250 to 300 words on Parkinson disease

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Jacopini, G. (2000). The experience of disease: Psychosocial aspects of movement disorders. Journal of Neuroscience Nursing, 32(5), 263-265. Retrieved from https://library.ashford.edu/ezproxy.aspx?url=http%3A//search.proquest.com/docview/2 19172994?accountid=32521 • • • This article reviews the impact on quality of life of degenerative disorders and psychosocial problems that can arise Accessibility statement (Links to an external site.)Links to an external site. Privacy statement (Links to an external site.)Links to an external site. Ray, R. A., & Street, A. F. (2006). Caregiver bodywork: family members’ experiences of caring for a person with motor neuron disease . Journal of Advanced Nursing, 56(1), 35-43. doi:10.1111/j.1365-2648.2006.03977.x. Retrieved from the EBSCOhost database in the Ashford University Library. • This article delves into the care of an individual with a degenerative disease. It also considers the needs of the caregiver. • • Accessibility statement (Links to an external site.)Links to an external site. Privacy statement (Links to an external site.)Links to an external site. Moore, K. A., & Seeney, F. (2007). Biopsychosocial predictors of depressive mood in people with Parkinson’s Disease. Behavioral Medicine, 33(1), 29-37. • • • This article examines the psychosocial correlates to depression in individuals with Parkinson’s disease. Accessibility statement (Links to an external site.)Links to an external site. Privacy statement (Links to an external site.)Links to an external site. SOC313 Family Document Throughout this class, we will meet two families, the Maldonado’s and the Olson’s. The two families are considered extended family via Sarah and Joe Miller. We will learn about their relationships, work environments, and the psychosocial effects related to health challenges faced by each family. You will use this document for the discussions and written assignments. We begin with the Maldonado family. Manny and Donna Maldonado have been married for 42 years. Manny is age 65 and Donna is 63. Sarah, Mike and Becky are the children of Manny and Donna Maldonado. Sarah is the eldest daughter, followed by her brother, Mike, and her sister, Becky.   Manny is Hispanic American and owns a 20,000-acre produce farm that has been in his family for three generations. Although Manny speaks and understands English, he prefers to speak Spanish. This creates a language barrier between Manny and other family members who do not speak Spanish. Donna is fluent in Spanish, having learned the language from Manny and his family. Donna works on the farm with her husband. She has long suffered from mood swings, which is mostly frustrating to Manny. He says it is “brujeria,” meaning her moods are caused by witchcraft and “mal d ojo” or “evil eye.” He believes someone put a spell on Donna. When this is believed to be the case, the person will visit a Curandero (healer) who will perform a healing ritual. o Sarah works as a nurse, and recently took Family Leave of Medical Absence (FMLA) due to her children’s recent issues. o Joe is the President of Illusion Technologies. Joe’s parents are John and Ella Miller. More details about Joe are shared in the Olson family section below.  Lucy, age 20, has a history of severe substance use disorder, along with having been diagnosed with bipolar disorder. In the past two years, Lucy has had four different jobs. o o o She is unable to hold a job long-term. She now works on her grandparent’s produce farm.  Josh, age 17, has been sneaking away with friends, smoking marijuana and skipping school.  Evan, age 10, was recently diagnosed with leukemia; however, he has not yet started treatments. Evan’s doctors have recommended chemotherapy, radiation, and a bone marrow transplant. Sarah and Joe intend to follow this treatment plan. Mike Maldonado is age 36. He currently works for a state University as a tenured faculty of the College of Agriculture and Life Sciences. Mike was recently diagnosed with HIV. Dan was Mike’s husband. He recently passed away at the age of 38 due to an AIDS-related illness. They were married for 10 years. Mike and Dan did not have any children. Becky is age 33. She is divorced and working on the family produce farm as well as attending a local college at night to complete her bachelor’s degree in Child Psychology. She has one child, Abe.  Abe is age 12. He is a good student, but his behavior has changed recently, showing anger and defiance towards both of his parents and several teachers at school. His mother, Becky, has been treating Abe’s behavioral changes with diet and alternative medicines. Next, we will meet the Olson family. Frederic Olson was married to Mary Olson. Mary passed away 10 years ago at the age of 77. Frederic is age 87. Ella is the only child of Frederic and Mary Olson.   