Holistic Patient-Centered Care for Ratin: Evaluating Outcomes and Reflection

The assignment content discusses the evaluation of outcomes for a patient with Parkinson's disease named Ratin, focusing on his mobility, mental status, and medication management. The report reflects on how nurses can provide patient-centered care to Ratin using Miller's functional consequences theory, emphasizing the importance of clinical reasoning cycles and goal setting. The summary also highlights the need for increased social support, proper medication management, and patient education to enhance Ratin's quality of life.

Running head: CASE STUDY OF MR. RATHIN BHAI
Case Study of Mr. Ratin Bhai
Name of the student:
Name of the university:
Author note

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CASE STUDY OF MR. RATHIN BHAI
Introduction
The clinical cycle is a form of tool that are been used by the professionals of the healthcare who
are residing in the states of Australia. The tools are there for helping the nurse for assisting
them for the reasoning for the clinical aspects, judgement that drawn from the clinical
background, solving the problems, making proper decisions and applying the proper clinical
way to think. Following this process the nurse follows the sequential form of the patterns for
collecting the important clues about the patient that helps them to process the information for
having a better form of understanding the actual condition of the patient. It somehow also
helps the patient for planning and implementing the proper form of the implementing the
interventions that are followed by evaluating the outcomes and then reflecting the procedures
for developing the skills and the various forms of the knowledge (J.E:, 2014). This assignment
thus focuses on the nurse using the effective cycles for handling effectively the case of
Parkinson’s disease and how the sequential form of the procedures are helpful for providing a
better form of life to the patients.
Basic Information of the Patient
This step helps the nurses to list the possible information about the patient.
The name of the patient is Mr Ratin Bhai who is 87 years old and who resides in Australia. The
major problem with which Ratin Bhai has been hospitalized is Parkinson’s disease. He has been
having Parkinson’s disease since four years and was diagnosed with hypothyroidism since the
same timeframe of four years. He is widow and lives in his two-storey house alone. He is an
independent man after the death of his wife and handles all his day-to-day activities. However,
with his present physical condition, he is having various problems while doing all his household
chores. Ratin has small amount of income that is managed by him and he is very much careful
with his money. The independence of Ratin is somehow getting disturbed due to the constant
tremors that he is having in both the hands. This is restricting him to do daily activities like

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cooking, making a cup of tea or doing his own buttons and laces of the shoe. Therefore, Ratin is
now worried that as his condition has worsened how he able to survive in the future.
Process Information
This step includes the interpretation and analysis of the information of the patient that is
collected from the various signs and the symptoms and discriminate them based on the
information that are required and that are not required.
This process is then followed by relating them and to infer them from the opinions and then to
match them with the situation of the patient and therefore to predict the outcomes for the
patients. It is the duty of the nurses to check that whether the patients are taking their
medicines in the appropriate time or not (J.E:, 2014). The current problem Ratin Bhai is that his
tremors in both the hand have increased in a huge amount and his symptoms suggests that his
tremors are result of various medical problems and not due to his negligence in taking the
medications (Canning, et al., 2015). However, by relating it with the knowledge of the nursing,
the nurses should be able to match the symptoms of the diseases that suggest that what the
main reasons are for the condition of the patient.
It has been observed that a large number of patients who have aged have the tendency to
encounter various physical problems that can include the tremors in the hand, shaking in the
limbs and as a result of this the handwriting of the individuals also changes and it can affect the
lifestyles of the patient. The patient can also go through the loss of sensations and other
problems of dizziness. The above are all the several symptoms of Parkinson’s disease (Canning,
et al., 2015). However, it has been encountered that the patient has been undergoing
Parkinson’s disease past four years. It has been found that the patient is suffering from
problems in mobility, tremors in the hand that is the common symptoms of Parkinson’s disease.
Identification of the problem of the Patient
In this case, it can be observed that Mr. Ratin Bhai is suffering from Parkinson’s disease. This
disease is generally caused due to the destructions of the neurons that may cause the death of
the nerve cells (Dalton, L., Ge, Levett-Jones, & T, 2015). Therefore, due to the death of the

