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Case: Mr. Aponi is an 85-year-old Native American male currently residing in a long-term care facility. His wife passed away 5 years ago and he has no children. For the past 7 weeks, Mr. Aponi started to show some cognitive decline, forgetfulness, and developed other medical issues. Due to his inability to care for himself, he was placed in a long-term care facility. Mr. Aponi's cognitive decline limits his ability to respond appropriately to questions and at times, he gets easily agitated and resistant to care. He refuses to take his medications, spitting them out, gripping the bedside rail when the nurse tries to turn him and yelling out for his wife to save him. Mr. Aponi's frequent incontinence necessitates the development of therapeutic communication to facilitate activities of daily living (ADL) care and frequent skin hygiene. The nurse calling for Mr. Aponi for the first time, learns that talking slowly and softly is the most effective way of focusing Mr. Aponi's attention and prompting him to follow basic instructions such as turning side to side. The nurse feels uneasy about speaking to Mr. Aponi as if he was a child in some ways, but finds that this manner of speech keeps him calm and responds well to praise and compliments that he is very helpful to the nurse in assisting with his own care. Frequently, Mr. Aponi gets very confused, agitated, and unable to recognize any of the staff that consistently work with him. He requires frequent redirection to try and calm him down. His periods of agitation are becoming more frequently and is progressively showing decline in cognition.
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