Case history
Lucille Legrand has lived in a CHSLD for 5 years. She has been a widow for ten years and has no children. She has had multiple sclerosis since 1985. While she has been able to control her symptoms and attacks well, in the last five years her general condition has deteriorated considerably. She suffered a great reduction in autonomy in her ADLs and DAs, and placement in a CHSLD became the only option for her.
She has an active life at the CHSLD and she is the chair of the users’ committee. She has always said, “My body is no longer keeping up with me, but my brain is just fine!” She is greatly fulfilled by this role.
She needs help to get up and into her electric wheelchair, but she controls it independently. She needs some help eating, because she has difficulty with the fine motor control of her upper limbs.
She has presented de novo confusion since yesterday afternoon. The doctor assessed her and asked to have her VSs and NSs assessed every 8h, and to do a urinalysis and culture by catheter. The results of the urinalysis came in this morning at 7:45 AM.
It is 8:00 AM and your colleague, the nursing assistant, informs you that Ms. Legrand was found lying between her bed and electric wheelchair, on the floor. She is making confused utterances about person and place. She was put back to bed and the nursing assistant did not notice any apparent injury. She checked the VSs and they are normal.