Dementia (Case study)

Audrey (aged 71) and Edward (aged 74) are a couple who have been married
for nearly fifty years and have a very close relationship. They have lived in the
same home for over 35 of those years and enjoy where they live – although in
recent years there have been many changes in the area, with new subdivisions
being made, many new buildings along with new roads and changes to existing
street configurations.
Dr Susan Saunders has been their general practitioner for the past ten years. Dr
Saunders notes that over that time they have attended routine appointments
together and have enjoyed generally good health, although Audrey has some
mild arthritis in her hips and fingers. Today, Edward has made an appointment
to see Dr Saunders without Audrey present. He tells Dr Saunders that he is
worried about Audrey’s memory. During the last month, Audrey has misplaced
her car keys three times (although on each occasion she did find them a short
time later). Having recently watched a documentary about dementia, Edward is
very worried that Audrey might have dementia. He has thus been watching her
closely for any other possible signs of dementia, and a couple of events have
added to his concerns.
Edward explains that last week Audrey walked into their lounge room, and
completely forgot what she had gone in there for. She retraced her steps
however, and remembered she was going into the lounge room to get her
reading glasses. Edward added that during a recent cleaning spree, they had
rearranged the items in the kitchen cupboards. A couple of days later when
making a cup of tea, Audrey forgot that the cups had been moved, and she went
to the wrong cupboard to get them. Although she immediately realised what she
had done, laughed about it, and quickly went to the correct cupboard, this
incident just added to his concerns.
Dr Saunders asks if they have noticed other changes. For example, has Audrey
had any new health issues? Is she managing her daily activities and chores?
Edward confirms that Audrey has not had any recent illnesses or medication
changes, is still participating in all her regular activities including driving her car,
going out with their friends to play golf and, as usual, continues to share all the
cooking, gardening, and housework duties with Edward. She has also been very
busy planning and organising a trip to Europe to see friends in Germany and
Croatia. Edward tells Dr Saunders that Audrey has always enjoyed organising
their holidays away and on this occasion she seems to be managing it well.
Edward also tells the doctor about one odd incident that happened about six
months ago – he tells the doctor that Audrey was driving home from a friend’s
house and became disoriented and could not remember how to get home on this
usually familiar route. He said that Audrey pulled over and rang him on her
mobile phone to tell him that she could not remember the way home, but after
they spoke for a couple of minutes she suddenly said that she had just
remembered the route and would be home shortly. She then made it safely
home without further incident. Otherwise, apart from the memory issues
mentioned earlier, Edward says there have been no other concerns or issues
worrying them.