health/alzheimers-
caregivers/index.html

Halazun, D. (2012, January 23). Brain games may help thwart Alzheimer's: study. In abc news.
Retrieved November 14, 2012, from http://abcnews.go.com/blogs/health/2012/01/23/brain-
games-may-help-thwart-alzheimers-study

Santana-Sosa, E., Barriopedro, M., Lopez-Majores, L., & Perez, M. (2008, May 6). Exercise
training is beneficial for Alzheimer's patients. Intj Sports Med. doi:10.1055/s-2008-1038432