Biomedical Engineering Reference
In-Depth Information
and colleagues (2011) developed an ICF Core Set for Matching Older Adults with Dementia
and Technology (MOADT) to provide a systematic coding scheme for health information
systems and to establish a common language for describing the ATA. The MOADT rep-
resents a useful tool for better communication between the different centers for techni-
cal aid, institutes for geriatric rehabilitation, geriatric medical centers and institutes and
people with dementia, their families, and caregivers. In the process of “matching older
people and technology,” it becomes essential that the geriatrician works with providers to
identify appropriate technology for an older client.
To provide an example of the geriatrician as a professional consultant in a center for
technical aid, a clinical case is described linking a geriatric assessment and the ICF per-
spective with an explanation of the factors that influence the matching process whilst con-
sidering a hypothetical scenario of the progression of a health condition.
13.8 Case Study and the ATA Process
Name: A.B.
Age: 73.3 years
Age at the beginning of disease: 70 years
Diagnosis: ICD-9-CM Diagnosis Code 331.0 Alzheimer's disease, I10 hypertension, M81.0
osteoporosis, F32.9 depression
Since the age of about 70, Mrs. A.B. began to notice memory problems (difficulties in
naming, difficulties in finding personal effects, episodic memory deficits). As the months
passed there was a slow worsening of her medical and functional conditions. Recently, she
lost the ability to perform IADLs without assistance and she now frequently appears to be
apathetic and depressed.
The anamnestic data show cataract surgery (at the age of 71), hypertension (at the age
of 67), and osteoporosis (at the age of 62). At the age of 65, Mrs. A.B. presented depressive
symptoms and underwent pharmacological treatment with citalopram. This treatment
produced relevant benefits and was stopped after two years. One year ago, the same
antidepressant drug was reintroduced. The family history shows a sibling who died
from dementia (probably Alzheimer's disease) and a living sibling who has Parkinson's
disease.
She is assessed every six months by a geriatric center to monitor the evolution of the
disease and to maintain pharmacological treatment. Before the onset of the disease the
patient spent time in housekeeping and in volunteering. In particular, she shopped for
necessary items and worked for Caritas in the parochial center of the town. She was able
to walk to services and the parochial center, and she was also a factory worker (she has
eight years of education).
At the moment, Mrs. A.B. lives with her husband near the home of one of her two daugh-
ters. The town is very small and several services are within walking distance. Familiar
people provide a valid form of support in allowing her to maintain her residual autonomy
and to create situations for socialization and participation, but they are committed for the
greater part of the day. If nobody is present, Mrs. A.B. spends her time watching televi-
sion. If somebody indicates when they must be performed, she can carry out the ADLs
by herself (dressing, toileting, transferring, continence, and feeding), except for having a
bath because of her fear of falling. Regarding instrumental activities, she can dial a few
