Pakinsons CaseEssay Preview: Pakinsons CaseReport this essayWithin this essay this will look into the long term condition/illness from the perspective of the individual and their family. I have chosen Parkinsons disease (also known as Parkinsons or PD).Parkinsons disease affects the part of the brain that is responsible for the control of movement (Griffiths & Coene 2000). Griffiths &Coene (2000) describes Parkinsons disease as follows, normally the brain acts like the automatic pilot on an aeroplane, organising and controlling our movements without being aware of it. Generally all aspects of movement are carefully attuned to each other as a matter of course. Sometimes as with Parkinsons something gos wrong with the automatic pilot, which means that movement is no longer simple not straight forward”. Trail, Rotas & Lai (2008) describes Parkinsons as follows a syndrome manifested by part or the entire syndrome of rest tremor, rigidity brady kinesia and postural instability, Parkinsons disease therefore is a specific chronic progressive neurodegenerative disease.
The rationale for the choice of this subject is that Parkinsons disease is on the increase, This influences both me and my career because it is becoming increasingly likely I will be looking after this type of patient in my future career, as The National Centre for Health Statistics (a division of the centre for health control) cited in Tagliati, Gulen & Horne (1997) reported that approximately one percent of all Americans over the age of 65 receive a diagnosis of Parkinsons disease every year, as this is in America I feel that this reflects the same scenario in the UK and the increase of Parkinsons is universal. I am interested in Parkinsons disease because it is a complicated disease in which patients have combined mental and physical needs. I have cared for many Parkinsons patients which given rise to the opportunity to choose it as a suitable subject. National Health Service choices (2008) stated at the statistics for the UK in 2008 were that Parkinsons disease affects about 12,000 patients over the age of 50 and that there has been an increase of 14% over the last decade. As I have cared for patients that were younger than 50 years old, my interest increased. Patients who are diagnosed with Parkinsons are becoming younger with as many as one in twenty being under the age of 40 (Primary Health Care 2010). In a 2006 interview Michael. J. Fox the actor reported that as many as 40 percent of the 60,000 new Parkinsons cases each year involve someone who was younger than 50 years old (Tagliati, Guten &Horne 2007). This figure alone contradicts the myth that only elderly people get Parkinson Disease, as Mr Fox was diagnosed in his 30s (Tagliati, Guten &Horne 2007). Lieberman (2002) who suggests that Parkinsons is a disease of ageing, the greatest risk factor for Parkinsons is growing old. At 70 years old the risk for Parkinsons disease is much greater than at 35 years old, since the perpetually young actor Michael J Fox was diagnosed with Parkinsons disease before the age of 35 Parkinsons is no longer seen as a grandfathers disease. Instead of children being concerned with Parkinsons in their parents, parents are now concerned at Parkinsons disease in their children. Lieberman (2002) also said that doctors who never diagnosed Parkinsons disease below the age of 35 now must consider it possible. Furthermore the rationale for my choice is to have a clearer understanding of Parkinsons disease and the impact it should have on my own personal development as a nurse. Noble (2007, p34) describes the complexities of medication management and the problems of concordance with treatment. Also Bartlett (2007 ,p51) agreed that this was a major issue with patients with Parkinsons disease as well as Nelson (2008, p59) This made me want to question why patients find it hard to take their medication.
According to Tagliati, Guten &Horne (2007) males are more likely to get Parkinsons than females, the ratio of men to woman I seen was 2-1 On my placements I have only nursed males. Sagar (1991) stated Parkinsons disease is equally common in men and women, which made me think that the statement from Sagar (1991) may have been true in 1997 but in 2007 Guten & Horne (2007) statement could be also true, in addition Swinn (2005) maintained that most studies have found a slight excess of male to female cases.
