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John's story

John is a 73-year-old man living with his wife in their family home in a rural town. He was diagnosed with Alzheimer's disease by a geriatrician five years ago. His behaviour became more problematic in the last six months. His wife reports John often paces around the house in an agitated state in the evenings. He wandered onto the main road a week ago and this prompted the family doctor to refer him for an urgent psychiatric assessment. The decision was made to admit him to an inpatient unit because his wife is under tremendous stress from looking after him.

John has been observed to be disorientated. He believes he is in his early 20s and is staying in a hostel. He often misidentifies his wife as his mother. He tried to leave the ward on the day of admission and threatened his nurse with a wooden stick. He believes the staff are keeping him from going to work. He threatened to jump out of the window on one occasion. John is compliant with his medications, but has little understanding of the rationale for taking them.

John describes seeing people coming to the house. He believes they are trying to take over the house. He gets distressed and angry. He was arguing with his wife (who can't see these people) during the initial assessment on the ward when he could not convince her.

John's physical health is generally good, except for mild arthritis in his knees which doesn't seem to limit his mobility. His personal care is satisfactory and he is able to shower and dress himself. His wife reports she is taking over all of the house chores, for example cooking, shopping and paying the bills. John attends the day care facility, which he enjoys, at a local rest home once a week. Otherwise, he has no outside contact and he stays at home under direct supervision from his wife. His wife has regular contact with the Alzheimer's society and she finds the support and advice very helpful. However, she is thinking about the option of rest home placement for her husband because she is finding it difficult to cope with the agitated behaviour in the evenings.

Page last updated: 9 December 2008