Physiology of Parkinsons Disease - Essay Example

RUNNING HEAD: Parkinson’s disease Parkinson’s disease Name Course Instructor Date Introduction Parkinson’s disease is a disorder that mostly affects the essential brain nerves commonly used in harmonizing all the movement of the muscles, causing the patient to continuously shake, becoming stiff and facing a lot of hardship when walking, balancing or even coordinating body parts. Some of the most likely causes of Parkinson’s disease are certain medication drugs like those used in some paranoia which bring about severe side effects to the brain. Another known cause of Parkinson’s disease is a condition known as shy-draggers syndrome, which is mostly correlated with irremediable dementia disorder, which becomes relatively perilous when it gets in touch with the Parkinson’s disease. Another factor that can drastically increase a person’s chances of getting Parkinson’s disease is excessive boulevard drugs, since they decrease the dopamine chemical levels produced by neurons. Some of the major symptoms of the disease include; constant shaking tremors on the lower jaws, arms and legs, a wobbly handwriting, excess saliva, nightmares, inability to button up clothes, too much depression, cutting of food, and to some extent even inability to walk. One way of diagnose Parkinson’s disease is through accessing the patient’s previous medical history and the prevailing symptoms that the patient may be suffering from. In some cases, a patient can be diagnosed with dual diagnosis. This involves being diagnosed with two interacting diagnosis (Evans, Katzenschlager & Paviour, 2004). Joel, Sheldon and Edward (2003), states that people who undergo dual diagnosis are faced with a lot of psychosocial problems. Joel et al. (2003) further states that such individuals also ail from substance abuse and emotional illness. It is essential to note that this form of body disorder does not require blood sample or any form of x-rays since it is hardly recognizable in the body. Nevertheless, there are special x-ray machines that can assist in detecting other infections signs present in the patient’s body. Even without any known medication drugs that can successfully treat any causes of Parkinson’s disease, one can opt for alternative drug treatments that are useful in management of the disease. Such drugs include Ropinole, Bromocriptine, Tolcapone, Pramipexole, Slegiline and Carbidopa-Levodopa. However, the most dominant thing of all is to ensure all the instructions are strictly followed for avoid any devastation from happening thereafter. Non-motor features like dysautonomia and dementia occur recurrently, more so in the advanced stages of Parkinson’s diseases. The disease is not regarded as a single disease entity neither does term essentially denotes the same for all clinicians. The physiotherapy programmes are requisite to identifying key elements of Parkinson’s diagnosis of and are centered on personal problems. In reference to Richard and Serge (2008), these programmes incorporate: Communication: Richard and Serge (2008) indicate that the patients of chronic ailment who are not very independent can suffer from inability to communicate if they are being hampered by dysphonic voices; as a result one ends up in a quiet speech. Richard and Serge (2008) in additional indicates that a combination of abridged facial expression combined with dysphonic voice can make the patient seem unsociable. In addition, thought processes are slowed a factor that makes impatient caregivers deny Parkinson’s disease patients satisfactory time to communicate. Evaluation should account the recommendation of language and speech therapy. In keeping with Waterfield (2002), elderly patients may possibly slack their hearing and further lack of assessment may result to misunderstanding. Cognitive function: persons suffering from Parkinsononism have a declined cognitive function compared to other healthy people. According to Donald, Hubert and Michael (2009) depression can impinge on about 50% patients with Parkinson’s ailment. In reference to Richard and Serge (2008), cognitive function assessment must include a legitimate measurement scale that can evaluate an individual’s ability to comprehend and adhere to advices. If nocturnal turns to be a persistent dilemma, the patient may endure sleep deprivation a condition that can exacerbate damaged cognitive function and dejection. Continence assessment: several physiological alterations may in various cases influence the ability to maintain uniformity among the elderly. Cautious assessment must be undertaken through the use of a recognized consistency care pathway or an assessment tool (Brian & Susan, 2001). Through knowledge of age and related diseases the assessor must be in a position to establish the prevailing continence hitch in a patient. In keeping with Gagne & Power (2010), Parkinson's constantly progress with time. Gagne & Power (2010) have given stages that are commonly used to estimate the diseases progresses; motor symptoms. In