Confronting early dementia – Yes doctor, but you didn’t mention my failing mind (clip)

Background  (111-030-06-3) Rami and Yigal 

The patient‘s memory has been failing for some time and he had complained to the family doctor about his fear of dementia ( that’s in the family) . He was recently hospitalized with confusion 2nd to sepsis from pyelonephritis. The discharge note recommends further cognitive work-up. Just prior to this clip the doctor was handing-over his treatment plan for the patient’s urological condition. He is interrupted by the patient almost at the end of that explanation.

The action

The patient gets agitated and insists that the doctor relate to his concerns about his cognitive state. The doctor explains defensively – but without getting the patient’s attention-  that that’s what he intended to do next.

Educational opportunities
  • This clip is a short and well-defined example of the “affect “ and “significance” elements in CASE. It also demonstrates how strong emotions and concerns will keep returning in an interview until they are heard and felt to be heard (Note: The patient had mentioned this concern at the beginning of the interview without getting any response from the doctor). As with any clip on ”affect”: “ how many different emotions and concerns can you name in this clip?”
  • [Could be viewed with next clip to trigger a discussion on response to cues]

Video with full cues

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