Need help doing a psych eval on "On Golden Pond" movie.

[dixiemama]

We have to do a big report on two movies. One of them is "On Golden Pond". I am a little confused. We have to list all DSM-IV-TR diagnosis for the main character (Norman). We have to then give examples of how the patient meets the criteria from the movie. I came up with dementia. I can't really say Alzheimer's definitively can I, since I don't have any history, tests, etc? I have examples of each dementia criteria so that is not really my problem. My problem is with additional diagnosis classifications. Our text says that most people with dementia meet the criteria for depression also. On major depressive disorder, I can assume that he meets the criteria of a change in previous function and that they impair functioning (espcially socially) but the 3rd criteria is that he meet at least 5 of a list and I don't see him exhibiting 5. Is dementia the only DSM diagnosis you would come up with for Norman? Very hard to do a psych eval when you can't ask your patient any questions or look at their history!

[Daytonite, BSN, RN]

no, you cannot say "alzheimer's". that is a medical diagnosis. you can only list the signs and symptoms of alzheimer's that he exhibits. all diseases and conditions can be broken down into their signs and symptoms. the signs and symptoms are the evidence that prove the existence of the disease/condition. [we do the same for nursing diagnoses.] if you find that a patient is not meeting some of the criteria for a certain diagnosis, then that diagnosis doesn't apply to them. you can't make a square peg fit in a round hole. something else is the answer.

as i recall, norman had memory and confusion problems. people with dementia may also be depressed but not all are. people with confusion may also have signs and symptoms of anxiety (i think you'll find norman had a lot of those), impaired memory (he had a lot of that as well), low self-esteem, perception problems, disturbed thought processes, tendency for violence and injury. my psych books indicate that dsm-iv-tr diagnoses for someone like him would relate to his confused state: the deliriums, dementias, dementia with delusions. wasn't there an incident in the movie where he became confused when picking strawberries and began imagining things? that's delusional (nursing diagnosis: disturbed sensory perception). alzheimer's includes memory impairment (recall that he can't remember things his daughter brings up about her past), poor judgment (his choice of fishing location and times) and a lot of mood disturbances (look at the signs and symptoms of anxiety: [color=#3366ff]anxiety).

[shirls30]

Wow, it's been a long time since I've seen that movie, but could you use something like self care decline, or something with his ADL's? I took care of dementia patients years ago in a nursing home, I can remember there was ineffective coping, malnutrition issues as well the obvious cognitive deficiencies. I hope this helps.