reference to Evans Katzenschlager and Paviour (2004), if Parkinson's disease is not treated at its initial stages, the condition advances aggressively in the early stages then slows down later. Failure to administer treatment at the immediate later stage can lead to individuals loosing independent ambulation after an estimated duration of eight years (Evans Katzenschlager & Paviour, 2004). Nonetheless, it is not common to find people who have not been taken care of today. Medication has advanced the prognosis of motor symptoms (Gagne & Power, 2010). Evans Katzenschlager and Paviour (2004) argue that Parkinson's disease type of disability since it brings undesired effects of levodopa. Persons taking levodopa can take up to fifteen year to develop to elevated stage of dependency where they entirely depend on caregivers. Cognitive impairment, according to Evans Katzenschlager and Paviour (2004), has been recorded to be more recurrent to patients of 70 years and above. The Role of a Parkinson's Nurse Specialist In reference to Karle and Boys (2001) the role of a Parkinson's nurse is elementary in coordinating the disease’s management. The Parkinson’s Nurse Specialists (PNS) also avails access to advise, because the act as a source of information and a medium to public awareness. Nurse specialists’ roles as defined by Donald, Hubert and Michael (2009) is diverse and challenging, and encompasses patient management, assessment of patients, and provision of support to informal caregivers. In all stages of the Parkinson’s disease, patient and caregivers contact is vital (Karle and Boys, 2001). In keeping with Higgins (2007) statement, the purpose of diagnostic, continuance consistent assessment and palliative care is to lead towards maintaining extended period of independence maximizing abilities and minimizing disabilities. In keeping with Redman (2007), Nurses offer advise with the primary and secondary care sector and is based on their settings. Redman (2007) further states that a care plan must be established ones a problem are identified; it involves mutual agreement by both nurse and patient resulting to individual holistic care. A well-informed carer or patient feels empowered when actively involved in the care management (Redman, 2007). “National Institute for Health and clinical Excellence” recommends that patients with duo-diagnosis should have frequent access to services which can be monitored by specialist nursing. Example of these services include; provision of a continuous point of contact including home visits for support; appropriate monitoring and alteration of medication; and providing reliable information on clinical and social matters that concerns Parkinson's Disease, “National Institute for Health and clinical Excellence”. Counseling Assistance to facilitate accepting diagnosis and addressing issues like coping with long-term chronic illness are crucial features of this role (Higgins, 2007). As determined by Higgins, the Parkinson's Disease Nurse Specialists focus largely on the effects of physical, psychological social aspects and spiritual implications that are connected with the disease. Chronic ailments can impact on the entire family including the children. Higgins (2007) adds that it is important for the members of the family to adopt a forum in which they express their views. O’Reilly, Finnan & Allwright (1996) acknowledges that empathetic and knowledgeable approach of diagnosis of Parkinson's is important when dealing with sensitive issues, this helps them in recognizing the best support service like erectile dysfunction clinic that are locally available. Drug management In reference to The National Collaborating Centre for Chronic Conditions, (2006), Parkinson's Disease greatly differs from other neurological conditions in the way the disabilities related to the disease fluctuates unpredictably in a day. The article analysis major aspects of Parkinson's Disease Nurse Specialist (PDNS) role as; offering guidance and information on titration, advise, dietary and potential side effects. In keeping with the article, a greater understanding of how and when to administer medication should lead to improving the patient, and the patient benefits from the prescriptions offered. Concordance, which is a new concept, describes the agreement between the patient and the prescriber, in partnership, on medicine. Ibid, collaboration can be improved dramatically once a patient has been educated on the nature of his disease and possible treatments. Specialized Nurses are well placed to identify medications adverse effects and are well aware of the need to submit a complete incident yellow card report to the safety of medicines committee. They also give advice on medication which is also extended to apomorphine -this is a powerful dopamine agonist currently available as a subcutaneous injection. Donald, Hubert and Michael (2009) in their book have documented that the apomorphine programme success depends on continuous advice and encouragement of Nurse Specialist. Various