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Case 1

Case 1. A.J. 94 year old lady in residential home. Dementia Aortic stenosis Chronic Kidney Disease, stage 3 OA knees Hypertension Glaucoma. A.J. contd. P.M.H. September 2011 Transient Ischaemic Attack May 2002 Right cataract extraction and implant Medication Clopidogrel 75mg daily

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Case 1

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  1. Case 1

  2. A.J. 94 year old lady in residential home • Dementia • Aortic stenosis • Chronic Kidney Disease, stage 3 • OA knees • Hypertension • Glaucoma

  3. A.J. contd. P.M.H. • September 2011 Transient Ischaemic Attack • May 2002 Right cataract extraction and implant Medication • Clopidogrel 75mg daily • Maxidex eye drops 0.1% daily to R eye • Laxido orange • Zeroderm ointment

  4. A.J. contd. Hospital admissions: • 2008 admitted from home after a fall • Anterior dislocation of shoulder • CKD diagnosed • Aortic stenosis confirmed on echo • Discharged to residential home

  5. A.J. contd. • 2010 admitted after further fall • Displaced fracture R distal humerus –fixed internally • CT scan head – no bleed • 2011 admitted after an episode of weakness and slurred speech with no evidence of infarct or bleed on CT scan- diagnosed as TIA • Echo confirmed aortic stenosis and 24 hour tape and blood tests normal other than known CKD.

  6. A.J. contd. • Discharged back to residential home but became more aggressive and transferred to different home April 2013 ISSUES: • New G.P. with no prior knowledge of person • No formal diagnosis of dementia in records • DNACPR was in place( G.P. had done after T.I.A.) • Elderly, more frail , no plans in place for future care • Settled in home, mobilises with help, eats and drinks well

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