Bipolar Disorder and Dementia: Case Study

Client Information Identification

The client is a 72-year-old male born in Los Angeles and married with three children. The client is a Jewish who thinks Muslims hate him. The client at hand attended UCLA for two years and then transferred to USC for four years for pharmacy school. He worked for 42 years as a pharmacist and owned a business, which he sold later. The client lives with his family, and his wife is the caretaker of the family. It is important to note that the client has no siblings.

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Presenting Problems

The client was taken to a healthcare facility where he was diagnosed with bipolar and dementia; however, not in bad condition. He was treated but started shaking because of medication. However, the symptoms of dementia are not adverse.

Attempts at Problem Resolution

The client's wife takes him to Opica healthcare for medical attention. The struggle continues because the client's family is worried about his health. The family has attempted to take the patient to various healthcare facilities where he gets medical attention and goes home. Precisely, the wife and other family members are working hard to ensure that the client regains good health.

Psychosocial History

The client was born with a single mother who used to abuse number substances. However, the client lived with his month until 18 years when he moved to live an individual life. In spite of the fact that the client's mother abused drugs, he was not diagnosed with a disorder. Nevertheless, he developed mental stress because of the state of his mother that caused bipolar.

Health/Psychiatric History/Medical/Status

The client at hand is diagnosed with bipolar and dementia that needs medical attention to support his health condition. The client's family has tried to take him to various medical facilities for help. Nonetheless, the client's dementia is not serious.

Substance Abuse Status

It is evident from above that the client's mother exposed him to substance abuse. However, the client was not diagnosed with a disorder related to the aforementioned condition.

Domestic Violence

The client was not exposed to family violence. In spite of the fact that his mother abused some drugs, she took good care of the client.

Cultural/Subcultural Issues

The client in question is from a middle-class background, but this does not bother him. What is more, his medical illness not affects his progress in therapy because his wife takes good care of him. However, the death of his mother affects him in a considerable way.

Mental Status Examination

Appearance: Good dressed; however, sometimes does not take care of hygiene

Behavior: Shaking because of medication

Cooperation: He is very cooperative

Speech and Language: explains in a good and understood speech and language

Affect: appropriate

Mood: not happy

Orientation: excellent sense of orientation

Intellectual Functioning: appropriate for age

Judgment: good judgment

Insight: appropriate insight

Attention: Good attention

Memory: Reserved

Thought Process: Logical

Thought Content: Effective

Assessment

In this case, cognitive-behavioral and family-focused therapies are important. To begin with, cognitive-behavioral therapy helps one to examine the way thoughts influence emotions. What is more, an individual is capable to learn the way to change negative thinking patterns as well as characters into more positive ways of responding. In bipolar case, the concentration is on managing signs, problem solving, as well as getting rid of relapse triggers (National Collaborating Centre for Mental Health, 2006). Similarly, family-focused therapy indicates that it is hard to live with an individual who has been diagnosed with bipolar. In particular, this causes the family train and marital correlations. Therefore, the aforementioned therapy addresses the preceding issues as well as works to restore a healthy and supportive home environment. In this case, a family that has a person with bipolar is educated pertaining to the disorder and the way to cope with its signs.

With that said, the client at hand has attended two seasons, and he is on with the treatment. The therapy is scheduled to take approximately six months. In spite of the few sessions attended by the client, the results are promising, and in case he continues with the sessions, he may recover from the disorder.

Differential Diagnosis

The client is diagnosed with bipolar and dementia. It is important to comprehend that the disease mentioned above is a lifetime condition and runs unpredictable course of difficulties (Winblad et al., 2004). When the disorder is not treated, the results can be devastating. It is unfortunate that the recurring depressive, as well as manic episodes that characterize the disorder, make it hard to lead a stable and productive life.

Treatment Plan

The client is scheduled to continue with the current therapy program that regarded highly structured. In particular, the preceding program contributes to consistent interventions as well as has qualified staff that continues to heighten the client's family correlations, effective coping approaches, and social skills (Miziou et al., 2015). Similarly, the client is allowed to take part in an individual therapy once per two weeks to help him reach personal goals.