nurses have been trained and function as supplementary prescriber of medication. Edification Increasing awareness of diagnosis of co-occurring illnesses through education and training is important (O'Sullivan et al., 2007). Many Nurse Specialists identify giving formal care to their patient as their key role. However, they are also finding educating on chronicle illness as a key part of their role. This education entails the provision of evidence-based learning to persons suffering from co-occurring illnesses together with their families, carers, nurses among other members in the multidisciplinary team. According to Heap and Dryden (2001), education is particularly important where health care professionals are not vastly experienced on co-occurring illnesses or in places of high turnover of staff. In keeping with Heap and Dryden (2001), education should be provided in a manner that is no threatening or insinuating any feelings of deskilling the health care team. Education on Chronic Diseases acts as a catalyst to increase public awareness and to reduce incidences of misinformation. Education should also be done on the carers and their patients. The Nurse Specialists commitment to educating and exploring new knowledge on advanced medical treatments strategies, quality and clinical effectiveness of are of paramount importance. Use of nurse can reduce hospital admissions, consultations, out-patient appointments, and improve clinical out comes and health of Parkinson's disease patients and carer. Carer support To conform to Heap and Dryden (2001), the impact of co-occurring illnesses on caregivers can not be underestimated. Concurring with Heap and Dryden (2001), looking after a person with co-occurring illnesses can be stressful. He states that in some cases it may lead to social isolation, mental and physical health complications. Spouses with partners suffering from such diseases are recorded to have worse psychological, social and physical profiles. O’Sullivan et al. (2007) states that caregivers who provide extensive care, experience worst health conditions. They indicate that, appropriate intervention and identification of caregivers needs should be prioritized. It is acceptable for the carers to consequently experience stress due to psychiatric manifestation of co-occurring illnesses occurring in patients. The burden carried by the caregivers who in most cases lack good nights and rests can greatly impact on their ability to work during the day (O’Sullivan et al., 2007). According to them, a formal assessment used to evaluate the caregivers problems like; provision of practical, psychological support and the sleep evaluation tools should be prioritized. In reference to O’Sullivan et al. (2007), there have emerged serious issues over the past years relating to impulsive behavior in some patients on dopaminergic medications. Such behaviors include; gambling, hyper-sexuality and punding. These behaviors may result to devastating financial constraints at a personal level as well as on the entire family. Early identification of these problems, through questioning during the nursing assessment and offering support to the family members may mitigate such an escalation References Brian, D &Susan, M. (2001). Parkinson's disease. Philadelphia: Lippincott Williams & Wilkins. Chrysalis. 2010. Psychotherapeutic Counseling. Year One. Module Eight Handout. Donald G, Hubert, F & Michael, O.(2009). Parkinson's disease. London: Manson. Evans, H., Katzenschlager, R., & Paviour, D. (2004). Punding in Parkinson’s disease: Its Relation to the Dopamine Dysregulation Syndrome. Mov Discord. Gagne, J. & Power, M. (2010). "Anti-inflammatory Drugs and Risk of Parkinson Disease: A Meta-analysis". Neurology 74 (12): 995–1002 Higgins, M. (2007). Developing and Supporting Expansion of the Nurse’s Role. Nurse Stand. Heap, M and Dryden, W. (2001). Hypnotherapy, A Handbook. Buckingham: Open University Press. Joel S, Sheldon G & Edward H (2003) Dual diagnosis: evaluation, treatment, training, and program development. Springer publishers. Karle, H and Boys, J. (2001). Hypnotherapy, A Practical Handbook. London: Free Association Books. O'Sullivan, B. & Schmitz, J. (2007). Parkinson's Disease. Physical Rehabilitation. 5th Ed. Philadelphia: F.A. Davis. pp. 856–7. Redman, B. (2007). The Practice of Patient Education: Case studies approach (10th Ed.). St Louis, MO: Mosby Elsevier. Retrieved from University of Phoenix eBook collection Royal College of Physicians (2006). Parkinson's disease : national clinical guideline for diagnosis and management in primary and secondary care. London: Royal College of Physicians. Richard, N & Serge, P. (2008). Parkinson's disease molecular and therapeutic insights from model systems. Amsterdam Boston: Elsevier Academic Press. The National Collaborating Centre for Chronic Conditions. (2006). Diagnosing Parkinson's Disease. Parkinson's Disease. London: Royal College of Physicians. pp. 29–47. Waterfield, R. 2002. Hidden Depths, The Story of Hypnosis. London: Macmillan. Read More