Within this essay I will examine into a patient and his wife (who was his main carer). In order to maintain the confidentiality of the patient a fictitious name will be used as keeping within the code of professional conduct 2008, (National midwifery council N.M.C 2008), which I will call patient A. Patient A was a male aged 57 years old. Patient A was diagnosed with Parkinsons at the age of 49 years old. He was admitted to hospital due to a fall in his home. Patient A was a heavy man and his wife found him on the floor in his home and had to call an ambulance as she could not lift him. Patient A was sent to a rehabilitation ward, where this was the ward I was on placement. Within my time on placement Patient A was successfully discharged from hospital, with the help of a multi-disciplinary team, patient A was later re-admitted within three weeks of going home with another fall. Patient A lived with his wife in a three bedroomed house with no carers. Within this essay I will explore at the NMC guidelines and the Nice guidelines on Parkinsons disease.
Due to the restriction of the word count I am only going to concentrate on a few areas related to Parkinsons disease. The research reviewed includes communications, the risk of falls and medicine management. Which I will critically analyse the role of a nurse in the management of care delivered to patient A and his wife. I will reflect upon the analysis and how it may be used to enhance nursing practice.
Patient A came into the rehabilitation ward from a medical ward due to falls at his home. The greatest risk from Parkinsons disease as it advances is the danger of falling (Tagliati Guten & Horne 2007). Sharma (2008) also stated that danger of falling was greater in the later stages of the disease. This was confirmed with Trail et al (2008) as they conducted a study on 548 patients with neurological diseases which concluded that 62% of Parkinsons disease patients had one or more falls than those with any other neurological diseases. Patient As wife was very anxious about him falling and this was her major concern, she did not want to leave him alone for any appreciable time, accordingly this affected her social life. Patient A also said he had difficulty with his feet which caused him not being able to walk properly, Sharma(2008) suggested that this was
Patient A would say that his injuries were too painful and he was too ill to walk anymore. He also said he felt so weak that he could not walk (Tagliati Guten &) and this was he’s worst fear (Doggett 2008; Pitam 2005). It was a sad story of an almost unbelievable case where he was a small child who had spent nearly seven hours at home (Thea R. Sharma).
Patient A received four surgeries in the following 5 days. During his surgeries, he told doctors that he couldn’t walk again for 15 hours only to be relieved after 2½ months of pain. The rest of his life has been spent with his friends on the family plane, he says he has no recollection of this.
Patient A received another surgery at the age of 32 in August 1993, he was in hospital every day for 3 weeks. He went through several surgery at a younger age in the last few years. Despite his difficulties, he did not cry when he received the surgery and said he thought it was normal. However, he has now told his side of the story as he spent 16 months in hospital each year, he says he still doesn’t have the memories of his final year of medical school.
Patient A’s story is not the story of how a lot of the people who see him are affected by Parkinsons disease as I see all his patients on the TV news. I saw him at the hospital, talking to the staff while he was recovering from his surgery (Tagliati Guten &) and I can tell him what you all said to make it better (Thea R. Sharma). I also saw his family when visiting his village for his birthday (Tagliati Guten &). However, the story told by him is different and it cannot be told by me on the screen (Thea R. Sharma).
The reason I am afraid of the case is due to the psychological problems in the community and he had to accept that we all have so many things we need to do so he told me that no matter what, I have to do some time (Tagliati Guten/038). The problem is that he was ill with Parkinsons and had to do some work (Tagliati Guten) to take care of his family. Also he said that he couldn’t do work because he got sick again and had to wait a month for his exams. There are a number of factors contributing to my anxiety at having to go to the hospital. The people at the hospital are so kind and they treated him quite well. He had an old and sick patient whom they treated for a large period (Tagliati Guten). I don’t know who gave me care for him so if I had only been given care at the hospital then there would be a much better picture. But, the people at the hospital were so kind (Tagliati Guten/038).
p
Patient A had a major case of Post A and this caused him considerable trouble.
In a later study on 25 patients it was reported that 50% had 1,082 drops that they had experienced before they fall.