Fredric has pronounced symptoms from Parkinson’s disease. He has tremors and balance problems, along with muscle stiffness and gait (manor of walking) changes. He struggles to begin any movement. However, once he is moving, he cannot stop easily. His gait has changed to smaller steps and shuffling. As he progresses through the stages of the disease, Frederic needs increasing assistance with his activities of daily living (ADLs), which entails bathing, dressing, food preparation, eating, taking medications, et cetera. He recently moved to an Assisted Living community and only leaves the facility for medical appointments. The family visits Grandpa Frederic on an alternating schedule at his new home every week. The Assisted Living community has regularly scheduled social events in which Grandpa Frederic actively participates. o Ella is married to John Miller. Ella and John are both 70 years old. John and Manny Maldonado are best friends. Ella and Manny grew up together on their neighboring farms. Ella and John recently sold their 10,000-acre farm to the Maldonado family since the two farms were adjacent to each other. o Ella has been trying to heal herself from breast cancer using a variety of natural means. She grew up on a farm and was accustomed to using home remedies. Therefore, Ella is not willing to utilize Western medicine practices. o While the alternative health care methods kept Ella in remission for a few years, recently she learned the cancer has returned. In addition, the cancer has metastasized to her lungs and bones. Ella has chosen to forego Western medical treatment options such as chemotherapy, radiation, and pharmacological breast cancer treatment medications. She has requested to live out her last days at home. Ella has agreed to be admitted to Hospice home care, with John as her primary caregiver. Ella and John are seeking quality palliative end of life care. o John, Ella’s husband, is of Native American origin. He is well educated and uses Western medicine, but relies heavily on Native American methods, such as meditation and banishing bad spirits from their home. John speaks fluent Spanish, having learned the language as a child. o John is an attorney for the Maldonado produce farm and his son’s company, Illusion Technologies. o John and Ella’s children are Sam, age 50, Lila, age 45, and Joe, age 43.  Sam is divorced and has no children. He works as a foreman on the Maldonado produce farm. He is an alcoholic and has been diagnosed with severe substance use disorder due to his alcohol addiction. His alcohol use is affecting his position as the foreman. Over the past few months, he has experienced emotional outbursts, missed work, and started arguments with the workers, third-party wholesalers, and Al Goldberg (Olson family).     Sam has been upset that his parents sold the family farm to the Maldonado family instead of passing it down to him. Lila, age 47, is married to Al Goldberg. She is a Social Worker for the state. Her job is very stressful as her caseload includes at-risk children. There is a great deal of documentation required; therefore, she works many 10 to 12 hour days. Lila is overweight and has Type II diabetes. She has not controlled her weight or diabetes well. Recently, her doctor changed her medication. She is now taking daily insulin injections to help manage her diabetes. Al, age 47, Lila’s husband, is the general manager of the Maldonado family produce farm. Al had first option for buying the Olson family farm. He opted out of purchasing the farm and agreed with the sale to the Maldonado family. He has no known health issues; however, due to an early childhood trauma, he is afraid of hospitals and funeral homes.  Alisha is Lila and Al’s only child. She is 20 years old and is currently attending college full time on a nursing scholarship. The college campus is an hour away from her parent’s home. She lives on campus in the dorms, does not work at this time, and has no known health problems. Joe, who is Sarah (from the Maldonado family) Miller’s husband, is the President of Illusion Technologies, a rapidly growing company with 50 employees. He has a patent pending on two security-based software programs that could be worth millions. He and his father are in negotiations to purchase land to build a state-of-the-art office building. Sarah, Joe’s wife, is a nurse and recently took a Family Medical Leave of Absence (FMLA) due to the health and behavioral problems with her children. Details about Joe and Sara’s children are shared in the Maldonado family section. The family members share a long history of friendship and love of farming. They have shared many life events, such as holidays, births, and deaths. Their families have been intertwined for generations through the raising of the children and grandchildren. For the most part, the families get along well. However, even though they share some of the same cultural traditions and backgrounds, they do clash from time to time. For instance, some of the Olson family members are not in full agreement with Ella’s use of home remedies and alternative treatments for her breast cancer. However, the Maldonado family understands