Clinical Speciality Task - Aged good care related case study.
INTRODUCTION:
For privateness through this case study the article writer will refer to the patient as Mrs A. This research study will investigate medical condition of Mrs A. Mrs A is 82 years old and has lived with Parkinson's Disease for the last twenty years. Mrs A is currently taking Levodopa, Atanol and Lepitol. Mrs A's symptoms 've got gradually worse as she has aged. Things that she used to have the ability to do are actually much more problematic for her, even simple things like getting out of chair, walking without shuffling her feet and keeping her balance. This case study will research different ideas of ageing and exactly how these relate to medical condition that Mrs A is suffering from. Models of care and attention will be mentioned as well as the best model of care to suit Mrs A and why this style of good care would be the best option option for Mrs A. This research study will also look at a management arrange for Mrs A to boost her standard of living through different interventions and strategies. This includes established review times to make certain Mrs A is getting the most from the management plan. Finally this research will research the legal and moral issues that could impact Mrs A.
Parkinson's is the next most typical neurodegenerative disorder, characterised by both motor and non-motor symptoms. The four main engine symptoms of Parkinson's disease are: Shaking or tremor, slowness of movements (Bradykinesia), stiffness or rigidity of the biceps and triceps, hip and legs and trunk, trouble with balance (postural instability)(Levy, pp. 1242-1246).
CASE Research - MRS A
For this research study we are researching the health of an 82 Yr old female with a prognosis of Parkinson's disease. Mrs A was diagnosed with Parkinson's disease in her early on 60s. She currently can take Levodopa, Atanol and Lepitol. She lives with her partner who is ?? years of age and in generally a healthy body. Mrs A is the one who prepares the meals and will the housework at home. But as the disease and symptoms have advanced, it is getting increasingly problematic for Mrs A to continue these activities without help from her hubby. She had been rather healthy before her examination, she was created in England transferred to Australia when she was ?? yrs. old. She did have problems with pneumonia double and experienced a fall season while crossing a road before her examination but besides that she was a wholesome woman. The prognosis came as a big distress to Mrs A and she went through a range of feelings, including denial. Unfortunately due to the denial she was experiencing this delayed her in seeking the help and medication she needed, which means Mrs A didn't start any medical treatment when she was diagnosed. Mrs A finished up starting medical intervention scheduled to her little girl taking her to appropriate meetings and convincing her that is exactly what she had a need to help Mrs A maintain her quality of life. Mrs A currently takes Levodopa 4 times every day to treat the symptoms of Parkinson's and has been taking this going back 20 years. Mrs A states that the Levodopa still works well for her symptoms. Despite taking her medications, Mrs A still currently suffers from a range of symptoms including the tremor, rigidness, tightness, difficulty walking, getting up and down, speaking, memory, tiredness, lethargy. These conditions have advanced as her years advanced. Mrs A produces risk factors for a lot of other conditions due to her Parkinson's symptoms such as dropping, choking, aspiration, etc. It's important for Mrs A to have the ability to still enjoy and have a good standard of living. This will require a management plan and overview of the plan to monitor its performance.
THEORIES OF AGING:
Parkinson's disease is an age-related disease credited for an age-associated increase in oxidative harm to the mind. Dopaminergic neurons cut down for a price of 5-10% every ten years in normal ageing; the rate and power of neuronal reduction in patients with Parkinson's disease is much more than that of just maturing. (Kumar et al. , pp. 478-504) Most ideas of ageing can get into two different categories, programmed and damage/error theories. (Jin, pp. 72-74) The programmed theory implies that ageing is already genetically programmed that occurs with time and little by little deteriorates until fatality where as the damage theory is the idea that external or environmental forces gradually damage cells and organs, resulting in aging and fatality. Individual damage theories focus on how a slow and constant damage to skin cells will eventually lead to cellular dysfunction. Damage ideas do not count on a pre-determined timeline for aging and infer that people could possibly increase our life expectancy if we take steps to protect our bodies from cellular damage. (Jin, pp. 72-74) Free radicals are also associated with aging. "The free radical theory of ageing states that we age because of free radical damage as time passes, "(Szalay, p. 1)
IMPLICATIONS OF THESE THEORIES ON THE HEALTH OF MRS A:
Due to the implications of Parkinson's disease, this disease pertains to the programmed theory of ageing due to the fact that there is no known exterior environmental factors that triggers Parkinson's disease. It is unknown what can cause Parkinson's disease but what is known is that your body internally puts a stop to producing dopamine leading to lots of the symptoms of Parkinson's disease.
