Later Life Case Study

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Bert was seen within the Dementia and Complexity in Later Life (DCLL) pathway within a Multidisciplinary Team, offering specialist input for individuals with dementia and older adults with complex mental health problems.
Client Profile
Referral
Bert was referred to the team by his GP for a neuropsychological assessment in March 2017. He was experiencing memory difficulties and had particularly noticed a change in his ability to find words and to hold onto bits of information in his working memory. Following an extensive neuropsychological assessment and Bert receiving a diagnosis of mild Vascular Dementia three months prior, it was agreed that I would see him for psychological therapy with the aim of supporting him in adjusting to his diagnosis.
Initial assessment Bert is a 73-year-old man who lives at home with his wife of 10 years, Maggie. Bert has numerous physical health difficulties including chronic pain in his back due to problems with his spine, constipation and sleep apnoea. Due to his mobility
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The “rages” were occurring approximately twice weekly. They described how Bert would push himself to do as many jobs as possible and would become incredibly angry when he made mistakes, when Maggie corrected him, tried to help him and told him what to do or what not to do. Bert would start to throw things, punch doors and shout “nasty” things at Maggie. Bert and Maggie understood these “rages” to be a part of Bert’s dementia as they were out of character for Bert and had only started approximately two years prior. During Bert’s episodes, he would be thinking “I am useless,” “I should be able to do this” and “Why can’t I get such a silly little job done?” Although Bert was unable to identify any physical symptoms linked to his “rages,” he did disclose that he had numerous physical health complaints, as reported