LD

Question 1

LD Challenging behaviour (history)

Answer 1

Clarify HPC (onset, duration, baseline, aggression, response)
Screen for psych disorders (mood, sleep, appetite, enjoyment, hallucinations, delusional)
Screen for medical illness (PMHx, medication changes, recent illness)
Environmental changes (environment, staff, residents, visitors, routine)

Question 2

Dementia in Downs syndrome (history)

Answer 2

Clarify HPC (onset, duration)
Explore memory difficulties (short-term, long-term)
Orientation (day/dates, confused, recognizing people)
Communication (word-finding, understanding, identify objects)
Functioning (dressing, washing, toileting, walking, money, shopping, food, transportation)
PMHx and risk factors (head injury, low mood)
Other psych disorders (mood, enjoyment, sleep, appetite, abnormal behaviour)
Risk (wandering, getting lost, fire, flooding, exploitation, abuse, aggression, self-injury).

Question 3

Depression in LD (history)

Answer 3

Clarify HPC (onset, duration)
Core features of depression (1-10, tearful, enjoyment)
Biological symptoms (Energy, sleep, EMW, appetite)
Other symptoms (concentration, self-worth, guilt, psychotic features)
Past psych history, PMHx, medications
Risk

Question 4

Temporal lobe epilepsy (history)

Answer 4

Clarify HPC (onset, duration)
Pre-ictal phase (vacant, visual disturbance, unresponsive, involuntary movements)
Ictal phase (duration, LOC, movements, continence)
Post-ictal phase (confusion, sleepiness, memory, headache)
PMHx (medication, conditions, substances, FHx)

Question 5

Pregnancy/parenthood in LD (d/w family)

Answer 5

Clarify HPC
Parenting concerns (Baseline functioning, work)
Explain role of social services (assessment, support, care)
Sterilization (consent and capacity)
LD in child (family history, genetic testing, aetiology of LD, antenatal care)

Question 6

Abuse in LD (history)

Answer 6

Clarify HPC (onset, duration, course)
Explore social circumstances (family relationships, frequency of visits, bruising etc)
Psych screen (mood, enjoyment, sleep, appetite, aggression, easily startled, abnormal behaviour)
Med screen (PMHx, meds, seizures, new Sx)
Baseline skills (communication, ADLs, other residents)