Harry is an 84 year-old man with a 10-year history of Alzheimer’s-type dementia. He has recently moved into an aged care facility, as his wife could no longer manage to care for him at home. Since admission to this facility he has presented some challenges to staff caring for him. During the afternoons and evenings he paces the wing of the facility, shouting that its time for him to go. He rattles the doors and gates and becomes physically aggressive, pushing people away when they try to calm him.

Staff report that Harry has some difficulties sleeping. Although he settles in his bed at night and stays there, he does not fall asleep easily, usually staying awake for many hours staring at the ceiling and talking to himself.

Three days ago Harry required a dressing on his hand as he cut himself while hitting a door, trying to get someone to open it. This seems to be causing a moderate degree of pain, for which his doctor has prescribed regular pain relief. He now needs assistance in eating meals because the injury is to his dominant hand. Harry always requires full assistance with showering and dressing, and is doubly incontinent.

Harry’s dementia is at an advanced stage and he recognises no one. Staff observe that when his wife is around Harry seems to calm down a bit. He doesn’t really recognise her, but seems to be soothed by the sound of her voice. Harry’s wife visits a couple of hours every day.

Harry is located in a secure, dementia-specific wing with well-trained staff caring for him and an appropriate activities program running both morning and early evening sessions.

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