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Journal of Family Medicine and Disease Prevention





DOI: 10.23937/2469-5793/1510052



Eighty-Eight Year-Old Demented Woman Lives Alone Independently: A Case Report

Koh Iwasaki1* and Shin Takayama2


1Long term Care Facility Aoinosono-East Sendai, Tohoku University Hospital, Japan
2Department of Education and Support for Regional Medicine, Kampo Medicine, Tohoku University Hospital, Japan


*Corresponding author: Koh Iwasaki, Long term Care Facility Aoinosono-East Sendai, Tohoku University Hospital, Sendai City, Japan, Tel: 81-22-288-6366, E-mail: iwasaki.koh67@gmail.com
J Fam Med Dis Prev, JFMDP-3-052, (Volume 3, Issue 1), Case Report; ISSN: 2469-5793
Received: November 30, 2016 | Accepted: February 25, 2017 | Published: February 28, 2017
Citation: Iwasaki K, Takayama S (2017) Eighty-Eight Year-Old Demented Woman Lives Alone Independently: A Case Report. J Fam Med Dis Prev 3:052. 10.23937/2469-5793/1510052
Copyright: © 2017 Iwasaki K, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.



Case Report

An eighty-eight-year-old woman with a Mini-Mental State Examination (MMSE) [1] score of 14 lives alone independently in Ogatsu ward, Ishinomaki, Japan. She has hypertension, and she is taken care of by our visiting care service. One day, we found that she could not take her drugs in a punctual manner. Drugs that had been left for 120 days or more were found in her house. She lives alone, cooks, washes, cleans the house, and also takes care of her garden. The Barthel Index [2] was fully scored, showing that her basic activity of daily living (ADL) was independent, whereas her instrumental ADL (IADL) was 4/8 on the IADL scale by Lawton MP and Brody EM [3]. Although she could not perform a 3-word recall and calculation in the MMSE, she could call her daughters and pay the doctor's fee correctly. She never travels far by herself as she cannot drive a car.

The care team discussed the reason of her independence and the plan on how to provide care for her. We concluded that she was independently capable of living in her own home in her small, very familiar community. She has three close, familiar friends nearby to frequently chat and drink tea with. Situated near the city of Ishinomaki - which was destroyed by the great tsunami in 2011 - her small community is safely located far from the city center and on a hilltop. These very stable circumstances keep her ADL independent. Olsen C, et al. also pointed out that the quality of life of home-dwelling individuals with dementia was better than that of nursing home residents [4]. Therefore, we decided to keep her surroundings the same as long as possible, monitored carefully by a team. Dementia is a severe socio-medical problem, but she suggests to us the possibility of and means to keep life independent for demented elderly persons.


Disclosure Statement

No funding or financial support was received for this letter. The authors declare that there is no potential conflict of interest regarding this manuscript.


References
  1. Folstein MF, Folstein SE, McHugh PR (1975) "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12: 189-198.

  2. Mahoney Fi, Barthel Dw (1965) Functional Evaluation: The Barthel Index. Md State Med J 14: 61-65.

  3. Lawton MP, Brody EM (1969) Assessment of older people: self-maintaining and instrumental activities of daily living. Gerontologist 9: 179-186.

  4. Olsen C, Pedersen I, Bergland A, Enders-Slegers MJ, Jøranson N, et al. (2016) Differences in quality of life in home-dwelling persons and nursing home residents with dementia - a cross-sectional study. BMC Geriatr 16: 137.

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