and supports her choices. Further, Ella is encouraging Sarah Miller and Mike Maldonado to pursue Complementary and Alternative Medicine (CAM) to treat Evan’s leukemia and Mike’s HIV. The members of both families are dealing with very busy schedules and major health challenges. Degenerative Disease: Huntington’s Disease and Parkinson’s Disease 3 Juice Images/SuperStock Kenneth Lambert/Associated Press Learning Objectives 1. Compare the biological differences of two neurodegenerative diseases 2. Describe how a neurodegenerative disease affects different individual, familial, and social domains 3. Understand the different implications of an early-in-life diagnosis versus a later-in-life diagnosis 4. Demonstrate an understanding of medical management and treatment approaches for a neurodegenerative disease 5. Consider larger social issues that affect individual and family needs of those diagnosed with a neurodegenerative disease atL80953_03_c03.indd 65 12/3/13 3:22 PM Section 3.1 Introduction to Neurodegenerative Disease CHAPTER 3 3.1 Introduction to Neurodegenerative Disease “G eorge, you’re slumping. Sit up straight.” George was attending his niece’s wedding rehearsal dinner, and it was his younger brother Steve, the bride’s father, who scolded him. George’s wife Joan was both surprised and relieved. She was surprised that Steve would criticize George in public, but she had noticed George’s increasingly bad posture and was relieved that others in the family were aware of it and pointing it out to him. A chance discussion with a friend several months later gave Joan a clue to what was happening. Joan’s friend described changes in her husband, who had just been diagnosed with Parkinson’s disease (PD). They were quite similar to the changes Joan was seeing in George. After this breakthrough, it took another three months before they were able to see a neurologist who specializes in movement disorders. When they did, the diagnosis was confirmed at the first appointment. George and Joan were lucky—it often takes several visits to many physicians over many months to correctly diagnose PD, and George’s initial symptoms were not the classic ones. PD and Huntington’s disease (HD) are two of the three most common neurodegenerative diseases. (The third is Alzheimer’s disease, which is covered in “Psychiatric Conditions” in Chapter 7.) This first section examines the biological basis of physical, psychological, and social problems seen with these two degenerative diseases, as well as common misperceptions. The second section applies Bronfenbrenner’s system of human ecology to these diseases over the life span. The third section delves into treatment approaches, and the final section covers social issues such as testing, stigma, caregiver burden, and the continuum of care. Definition and Brief History In degenerative disease, the structures or functions of a particular body system, tissue, or organ deteriorate over time, leading to progressive disability. A wide range of disorders falls into this category, including osteoporosis (bone loss). In neurodegenerative disease, the neurons (nerve cells) in the brain are primarily affected, leading to dysfunction (loss of normal activity) and death of cells in specific areas of the brain. Examples include Alzheimer’s disease and other dementias, PD, prion diseases (induced misfolding of specific brain proteins), motor neuron diseases (Lou Gehrig’s disease [amyotrophic lateral sclerosis, or ALS] being the most common), HD, and several less prevalent ones. Although it is not clear what starts the process, the affected person begins to have symptoms as more and more cells in a particular part of the brain sicken and die. Symptoms of neurodegenerative disease can vary widely and depend on which parts of the brain are affected. For example, in one person, nerve cells in the part of the brain that controls movement, the motor center, might be affected, and that person develops tremor (involuntary trembling or shaking), usually in one limb. In someone else, the part of the brain controlling speech might be affected, making it difficult for that person to express ideas in words. Evidence shows that neurodegenerative disease is becoming more common. Between 1990 and 2010, the worldwide burden of neurodegenerative disease, which includes mortality, disability, and decreased life expectancy, has increased dramatically. Compared with 1990, the estimated number of deaths in 2010 attributed to PD more than doubled, and the number of deaths due to Alzheimer’s disease and other dementias more than tripled. As people live longer, more people reach ages when PD and dementias develop. As a result, more people are being diagnosed with atL80953_03_c03.indd 66 12/3/13 3:22 PM Section 3.1 Introduction to Neurodegenerative Disease CHAPTER 3 these diseases and dying from them, so the total number of people dying from PD and dementias has increased dramatically during the last 20 years. As a larger number of people are developing these neurodegenerative diseases, the