I selected a patient that has been diagnosed with possible Alzheimer's disease with whom I worked as my subject, in order to further study the unique challenges and rewards of providing good nursing care to such a complex patient. …
Download file to see previous pages...
The key points of this analysis are the medical background and history of the patient, the psychological and sociological factors affecting her and her health, and finally how the patient and those psychological and sociological factors fit into a larger theoretical and policy framework.
About the Patient
In the interests of maintaining confidentiality and respecting patient privacy, I will be referring to this patient as Mrs. X. Due to her rapidly deteriorating mental and physical condition, Mrs. X's residential care home was no longer capable of providing the nursing services she required, and she was subsequently transferred into the mental health ward. Mrs. X has vascular dementia or Alzheimer's disease and has been declared legally incompetent to make her own medical decisions. In addition, she is prone to mild absence seizures, causing disorientation and occasional falls, though they do not induce unconsciousness. She is receiving phenytoin to treat the seizures.
Mrs. X's behavioural issues have progressively worsened to the point that she requires full care and constant monitoring. She will wander the halls of the ward at night screaming. Her husband believes that many of her mental issues are related to her lack of sleep, which does make her agitated and irritable during the day. She has difficulty communicating her needs, as she is completely non-verbal. This factor alone is greatly complicating her nursing care. Other complicating factors in Mrs. X's care are her dislike for the staff to attempt personal hygiene or care needs, and her refusal to comply with treatment regimens. For example, she was found to be refusing her medication by hiding pills in her mouth, and had to be switched to liquid suspensions. Psychological and Sociological Factors It is difficult to assess Mrs. X's psychological condition exactly, due to her dementia and non-verbal state; however, it is safe to say that she is clearly unhappy with the current situation. This is a concern, as a patient's psychological state is often directly related to their ability to heal when hurt or to keep themselves healthy in the first place (Gross, 2007). Even on the first layer of the Whitehead-Dahlgren model of psychological influences, her physical state of being, most effects on Mrs. X are strongly negative (Marks & Evans, 2005). She often seems unaware of her surroundings, becoming lost within the building, which is a traumatising event for her. This most often occurs at night when she wanders. Her sleeplessness is due to severe insomnia, a condition that further damages her poor psychological state. She is helpless to do anything for herself, unable even to eat, drink, or use the toilet without help. Even in her mentally compromised state, this level of dependence on others causes her a significant amount of distress. This is evidenced by her dislike mentioned earlier for staff members trying to attend to her personal care. She is in pain due to arthritis and frequent constipation, which also negatively impacts her psychological well-being. On the second layer and third layers, her lifestyle factors and social networks, the situation is equally as poor (Marks & Evans, 2005). She upsets the other patients by screaming and yelling, with the result that she has very little positive social contact with them. She
...Download file to see next pagesRead More
Alzheimer’s disease is a brain disorder caused by genetic history and/or lifestyle choices. It progressively diminishes a person’s ability to learn, communicate and reason. Also negatively affected are a person’s behavior and personality. They generally become increasingly agitated, anxious and delusional.
The disease leads to memory loss and confusion and affects nearly seven percent of the world’s old age population. The cause of the disease is unknown, but some researchers have linked it to neurometabolism, toxicology, virology and genetics. Ageing is a factor that triggers the onset of Alzheimer's disease, but it should be understood that this is not an ordinary ageing.
Recent studies have shown that approximately 4.5 Americans suffer from this progressive illness, for which a cure still has not been found. (http://www.nia.nih.gov/Alzheimers/Publications/adfact.htm)
There are various definitions for the Alzheimer's disease present on the internet.
All these problems do not affect person's capacity to hear and recognize new information, understand the meaning of the words addresses to this person, analyze the information, and carry out daily chores, as it happens with those who are from Alzheimer 's disease.
Memory loss is one of its earliest manifestations; however, other cognitive functions that are affected include orientation, comprehension, and calculating ability, learning capacity, language, judgement, reasoning and information processing (Draper, 2004).
However, a few cases have come to light where the patient was in his early fifties or even late forties. Approximately 24 million people worldwide are living with Alzheimer's (Ferri CP, Prince M, Brayne C, et al 2005). Estimates suggest that as many as 4.5 million Americans (ADERC-NIA, 2007) and 2.4 million Europeans suffer from Alzheimer's, which is considered to be the most wide spread form of Dementia in the human population.