John O’Brien is an 81-year-old man who had a major stroke 6 months ago and He now lives in a residential nursing facility: Applied Social Sciences Assignment, NUI, Ireland

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John O’Brien is an 81-year-old man who had a major stroke 6 months ago. He now lives in a residential nursing facility. John is now suffering from severe cognitive decline, memory loss, and is very confused. He often talks about his wife as if she was still alive although she died two years previously. Sometimes he wants to go to work at a factory which he retired from many years ago. Every day, there is more and more evidence of his cognitive deterioration. He can’t seem to remember which day of the week it is. One day, he was found staring at his own reflection in a mirror – it seemed that he didn’t recognize the man looking back at him. Some days, John doesn’t seem to recognize his own daughter, other days he does.

The daughter says he is no longer the same. John is usually put to bed at about 9 pm but does not want to go, he would rather go for a walk. When he attempts to get out of bed, he is gently put back in. Because he is trying to get out of bed the decision was taken to put him into a bed with bed rails. Now that John is getting more and more confused, his carers do not want him to go alone for walks even during the day.

This has led to situations where John is in a chair for long periods of time. A tray is kept in front of him and prevents him from getting out. For no apparent reason, one day John started to lash out at the nursing staff both verbally and physically. Now, staff has resorted to using sedation which has had the side effect of more confusion, agitation, drowsiness, and drooling. `