PRACTICUM

INTERNSHIP
REPORT

NAME - ESHANA RATHOD

ROLL NO. - 9436
Case 1
Mrs. VJ , 94 yr old female.
1.It was reported that there is a
certain decline in memory from past
2-3 years. Difficult to remember
recent things.
2. Issues with bladder control ,
therefore has to wear diaper.
3. loss of functioning left hand due to
broken peices of bone
4. Feels Lonely
PROBABLE DIAGNOSIS : No
disorder diagnosed.
OBSERVATIONS
She was not able to recall her name and
breakfast menu. Other past memories were
intact
As she faced bladder issue, her bed was
wrapped with plastic to avoid wetting the bed
General appearance was appropriate
While taking history , some repeatations of
some story was observed due to forgetting
Psychomotor activity was within normal limits
Speech was audible and relevant , reaction
time was normal.
No thought impairments were observed.
Oriented to time, place and year.
General knowledge was above adequate.
 CASE 2
Mrs. RM is a 67 yr old female with a b.com degree. She carries
out all the daily activities. Memory is intact..Patient reported
Name : R.M that she didn’t like it there in one room. She has missed home a
Age - 67 years lot and feels like going home everyday , but she doesn't want to
Sex - female be a burden in her children's life and thus trying to adjust in this
facility. Everyday it's hard for her to get up and find to be in a
Mother tongue - Marathi
room all alone. She has a heavy chest all the time and often cries
Occupation - Currently alone. It's hard for her to communicate with others and thus
unemployed remains in silence all alone. She has sleeping issues and thus
Marital Status - Widower take pills every night.
Educational Status - B.com
 OBSERVATIONS
It was reported and observed that she felt lonely and didn’t communicate much with other.
She wanted to go home and it was hard for her to live in that facility.
Sleeping pills were taken as she had difficulty falling asleep.
Dressing was appropriate, psychomotor activities were normal, speech was audible and relevant,
reaction time was normal.
Stress had been observed while talking to her. Her memory was intact and she was oriented to
time, place and year.
No thought impairment was observed.
When asked about time , date , and year , she answered appropriately.
While talking to her I often used to see tears in her eyes.
Tone was audible , reaction time was normal, speech was relevant.

PROBABLE DIAGNOSIS : Acute Adjustment Disorder

 CASE 3
Mr. Arvind Joshi, 82 year old male, architect. Its
Name : A.J been three and a half years since he is staying here.
Age - 82 years He mostly passes his time singing to a variety of
Sex - Male songs. His wife in 2018 and has one son who is
working in the US. After his wife's death he was
Mother tongue - Marathi
admitted to this facility. He reports that it is hard to
Occupation - Currently live here but there is no other option. He used to
unemployed wander to different places but now he is all alone
Marital Status - Widow and is not allowed to go outside. He said that “
Educational Status - kondun baslya sarkha vaat ta. Feels like we are in
jail. Not allowed to go outside.” He doesn’t like to
Architecture
talk much with strangers.
OBSERVATION
He was a little uncomfortable talking to me but still did answer some of my questions.

He used to avoid strangers and didnt like to talk much.

He felt lonely in his room and I used to hear him sing a lot.

Its was his hobby to sing and enjoyed that moment a lot

Sometimes he used to video his son leaving abroad

His general appearance was appropriate.

Memory was intact.while taking history.

It was difficult to understand his speech as it was not audible and clear. No signs of any mental disorder were observed.

Tone was inaudible , reaction time was normal, speech was relevant No thought impairment was observed

PROBABLE DIAGNOSIS : No Probable diagnosis

 CASE 4
Name- AD
Age - not able to recall
Early occupation- Government Officer
Current occupation- Housewife
Education- Msc. Economics
Marital status- Widow
Sex- Female
Client was dressed appropriately for the entire
session, she was lying on the bed for the entire time
wandering and lost in her thoughts. She was clearly
sad, felt nervous but couldn’t know the reason
behind as she did not remember her thoughts for a
longer time. Frequently she keeps saying that she is
too nervous and wants everyone to be happy, she
wants to bless everyone with happiness. Little
decline in cognitive function was seen as she
couldn’t remember, recall, and was not oriented to
time, following year. Much information about her
life, personal history or family history was collected
as she was not able to remember.
 ​
OBSERVATION

● Remembering life events becomes hard for her, basic knowledge of age, time, place is impaired.
● Confusion between her own words is observed. Like she may say that she is nervous but believes at the
same time that she is happy and can make others happy.
● Meaningless repeating of her own words is evident.
● Mild depression is seen as she express herself
● She sits in her room wandering for hours, getting lost in her thoughts.
● Unable to recall her own thoughts.
In content of thought, loneliness was observed.
Tone was audible, reaction time was normal, speech was relevant.
No thought impairments were observed.

