The client is a 97 YO woman, retired, living alone in a rented apartment. She is divorced with three adult children. The patient shared her apartment with two
sisters, both of whom died in 2020 (April and August). Her adult children all reside out of the state, and her daughter moved to Asia recently. She has a
medical history of vertigo, bilateral malignant neoplasm of the breast, HTN, CVA, hyperlipidemia, ataxic gait, urinary incontinence, eczema, asthma, left eye
cataract, and a recent diagnosis of mild cognitive impairment. She has no formal psychiatric treatment or diagnoses, no SIB, no substance use, no SA. She
came to the ED after expressing SI and becoming dysregulated during an office visit with her neurologist, indicating that she wanted to walk into traffic and
felt depressed and lonely. In the ED, she denied having active SI, listed her grandchildren and religious beliefs as protective factors, and said she would never
act on those thoughts. The client reports a depressed mood on most days, insomnia, racing thoughts, fear of leaving her apartment, increased forgetfulness,
and loss of 15 lbs. in the last two months. She also reported a fall in the bathroom but denied losing consciousness, only a bruise on the buttocks and lower
back pain a few days after the fall.
What is her differential diagnosis?
What are the rationales and diagnosis criteria?
What other information is needed to complete a care plan for this client?