Treatment Objectives

Objective 1: reduce the level of bipolar symptoms

Objective 2: ensure an excellent family relationship

Therapeutic Interventions

The therapeutic interventions to be used for dementia include pharmacological as well as non-pharmacological. To begin with, pharmacological intervention is drug intervention. On the other hand, non-pharmacological interventions include cognitive stimulation therapy, as well as physical exercise (Castle et al., 2009). On the other hand, bipolar interventions include psychoeducation, family intervention, as well as and mindfulness-based interventions.

Ethical and Legal Issues

The client is medically disabled. Specifically, the client's daughter is regarded as responsible individuals according to OPICA's admission contract in the client's document. The client's daughters are listed as the emergency covenants as per the client's file. What is more, the client signed an informed consent concerning services provided at OPICA in addition to his daughter according to the client's file. Similarly, it is evident that the client has a restricted capacity to defend or even speak for himself. It is clear that the current client is at risk for adult and financial abuse.

Prognosis

It is evident that the client and his family are receptive as well as willing to learn new interventions that can help them. What is more, the client has excellent support from his family as can be depicted from the reports provided. The client's daughters and wife are on the front line to help him recover from the disorder.

Alternative Perspectives

The alternative perspectives used in this case include mindfulness-based interventions, psychoeducational, and cognitive-behavioral therapy. To begin with, CBT is utilized as an adjunct to pharmacotherapy as well as involves determining maladaptive cognitions and characters that may be obstacles to patient recovery as well as ongoing mood stability (Martin et al., 2006). Additionally, psychoeducation intervention concerns the training of patients concerning the overall awareness of the disorder at hand. What is more, the aforementioned perspective involves avoiding substance abuse, early detection of new episodes, and treatment adherence. Lastly, mindfulness-based interventions targets at improving the capability to keep the client's attention on purpose in the present moment.

Recovery Perspective

The main recovery perspective is peer support that involves the client's family, OPICA staff who takes part in caring for the client's well-being as well as his ability to make other friends. What is more, the other perspective is strengths-based (Mendez, 2009). This is the client's capability to adhere to the given directives and client's participation in the therapy program. Also, this recovery perspective involves the client's resilience to intervention and the client's willingness to learn new methods of expressing himself.

Systematic Variables

Religion: the client is raised as a Jewish.

Race: the client is an American. Fortunately, he believes in receiving mental help. What is more, he cares how culture is perceived by other races.

Resource

Miziou, S., Tsitsipa, E., Moysidou, S., Karavelas, V., Dimelis, D., Polyzoidou, V., & Fountoulakis, K. N. (2015). Psychosocial treatment and interventions for bipolar disorder: a systematic review. Annals of general psychiatry, 14(1), 19.

Personal Challenges

It is evident that the current client suffers more from bipolar as compared to dementia. Therefore, the treatment and therapy process may concrete more on bipolar disorder as compared to dementia. It is fortunate that both the client and his family are cooperative to the treatment process. However, the client does not respond well to the process because of intense stress concerning adult and financial abuse.

References

Castle, D. J., Berk, L., Lauder, S., Berk, M., & Murray, G. (2009). Psychosocial interventions for bipolar disorder. Acta Neuropsychiatrica, 21(6), 275-284.

Martin, M., Clare, L., Altgassen, A. M., & Cameron, M. (2006). Cognition-based interventions for older people and people with mild cognitive impairment. The Cochrane database of systematic reviews.

Mendez, M. F. (2009). Frontotemporal dementia: therapeutic interventions. In Dementia in Clinical Practice (Vol. 24, pp. 168-178). Karger Publishers.

Miziou, S., Tsitsipa, E., Moysidou, S., Karavelas, V., Dimelis, D., Polyzoidou, V., & Fountoulakis, K. N. (2015). Psychosocial treatment and interventions for bipolar disorder: a systematic review. Annals of general psychiatry, 14(1), 19.National Collaborating Centre for Mental Health (UK. (2006). Bipolar disorder: the management of bipolar disorder in adults, children, and adolescents, in primary and secondary care. British Psychological Society.

Winblad, B., Palmer, K., Kivipelto, M., Jelic, V., Fratiglioni, L., Wahlund, L. O., ... & Arai, H. (2004). Mild cognitive impairment-beyond controversies, towards a consensus: report of the International Working Group on Mild Cognitive Impairment. Journal of internal medicine, 256(3), 240-246.