Free radicals are fast growing skin cells in the torso that are associated with individual disease, including tumors, atherosclerosis, Alzheimer's disease, Parkinson's disease and many others. (Szalay, p. 1) Things that can produce free radicals are located in the food we eat, the medications we take, the environment we inhale and exhale and this particular we drink. (Szalay, p. 1) This part of Parkinson's disease appears to back up the Damage theory. If free radicals overwhelm your body's ability to regulate them, a condition known as oxidative stress occurs. Free radicals adversely alter lipids, proteins, and DNA and result in a number of individuals diseases including Parkinson's disease. (Lobo, Patil, Phatak, & Chandra, pp. 118-126) Free radicals are manufactured either from normal essential metabolic operations in our body which support the Programmed Theory of aging or from external options such as contact with X-rays, ozone, cigarette smoking, air contaminants, and professional chemicals which supports the ruined theory of maturing. (Lobo et al. , pp. 118-126) The symptoms of Parkinson's Disease are only discovered once 50% of the nigral neurons and 80% of the striatal dopamine already are forever lost. (Kumar et al. , pp. 478-504) There happens to be still no answer for the ongoing question, what specific age group related factors predispose certain individuals to build up this common neurodegenerative disease?(Reeve, Simcox, & Turnbull, pp. 19-30)
MODEL OF Care and attention:
There are three main models of care, Consumer aimed care which is a financial model of good care and two medical models of attention which will be the Eden Substitute model and the individual centred health care model. For Mrs A, the individual centred good care model would be most appropriate as this model of care involves dealing with not the physical attention of the individual alone but the entire person, including their communal, cultural and individual identity requirements. (martin & Mills, pp. 22-29) This would be best suited for Mrs A as her health condition, Parkinson's disease results more than simply the physical body of the individual, it also impacts the way the person considers themselves, the way they think about life, it triggers depressive disorder in 90% of people with this condition and also influences the friends, family and family members of the person with the condition. (Anderson, pp. 323-332) Patient centred attention is important to make Mrs A feel like she is not alone and she is still has control of her life and what happens to her. This style of care can cater for Mrs A helping to make decisions together with the medical team and not merely have decisions made without any insight from her. This makes the patient feel heard, in control, respected and takes away a small amount of the isolation associated with this disease. (Kittle, pp. 4-6) There are also other symptoms that are not as easily seen as the physical ones. A lot of individuals feel embarrassed about their disease and for that reason will not discuss their condition and attempt to cover it. (Anderson, pp. 323-332) Mrs A have this for some time before her analysis by retaining the arm that was shaking anticipated to embarrassment, too little acceptance in the community and insufficient understanding about her condition.
MANAGEMENT ARRANGE FOR MRS A:
Mrs A happens to be taking Levodova 4 times per day for her Parkinson's she feels as though this is still heading well and expresses that she does not feel just like it is wearing off. Mrs A would benefit from a medication review from her doctor to be sure she actually is getting the most out of her medication plan. Mrs A and her hubby go for strolls day-to-day to keep themselves effective, which is excellent to help Mrs A's condition. Mrs A also needs to be referred to a physiotherapist to learn more specific exercises that relates to improving her condition and minimising symptoms. The physio will also be able to help Mrs A with gait and balance training standard protocol with strength training, as it has found to be effective in reducing comes up to six months after the treatment. (Skelly, Lindop, & Johnson, pp. 10-14) Weight training is a fairly new involvement for Parkinson's suffers but recent studies have shown a long-term reduction in motor symptoms based on progressive weight training twice weekly. (Pinter, pp. 123-130) There is certainly increasing facts that the effective care of patients with Parkinson's disease should require a multidisciplinary team of medical researchers, like the neurologist, Parkinson's disease nurse specialist, physiotherapist, occupational therapist, talk and language therapist, dietician, medical psychologist and communal worker(Skelly et al. , pp. 10-14) Mrs A is not offered these services yet. It's important that Mrs A gets recommendations to all or any important services so that it is ensured she actually is living the perfect quality of life. This includes a referral to a psychologist as treatment of behavioural symptoms in Parkinson's disease is merely as important to treat as it could greatly improve a patients overall function and standard of living. (Anderson, pp. 323-332) A recommendation to a physiotherapist to assist in improving gait, balance, improve aerobic activity, activity initiation and increase independence. Occupational therapist to provide help on preserving activities of everyday living, with the purpose of retaining friendships and family associations, encouraging self-care, examining any protection concerns, cognitive assessments and arranging any appropriate interventions. Speech and dialect therapist to improve Mrs A's loudness and speech, ensure any ways of communication can be found as the condition progresses. Mrs A could also benefit by witnessing a dietician to examine her meals and when she may be having any issues when eating or drinking alcohol.
Mrs A will also desire a recommendation to a continence advisor as she's recently disclosed that she actually is having trouble making it to the bathroom. She actually is very embarrassed concerning this and will not like to discuss it. Encourage Mrs A to have warm baths and massage therapy the muscle for tightness and muscle weakness. Teach Mrs A to make use of facial exercises and respiration methods to right what and volume level when she is speaking, this is to increase her potential to communicate effectively because of the decline in speech and facial muscle stiffness. Educate Mrs A on profound breath before speaking to increase the quantity and variety of words in phrases of each breath. (NANDA, pp. 1-2) The Country wide Institute for Health and Clinical Excellence suggests specialist review every 6-12 calendar months. (National Institute for Health insurance and Clinical Superiority, p. 53)
LEGAL AND ETHICAL CONDITIONS THAT NEED TO BE CONSIDERED FOR MRS A:
-reported difficult honest tensions between safety and autonomy
The balance of safety and autonomy, conceptualizing home attention as maintaining freedom rather than receiving dependence. (Denson, Winefield, & Beilby, pp. 2-12)
