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Case Study - Mrs. Doris’s Decline

Mrs. Doris, an 85 year old woman, was admitted to hospital two weeks ago after a serious fall and hip fracture.  You are asked to see Mrs. Doris as she is having difficulty participating actively in her therapy program due to confusion.

Prior to this admission Mrs. Doris had been living alone in her own home. Her husband passed away less than a year ago and her two children live out of province.  Mrs. Doris has maintained an active lifestyle and has always been very close to her friends and neighbours.  Until recently she has continued to drive her car and enjoy her  involvement with the ladies bridge club at her church.



After meeting with Mrs. Doris and reviewing her chart you obtain permission to talk to her neighbours and close friends. You become aware of the following:

  • slow decline over the last 6 months

  • forgetting where she put her purse and keys

  • increased difficulty with cleaning and cooking

  • mixing up several appointments

  • no longer attending weekly bridge games at the church

  • not seen out of home or driving her car


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A full physical, including mental status examination, reveals :

  • no physical or neurological deficits

  • difficulty following multi-step commands

  • poor short term memory

  • difficulty naming common objects

  • appears detached and disinterested

  • CAT scan:  generalized cerebral atrophy, increased ventricular size and presence of mild microvessel disease