standardized patient acting class response paper

Age: 50 yrs old

Marital Status: Married, husband is in denial about mother having a mental illness

Children: 2 children, an older son and a younger daughter: 4 years apart

Occupation: Elementary Education Teacher

Reason for coming to the doctor’s office: Forgetfulness

· Main point of attack: She was driving on the wrong way down a one-way street on median and then refuse to move the car b/c you think you are going the right way portrays mental instability (getting lost and she is having an an acceleration of mood swings)

Other: lost when driving to grocery store

· Lost when driving 5 miles from home

· Misplacing car keys, phone, glasses

· Asking repetitive questions（on the class）, such as what people's names, bringing her students to the wrong classroom after lunch, forgetting her students’ names sometimes

Extreme mood swings--degradation of interpersonal relationship, less like mom and starting to turn into another person…

· Triggers mood swings: She use to be more understanding with her students but more frequently snaps at them and is less patient when it comes to teaching if they do not comprehend a lesson or a question right away

· Very close with mom because you are very emotionally involved in this case (you and mom are quite close)

Starts forgetting her daughter for name/forgetting special event, forgetting “other family members” (like new baby)/ new relationships, forgetting memories that only the 2 of you share

About your major symptom : disoriented, cannot remember things happening around ;

-She is slightly aware of the severity of these small incidents and realizes that they are more abnormal than just regular forgetfulness at her age

Quality or what it is like: inconsistent, comes and goes

Severity: early onset, signs of memory loss but she is still able to function on her own

Location of symptom: head/brain

Duration: About 2-3 years, seen an increase over years

When symptom comes on: when completing tasks that require memory, confusion while reading

What you are doing / where you are when it happens:

- daily functions: when driving to familiar places such as the grocery store or local shopping, when doing things around house often misplaces valuables such as glasses or phone

-when talking to people forgets key details or events that have happened/ planned events

-for example, forgets some names of students in her class, forgets about events/stories that her daughter experienced in college, forgets specifics about key events in her son’s life, etc.

-cooks on a nightly basis for her family, recently had an incident when she cooked the wrong meal that didn’t make sense together and the family could not eat dinner-- made chicken and rice for dinner but served the chicken raw

What makes it better: Try to help her recall her steps;

In order to help her brain/memory she tries to exercise at least 3-4 times a week by jogging around the neighborhood or riding her bike, plays the piano, practices scales and reads sheet music, tries to sleep 7-8 hours a night to refresh herself in hopes to improve her memory; does crossword puzzles and watches Jeopardy and tries to answer the questions posed on the game show What makes it worse: progressing as years go on.

Anything else that is associated with the symptom: no

Negatives/ You do not have: pain

What you might be expecting from the office visit: most likely a diagnosis of early onset Alzheimer’s

Anything else that is bothering you: extreme mood swings, very young age for a Alzheimer’s diagnosis

Mother’s past history:

Childhood illnesses: none

Immunizations: got all shots

Hospitalizations: None

Surgery: None

Injuries: None

Allergies: Nuts, penicillin

Medications: Zyrtec (seasonal allergies)

Other Meds: Carries an Epipen

Social History: Not a smoker and not a drinker, no recreational drugs, happily married for 28 years, 2 children (22 and 26 yrs)

Alternative Health Care:

Travel outside the US: None

Your family history:

Mary’s mother was diagnosed with Alzheimer’s at 78 and died at age 83 (Mary’s husband is still in denial because he does not think it is plausible for Mary to have Alzheimer’s at such a young age).

Your education history: graduated college, Bachelor’s degree in Education from University of Illinois

Your typical day:

- commute 10 minutes to local elementary school

- Teaches 3rd graders from 8:30am - 3pm

- home by 5pm, cooks dinner for herself, her husband and her child that just moved back home after college

(one time she went to make chicken and rice but made chicken and spaghetti instead, forgetting what she wanted to make for dinner)

-runs errands often locally, maintains household

- gets 7-8 hrs sleep every night

Your hobbies:

- book club, jogging, riding a bike, plays the piano, spending time with her family

(Challenge question) Bring this up at the end if the student does not ask: What do you think the problem is or what might be causing it.

Early stage of Alzheimer. Aging might be one reason.

(is mom aware of what is going on?)