total number of person-years (number of people multiplied by the number of years) lived with disability has increased (Lancet Neurology, 2013). In addition to being classified as neurodegenerative diseases, both HD and PD are sometimes considered movement disorders. Abnormal movement (also known as ataxia) is a major aspect of both diseases. This section compares and contrasts the biology of HD and PD and how the biology of each disease leads to various physical, psychological, and social problems. Table 3.1 contrasts the features of HD and PD side by side. Table 3.1: A comparison of Huntington’s disease and Parkinson’s disease Huntington’s Disease Parkinson’s Disease Autosomal dominant, genetically inherited disease 90% of cases are sporadic, meaning a chance outcome not due to a genetic cause Causes progressive movement, cognitive (mental), and behavioral symptoms Four major areas are often affected: the motor system, cognitive or thought changes, behavioral and emotional changes, and the autonomic nervous system In the United States, about 30,000 people diagnosed with HD; more than 250,000 others are at risk for having inherited it. Worldwide prevalence of 2.7 per 100,000 U.S. prevalence between 500,000 and 1,500,000, (second most common neurodegenerative disease after Alzheimer’s disease) Overproduction of the neurotransmitter dopamine is at least partly responsible for movement disorders in HD Dysfunction and death of neurons in the substantia nigra decrease the amount of dopamine available to simulate nerves in the brain’s motor regions, and this lack of dopamine creates motor symptoms Onset typically between ages 30 and 50 Onset usually during ages 50s or 60s Predictive testing available (more than 90% of people at risk for HD do not undergo genetic testing) No objective test for PD; diagnosis based on clinical observation Motor or movement symptoms often become evident in ages 40s or 50s Early symptoms include impaired sense of smell, constipation, REM sleep disorder, slow reaction time, excessive daytime sleepiness, and impaired executive function A progressive disease with no treatment that can slow down, stop, or reverse its course A progressive disease with no treatment that can slow down, stop, or reverse its course Classic motor symptom is chorea (dancelike, uncontrolled rapid and jerky body movements) Classic motor symptoms include tremor, rigidity or stiffness, bradykinesia, impaired gait, and postural instability or balance problems Treatment goals are palliative: to reduce symptoms, maintain functioning, and maximize quality of life Treatment goals are palliative: to reduce symptoms, maintain functioning, and maximize quality of life (continued) atL80953_03_c03.indd 67 12/3/13 3:22 PM Section 3.1 Introduction to Neurodegenerative Disease CHAPTER 3 Table 3.1: A comparison of Huntington’s disease and Parkinson’s disease (continued) Huntington’s Disease Parkinson’s Disease Speech and language therapy, extra nutrients, physical therapy, and drugs that treat symptoms (e.g., agitation, depression) only Drugs used to treat motor symptoms either directly replace dopamine, delay its breakdown, or stimulate its synthesis and release (combination of levodopa and carbidopa, which replaces the brain’s decreased dopamine production) Death from medical complications of the underlying neurological disorder often occurs 10–20 years after clinical diagnosis Mortality risk over 20 years approximately twice that seen in a population of people without PD Huntington’s Disease The condition we now know as HD was described in the medical literature in 1872 by the physician George Huntington. Many members of his family throughout generations seemed to have the same unusual disease. The disease was first called Huntington’s chorea, because of the dancelike, uncontrolled, rapid, and jerky body movements seen in people with HD (chorea is Greek for “dance,” from which we get the word choreography). The illness was renamed in the 1980s, when nonmovement symptoms (e.g., cognitive and behavioral) were recognized as central to its course. Genetic Role HD is an inherited disease that causes progressive movement, cognitive (mental), and behavioral symptoms. Eventually the person with HD becomes completely dependent on others for activities of daily living (self-care activities such as feeding, dressing, grooming, bathing, mobility, work, and homemaking). It usually causes death 17 to 20 years after symptoms appear (Roos, 2010). Unlike many inherited diseases, HD is autosomal dominant: Dominant means the presence of one copy of the defective gene with exces ...
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School: Carnegie Mellon University

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Parkinson disease does not only affect the person suffering from it but also hurts the
family members. When we look at Fredrick's family, there are potential effects that may be as
a result of this disease. For this instance, the fam...

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