URDANETA CITY UNIVERSITY

COLLEGE OF HEALTH SCIENCES

STUDY GUIDE 3
AGING CHANGES THAT AFFECT COMMUNICATION

ACTIVITY 1:

SCENARIO 1: CASE STUDY

Mrs Schmidt is a 65 years old woman who has been staying at an acute care facility for over
30 months now. She has been suffering for several years from chronic obstructive
pulmonary disease and was placed on mechanical ventilation last fall. She was initially
admitted to your facility for a weaning .Last night ,the physician informed her that she was
to leave the acute facility, connected to the mechanical ventilation ,and that no further trials
will be initiated. This morning you asked Mrs .Schmidt about her preparations for leaving
the facility. In response, Mrs Schmidt starts crying dramatically and asks to see the
attending physician. She is extremely upset, stating that “no one told her about this” .She is
adamantly asking for an extension of her stay and for another weaning trial. However, she
is still has a Foley catheter (a thin, sterile tube inserted into the bladder to drain urine) in
place, which she refuses to let go, saying that, she “cannot be without it.”

QUESTIONS: Pls. answer the following and place it in a long bond paper, send via my
gmail.

1. What are the following potential challenges for communicating with Mrs Schmidt?
2. How would you assess for these challenges?
3. What are some following explanations for the communication difficulties described in
this vignette?
4. Is there anything that should have been done differently?
5. How would you explain Mrs Schmidt’s miraculous ability to wean?
6. How would you explain Mrs Schmidt’s refusal to” let go “of the Foley catheter?

ACTIVITY 2: CRITICAL THINKING EXERCISES

1. Mr Robert Smith is a 79 year-old man who was recently diagnosed with severe
hearing problems .Mr Smith is very upset about his diagnosis and refuses to wear his
hearing aids .What are some of the potential reasons for this emotional reaction?
What are some potential alternatives to hearing aids? What would be your
recommendations for Mr. Smith?

2. Mrs Williams is an 81year –old woman. She has been increasingly widrawn and
disengaged. Her appetite has declined and she has lost 15 pounds .Her primary care
provider recommended a course of antidepressant treatment in order to boost up her
energy and mood.
Mrs Williams took the medication for two weeks and stopped. What can be done to
increase the use of depression treatment in older adults?
What can be done to increase the use of depression treatment in older adults?
What information could be most useful for Mrs.Williams?
 3. Mr. Roberts was recently diagnosed with Alzheimer’s disease .His wife and two
daughters are extremely upset, calling you in order to learn more about Mr Robert’s
condition. How would you what be most useful for family members of patients with
Alzheimer’s disease? What should they expect? Is there anything the family can do
to help?
4. What information would be most useful for Mr. Roberts himself? Should he be
present when you discuss his diagnosis with his family members? What are some of
the pros and cons for doing so? How would you decide?
5. John is 85 year-old man who suffers from severe dementia. His caretaker reports
that lately he has been lately he has been extremely violent and sexual during
dressing. How are these behaviours related to communication deficits?

ACTIVITY 3: PERSONAL REFLECTIONS

1. What are some of the difficulties you might experience as a student nurse who has to
take care of older adults with sensory deficits?
What skills would be most important for you to gain in order to overcome these
difficulties?
2. What are your thoughts and feelings about treating older adults with depression?
What are some of the advantages and disadvantages of treating depression?
3. What alternative moods of communication have you used in the past? Which ones
were most effective and why? Which ones where most challenging and why?

PREPARED BY:

PRISCILLA R. BAUN, PhD

Faculty in -charge