Mr. Springfield suffers currently from recent memory problems and confusion, which, according to his wife, have been increasing slowly in severity over the past year or so. Mr. Springfield wanders from his home, now more frequently than ever especially during the late afternoon. He gets lost easily. Mrs. Springfield has been spending more time watching out for her husband because of his increased wandering. She has not yet sought support from any outside agencies.
The presenting problem is that two days ago, while Mr. Springfield was out wandering the downtown core area, he was hit by a car as he was crossing the street. He struck his head quite hard on the pavement. He was not wearing his hearing aid at the time. An ambulance took him to the Victoria Hospital in Halifax where he was seen in the Emergency Department by the attending emergency care physician. Mr. Springfield was admitted to an acute care medical ward for a 24-hour observation period with multiple bruises and a mild concussion.
A CT scan was performed to determine the extent of cerebral pathology, if any, as a result of his head injury.
Nursing staff reported that Mr. Springfield was behaving strangely upon admission. This was dismissed as being concussion-related. His wife was contacted (based on personal information that the nursing admitting staff found in his wallet). She arrived shortly after he was admitted to the acute care medical floor. While on the ward overnight, Mr. Springfield showed confusion and engaged in inappropriate behaviour (wandering the halls aimlessly, repeatedly searching through the drawers and closets of other in-patients, urinating in a garbage can, climbing into the wrong bed, etc). When asked by the nursing staff about his behaviours (e.g., 'What are you searching for?'), Mr. Springfield insisted that he wanted to go home...