Promoting Health in Extended Care

Question: Discuss about the Promoting Health in Extended Care. Answer: Introduction: This essay aims to discuss the identified priorities of care in the given case scenario. Out of the five priorities of care, the two selected care priorities are- increased risk of social isolation and medication assessment and management. The discussion regarding the care of the patient in the given case scenario will be based on the processes that will be identified in in the Levett-Jones Clinical Reasoning Cycle or Framework. It will utilize Millers Functional Consequences Theory of Healthy Ageing will as a theoretical scaffold. The confirmation regarding how the patients dignity is maintained through the planning of care and process of provision will be discussed. Additionally, the clients cultural background will be taken into consideration. In the given case scenario, the patient is a 77-year-old widower, named Johann Silvermann. He is suffering from Parkinsons disease and hypothyroidism four years back. His hypothyroidism is now controlled on medication. The patient resides alone in his home having two-storeys and his wife is no more. The couple did not have any children; hence, he lives alone. A brother of the patient lives with his family nearby. The patient does not wish to bother them in his daily life. He has limited sources of income, which can only cover his expenses. The patient felt a minor tremor in his hands, which is aggravating. He is not able to perform the daily tasks difficult for him. He is worried regarding his disease and wonders how he will face the uncertainties in the future. His current medications comprise Entacapone 200 mg q8h., Thyroxine 100 micrograms daily and Carbidopa/Levadopa 25/100 q8h. In the given case scenario, the patient is suffering from Parkinsons disease, in which the nerve cells of the brain become impaired as well as gets degenerated (Liao et al., 2013). The pathogenesis of this disease is unknown. It is chronic and in nature and is progressive, but it does not affect the individuals in the similar way (Peretz et al., 2014). A number of patients become disabled and others experience minor disturbances in motor functions. The physical symptoms of this disease include tremor, bradykinesia, rigidity, postural instability. The non-motor symptoms of this disease include depression, dysphagia, emotional changes, dysarthria, fragmented sleep, skin problems, constipation or urinary problems (Weerkamp et al., 2014). The discussion of care of the patient will revolve around two care priorities. The first one is Medical assessment and management. In the given case scenario, it utilize the processes recognized in the Levett-Jones Clinical Reasoning Cycle or Framework (Levett-Jones, 2013). The work of clinicians and nurses involves collection of cues, processing the information, and come to an understanding regarding the situation or problem of the patient, plan and implementing interventions, evaluate the outcomes, reflect on and learn from the process. Considering the situation of the patient, he is an elderly individual, who has been diagnosed with Parkinsons disease four years back. The patient was also diagnosed with hypothyroidism, four years back, which is now under control now. In order to collect the cues, the current symptoms of the patient will be observed in which his present symptoms of the disease will be taken into consideration. The minor tremor in his hands is aggravating. He is not able to perform the daily tasks. He has no one to look after him as his wife has expired 12 years back and he has no children. The planning and implementing of the interventions will be based on symptomatic and neuroprotective therapy (Magennis, Lynch Corry, 2014). Its goal is to provide a control associated with the signs and symptoms of this disease for as long as possible whilst reducing the adverse effects (Shin Habermann, 2016). A number of studies have reported that the quality of a patients life deteriorates, if he/she is not provided with an appropriate treatment after the diagnosis (Birren et al., 2013). For the treatment of Parkinson disease, the pharmacologic treatment can be divided into neuroprotective and symptomatic therapy. At present, there is no confirmed treatment disease modifying or neuroprotective therapy (Holwerda et al., 2012). For symptomatic treatment, Levodopa, coupled with Carbidopa, which is a peripheral decarboxylase inhibitor, is the gold standard (Magennis, Lynch Corry, 2014). It slows down the decarboxylation of levadopa to dopamine in the systemic circulation and allows for the greater distribution of Levadopa into the central nervous system (Weerkamp et al., 2014). For the motor signs and symptoms, it provides the greatest antiparkinsonian advantage for the motor signs and symptoms, with the smallest number of undesirable consequences in the short term; though, its long-standing utilization is associated with the progression of dyskinesias and motor functions (Eliopoulos, 2013). If dyskinesis and fluctuations become problematic, then it is difficult for res olving. The inhibitors of Monoamine oxidase can be considered for preliminary treatment of early disease. The nurse who is given the work of addressing the needs of the patients with Parkinsons disease is a specialist having an expert knowledge regarding the symptoms and treatment of Parkinsons disease (Vikstrm et al., 2015). The experience of this disease