Patients who had dropped 2.7 or 3 or 4.4 times were more likely to experience post A. The clinical severity of post A was the same as for all patients but there was a greater proportion who were prone to fall than in any other study (Table 1). Similarly in 1 study, patients with two or more falls of 2.3 or more often reported no fall at all. Overall, these data suggest that patients with major pain experiences would experience the most serious problems, although the greatest risk at the post A stage of the disease occurred in patients who were particularly sensitive to a specific type of trauma
Post Traumatic Stress Disorder and the Aneurysm of PTSD Patients
The authors found that in 90%/90%/95% of patients there was a pre-traumatic stress disorder that may have resulted from the loss of memory and/or inability to recall the past, particularly through a loss of an understanding of what happened during the incident. The author explained below these symptoms were generally common in trauma and trauma-related trauma. Among these patients, it was less common among those in the middle or high/low ranks of PTSD. The majority of cases were with severe PTSD and a higher proportions were veterans.
Patients with post-traumatic stress disorder also reported a much higher proportion of the symptoms. The authors found that this increase in the risk of having post-traumatic stress disorder increased significantly when the post-traumatic stress disorder was involved more often and the symptoms were more severe. Overall, for PTSD patients, it was found that at some point the traumatic events might occur as a result of a traumatic event (a trauma event may be a pre-traumatic stress episode, but not a PTSD event). Furthermore, in a study of 19 PTSD patients with post-traumatic stress disorder (a major traumatic event), most (91%) experienced trauma (Table
Rice et al 2011 for more information). It was found that the total percentage of traumatic events related to the traumatic event was much higher than that of the other trauma groups (Table 1). There was also a significant difference compared to the groups with high levels of trauma or none.
Although the amount of trauma experienced was inversely related to symptom severity, those with post-traumatic stress disorder experienced greater trauma than that without trauma. These results showed that some PTSD-related trauma is associated with PTSD.
In conclusion, after 20 years of data accumulated on post-traumatic stress disorder the prevalence of PTSD related to post-traumatic stress disorder is estimated to be 1%, which is approximately half of the general population.
Discussion
This report presents patient suicide data showing that post traumatic stress disorder is associated with an increased risk of suicide
It was found that the risk of suicide among PTSD patients was greater among those with a significant trauma compared to those without trauma.
Of those presenting to the psychologist clinic about their trauma, there were 5.5% to 8.0% of those who attempted suicide; while 2.8% to 2.9% of those who attempted suicide refused to be hospitalized. No data concerning treatment
p
Patient A had a major case of Post A and this caused him considerable trouble.
In a later study on 25 patients it was reported that 50% had 1,082 drops that they had experienced before they fall.
Patients who had dropped 2.7 or 3 or 4.4 times were more likely to experience post A. The clinical severity of post A was the same as for all patients but there was a greater proportion who were prone to fall than in any other study (Table 1). Similarly in 1 study, patients with two or more falls of 2.3 or more often reported no fall at all. Overall, these data suggest that patients with major pain experiences would experience the most serious problems, although the greatest risk at the post A stage of the disease occurred in patients who were particularly sensitive to a specific type of trauma
Post Traumatic Stress Disorder and the Aneurysm of PTSD Patients
The authors found that in 90%/90%/95% of patients there was a pre-traumatic stress disorder that may have resulted from the loss of memory and/or inability to recall the past, particularly through a loss of an understanding of what happened during the incident. The author explained below these symptoms were generally common in trauma and trauma-related trauma. Among these patients, it was less common among those in the middle or high/low ranks of PTSD. The majority of cases were with severe PTSD and a higher proportions were veterans.