PROBABLE DIAGNOSIS : Dementia with Alzhemier’s as subtype

 CASE 5
Name: SD SD is a 64-year-old female. Her mother tongue is Marathi. She
is a married woman. Her education level is not known and she
Age: 64 used to be a housewife. She has three children, one daughter
Sex: Female and two sons. The daughter is married and both the sons are
unmarried. Her complaints include memory impairment,
Mother Tongue: Marathi behavior disturbances, aggressive behavior, irritability, reduced
Occupation: House wife sleep, cognitive functions progressively declining, and
forgetfulness. The onset was sub-acute, the predisposing factor
Marital Status: Married being age and the course of illness is continuous. She has been
Education Level: Not known in the institution for around six months now. Any distinct
physical illness, abnormalities, disorders are not known. No
physical and psychiatric illness within the family is known.
Personal history and premorbid history is not known.
 OBSERVATIONS
During those activities it was observed that SD took part in the activities. She loved singing
bhajans and religious song. She even remembered all of them.
But during other activities like drawing and coloring activity, ball activity, jigsaw puzzle
activity, riddles activity she was not able to follow the instructions given to her.
Sometimes on repetition she would get the instruction. This showed a decline in cognitive
abilities like judgment, decision making, thinking, perception
She was also not able to draw a clock when told to do so, was not even able to place digits
around the circle.
Also, she was not able to distinguish that she is staying at the institution, for her she was
still at her home. She had no orientation of day, month, or year.

PROBABLE DIAGNOSIS : Major neurocognitive disorder

 CASE 6 Mrs RP was well groomed, polite and attentive. The rapport
​Name : XY could be established. She was brought up in Mumbai and had a
big family of four sisters and five brothers growing up. She is
Age: 82 Years connected to them through phone calls. She got married and
lived in Santa Cruz, Mumbai for most of her life. She had a loving,
Sex - Female content relationship with her husband of 56 years and they were
an adjusting couple. She mentioned being fond of traveling to
Mother tongue - Konkani Marathi temples, yatras and trips all around India. She also mentioned
being happy, close to her husband as they enjoyed each other’s
Languages : Marathi, Hindi, English company. Her husband passed away four months ago in march.
Later, after her husband’s death she fell on back and had
Occupation - Retired physical impairment and was admitted to this facility by her
daughter. She feels tired, fatigue easily and has sleep
Marital Status - Widow disturbances , headaches regularly. No insight abnormalities
were observed and she denied suicidal thoughts. In content of
Educational Status - Nursery primary thought worry was observed and her recent , remote memory
teacher was intact. She was oriented to time, place and years
 OBSERVATIONS
● Physically, legs and backbone were impaired and needed support while getting up from bed and
using the washroom.
● She despaired and felt emotional while talking about her husband.
● She is woeful as she cant walk, move and she is on bedrest for three months.
● Motor skills were limited as she couldn't participate in activities of clay modeling, drawing and
puzzle solving even when she wished too.
● She was dismayed as she mentioned that she can’t play her role of grandmother to her
grandchildren while they grow up because of her physical limited mobility. She mentions that she
wished her body physically supported her.
● Her memory was intact as she could mention the age of her children, grandchildren, marriage
years, relatives, religious places and countries.
● She liked being asked questions of general knowledge and talked about her life experiences.
● She felt tired and worried because of limited physical movement and bed-rest

PROBABLE DIAGNOSIS : Generalized Anxiety Disorder

 OBSERVATIONS DURING ACTIVITY

I completed my 2 month internship at Madhurbhav senior care and assisted living which is an old age facility in Pune.
Different types of activities and case histories were taken. The records of my observation during this time are noted down.
Many activities like singing, passing the ball, kicking and throwing the ball, drawing and coloring, solving puzzles ,riddle
solving activities,etc were conducted. During the singing , dancing session it was observed that many of them
participated and enjoyed singing old songs.
To get to know and communicate with each other we took the activity of passing the ball in which those who have ball in
hand when the song is stopped playing have to share his or her experience with everyone else. Sharing will help to create
bonds and ease the mind. Some of them shared accident incidences while others shared their achievement throughout
their lives.
For the coordination between hand and leg movement throwing and catching the ball the activity was conducted and
later on kicking the ball was also added. Then throwing the ball in the basket was carried out to understand whether their
speed, distance coordination is intact. Some did do it without any difficulty, and for some it was hard to understand and
took no interest in participating.
Drawing and coloring activity was the most interesting one and everyone participated in it enthusiastically. Everyone
enjoyed it and some thought reflection can be seen in their drawing. For eg. a lady had drawn her old house along with a
terrace and balcony which showed her episodic memory was intact and emotions were attached to that house.
Mini cog was administered as a part of activity. Everyone were told to draw a clock and indicate time. Many of them drew
it perfectly while some were just able to draw it but faced difficulty when indicating time. Some of them drew flowers
while some went blank. This helped us understand and have some sense of dementia patients.
During all these activities it was overall observed that some of them went aggressive , while others enjoyed it. Some told
us to shut down the activity while others thought all this was a childish act.
One thing common between all is that there was kind of loneliness with them everytime.
THANK YOU