is necessary for providing person-centered care, enabling the patient for identifying the and quickly responding to the symptoms that are changing. This minimizes the risks to the patients and families, and assists in preventing emergency admissions (David et al., 2015). The individuals suffering from Parkinsons disease along with their families value the nurses of Parkinsons because the patients understand the condition or situation (Weerkamp et al., 2014). The nurses understand the complex ways in which Parkinsons affects the individuals (Kogan, Wilber Mosqueda, 2016). The nurses try to make sure that patients dignity is maintained in the course of planning of care and provision. Additionally, they consider the cultural background of the patients. In the working lives of the nurses and other healthcare professionals, they come across a few number of individuals with Parkinsons disease (Steptoe et al., 2013). The nurses play a significant role in providing education to the patients regarding the condition and how the individuals are affected by it and minimizing the risks to the individuals with this condition. The nurses are placed ideally for providing education to the individuals suffering from Parkinsons disease together with their care providers and families (Holwerda et al., 2012). This approach facilitates the individuals in understanding their condition and treatment. It enables self-management and making shared decisions. The nurses come across a variety of settings together with clinics, healthcare centers, hospitals, care homes and the own home of the individuals. An expert support is provided by them and makes sure the continuity of care throughout the journey of the patient from diagnosis to death (Vikstrm et al., 2015). The second priority of care is increased risk of social isolation. Since the patient lives and he does not have a family, there is an increased possibility that his symptoms may deteriorate. In addition, he does not want to bother his brother and his family for carrying out his daily activities. The patient is having an increased risk of being lonely or socially isolated. He is near to his 80s and is a widower. He manages everything on his own, as he does not have any child, who can take care of him. A number of researchers have examined the effect of social isolation on the health consequences (Steptoe et al., 2013). According to their findings, the lack of social contacts poses a strong factor of risk for mortality. In addition, the older adults who live lonely and do not want to have any social contact have an enhanced risk of dying more rapidly. They also are more probable to experience reduced mobility in comparison to the older adults who live with their families and have socia l contacts (Hunter, 2012). Social relationships or associations are essential for the well-being of the humans and are significantly involved in health maintenance. In the older adults, social isolation is a particular problem when reducing economic resources and impairment in the mobility work together to limit societal contacts (Holwerda et al., 2012). The older individuals who are socially isolated possess an increased risk for developing cardiovascular disease, cognitive impairment, infectious illness and mortality. It has also been related with elevated blood pressure and some other associated problems (Rodin, 2014). For the patient in the provided case scenario, Millers Functional Consequences Theory of Healthy Ageing will be utilized as a theoretical scaffold. This theory draws from the other theories, which are relevant to the adults, holistic nursing and ageing (Hunter, 2012). The concepts of nursing domain of the individuals, health, environment, and nursing are associated with the exclusively with respect to the older adults (Eliopoulos, 2013).Functional consequences are the apparent effects of events, changes associated with age and risk factors that persuade the quality of life of activities of the adults on a daily basis. The factors of risk can originate in the surroundings or can arise from psychosocial and physiologic influences (Holwerda et al., 2012).When the functional consequences interfere with the quality of life or level of function of an individual, then they are said to be negative. On the other hand, when thy assist the utmost level of performance together with the smallest amount of dependence, then they are said to be positive. The negative functional consequences characteristically occur due to the combination of alterations that are associated with changes and the factors of risk. They may also result due to the interventions, in the cases, where the interventions become the factor of risk (Rodin, 2014). To conclude, the patient in given case scenario needs to be provided with an appropriate care regarding his Parkinsons disease and his increased risk of social isolation. The nurses should understand the complex ways by which Parkinsons affects the individuals. The nurses should try to make sure that the patients dignity is maintained in the course of the process of care planning and provision For the treatment of Parkinson disease, the planning and implementation of the interventions will be based on symptomatic and neuroprotective therapy. The goal should be to provide a control associated with the signs and symptoms of Parkinsons disease for as long as possible whilst reducing the adverse effects. 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