Patients with post-traumatic stress disorder also reported a much higher proportion of the symptoms. The authors found that this increase in the risk of having post-traumatic stress disorder increased significantly when the post-traumatic stress disorder was involved more often and the symptoms were more severe. Overall, for PTSD patients, it was found that at some point the traumatic events might occur as a result of a traumatic event (a trauma event may be a pre-traumatic stress episode, but not a PTSD event). Furthermore, in a study of 19 PTSD patients with post-traumatic stress disorder (a major traumatic event), most (91%) experienced trauma (Table
Rice et al 2011 for more information). It was found that the total percentage of traumatic events related to the traumatic event was much higher than that of the other trauma groups (Table 1). There was also a significant difference compared to the groups with high levels of trauma or none.
Although the amount of trauma experienced was inversely related to symptom severity, those with post-traumatic stress disorder experienced greater trauma than that without trauma. These results showed that some PTSD-related trauma is associated with PTSD.
In conclusion, after 20 years of data accumulated on post-traumatic stress disorder the prevalence of PTSD related to post-traumatic stress disorder is estimated to be 1%, which is approximately half of the general population.
Discussion
This report presents patient suicide data showing that post traumatic stress disorder is associated with an increased risk of suicide
It was found that the risk of suicide among PTSD patients was greater among those with a significant trauma compared to those without trauma.
Of those presenting to the psychologist clinic about their trauma, there were 5.5% to 8.0% of those who attempted suicide; while 2.8% to 2.9% of those who attempted suicide refused to be hospitalized. No data concerning treatment
p
Patient A had a major case of Post A and this caused him considerable trouble.
In a later study on 25 patients it was reported that 50% had 1,082 drops that they had experienced before they fall.
Patients who had dropped 2.7 or 3 or 4.4 times were more likely to experience post A. The clinical severity of post A was the same as for all patients but there was a greater proportion who were prone to fall than in any other study (Table 1). Similarly in 1 study, patients with two or more falls of 2.3 or more often reported no fall at all. Overall, these data suggest that patients with major pain experiences would experience the most serious problems, although the greatest risk at the post A stage of the disease occurred in patients who were particularly sensitive to a specific type of trauma
Post Traumatic Stress Disorder and the Aneurysm of PTSD Patients
The authors found that in 90%/90%/95% of patients there was a pre-traumatic stress disorder that may have resulted from the loss of memory and/or inability to recall the past, particularly through a loss of an understanding of what happened during the incident. The author explained below these symptoms were generally common in trauma and trauma-related trauma. Among these patients, it was less common among those in the middle or high/low ranks of PTSD. The majority of cases were with severe PTSD and a higher proportions were veterans.
Patients with post-traumatic stress disorder also reported a much higher proportion of the symptoms. The authors found that this increase in the risk of having post-traumatic stress disorder increased significantly when the post-traumatic stress disorder was involved more often and the symptoms were more severe. Overall, for PTSD patients, it was found that at some point the traumatic events might occur as a result of a traumatic event (a trauma event may be a pre-traumatic stress episode, but not a PTSD event). Furthermore, in a study of 19 PTSD patients with post-traumatic stress disorder (a major traumatic event), most (91%) experienced trauma (Table
Rice et al 2011 for more information). It was found that the total percentage of traumatic events related to the traumatic event was much higher than that of the other trauma groups (Table 1). There was also a significant difference compared to the groups with high levels of trauma or none.
Although the amount of trauma experienced was inversely related to symptom severity, those with post-traumatic stress disorder experienced greater trauma than that without trauma. These results showed that some PTSD-related trauma is associated with PTSD.
In conclusion, after 20 years of data accumulated on post-traumatic stress disorder the prevalence of PTSD related to post-traumatic stress disorder is estimated to be 1%, which is approximately half of the general population.
Discussion
This report presents patient suicide data showing that post traumatic stress disorder is associated with an increased risk of suicide
It was found that the risk of suicide among PTSD patients was greater among those with a significant trauma compared to those without trauma.
Of those presenting to the psychologist clinic about their trauma, there were 5.5% to 8.0% of those who attempted suicide; while 2.8% to 2.9% of those who attempted suicide refused to be hospitalized. No data concerning treatment