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CASE STUDY OF MR. RATHIN BHAI
neurons negatively affects the production of the chemical messenger known as dopamine.
Therefore, the decrease in the production level of the dopamine in the brain increases the
abnormal activity of the brain (Hunter, Arthur, & C, 2016). However, this phenomenon causes
Parkinson’s disease. The major cause of such disorder is age. This problem is majorly begins
during the middle and old ages and the amount of risks increases with the age. Another major
cause of the disease is the gender of the patient. It has been observed that Males are prone to
this form of disease. However, it is the sole responsibility of the healthcare professionals and
the nurses to develop a nursing care and give proper medications for improving the conditions
of the patients (Kuipe, R., Pesut, Arms, & T.E, 2016).
Establishing goals
According to the functional consequences theory of Miller, older adult patients are to
experience functional consequences due to old age. The consequences are due to age related
factors and risk factors for health complications arise in addition to this. Without interventions,
functional consequences are more commonly negative. If appropriate interventions are
provided, the consequences are less drastic. For implementing the suitable interventions that
make the functional consequences positive, nurses must establish patient centred care goals
that can deter the negative outcomes to a considerable extent (Alligood, 2014). In case of Ratim
bhai, the main nursing goal would be management of Parkinson. Parkinson disease has drastic
impact on the patient’s functional ability as patients suffer tremor in hands and have slowness
of movement. Postural instability is also an additional problem (Safarpour, Boyd, Dorsey,
Racette, & Willis, 215). In the present case, Ratim Bhai suffers tremor in both hands and have
altered mobility. The second goal would be to provide social support to the patient. Ratim Bhai
is found to live alone at his home with no immediate social support. According to (Banbury,
Chamberlain, Nancarrow, Dart, & Parkinson, 2017) social support is significant for patient at old
age. For patients living independently, it is crucial that a form of support in physical presence is
present. The third nursing goal would be medication management as medication management
for elderly patients is a common issue and Ratin Bhai is to follow a medication regimen on a
daily basis.

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CASE STUDY OF MR. RATHIN BHAI
Take action
The nursing action that is to be taken on a priority basis is to combat disturbed thought process
of the patient. The patient is to be assessed for depressive behaviour and orientation. This is
pivotal since depression is common in patients suffering from Parkinson’s disease. Since the
patient is currently given three medications, it is necessary that the misuse of these drugs is
avoided by assisting the patient with the side-effects. Impaired physical mobility i a concern and
limitation in independent movement is to be addressed. The patient is to be instructed with
methods that can initiate movement. In addition, the patient is also to be instructed to move at
different positions, such as placing hands on supports, getting out of chair, bending forward and
standing or sitting in a particular position. Parkinson disease is a cause of rigidity tremors and
altered mobility that takes a toll on the quality of living of the patient. Ratim Bhai can be
instructed to perform daily exercises that would help in increasing muscle strength. The
rationale is that exercise prevents contractures and brings improvement in dexterity and
coordination. The patient can also be assisted with warm baths and helps in relaxation of
muscle spasms (Potter, Perry, Stockert, & Hall, 2016).
For addressing the need of social support, the patient can be referred to a social support group
whose representative would come at Ratim’s home to provide him with the services. A strong
social support helps in addressing the long-term emotional impact that Parkinson’s disease has.
Research highlights that support from informal sources are significant in patient outcomes and
thus Ratim’s family members living nearby are to be engaged in the care process for him. They
are to be educated on the implications for patient care for this disease and must be motivated
to extend help for Ratim’s care (Ghorbani Saeedian, et al., 2014).
Since medication management plays an important role for the patient care, appropriate steps
are to be taken to ensure that strict adherence to medication regimen is there. The patient is to
be provided with a medication box with that covers all medications to be taken. A medication
chart is to be made that placed near the medication box for the patient to follow. An
automated reminder for can be set with such devices so that no medication is missed. The

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CASE STUDY OF MR. RATHIN BHAI
patient is to be educated on the side effects of the drugs so that the patient can be aware of
the consequences that might arise (Lindblad, Flink, & & Ekstedt, 2017).
Evaluation of outcomes
It is expected that after the nursing interventions proposed are implemented in practice, the
patient outcomes would be better. Evaluation of mobility of the patient can be adjudged by
reduced tremors and increased ability to perform daily activities of living. Impact of increased
social support would be reflected through enhanced mental status. Lastly, proper medication
management would eliminate the chances of mismanagement of medication and ensure
patient education of the implications of the medications (Potter, Perry, Stockert, & Hall, 2016).
Reflection
From this report, I have learned that nurses can provide the holistic patient centered care to
Ratin by following Miller’s functional consequences theory. The Miller’s consequences theory
will allow the nurses to give them the wellness to older adults like Ratin. To increase the life
expectancy, the disciplines of the nurses would help them take the principles of clinical
reasoning cycles to collect information of the patient, process the information and predict the
outcome. Finally, I have understood the correct strategy to provide the patient centered care
and establish goals accordingly followed by the evaluation. I also have learnt that medication
management which is the most important step that the nurses must take in order to set up
their intervention goals. The nurses can use the recent technological systems and survey plan
followed by statistical analysis to help Ratin get the best quality care services. I now have the
knowledge of strategies that could be taken to manage Parkinson disease. Next time I can take
more steps accordingly to enhance and improve the quality of care for Ratin and help him
manage the conditions of Parkinson disease.
Conclusion
The report would reflect upon the ways the nurses can take in order to provide the patient
centered care to Ratin. Ratin would be provided with special care for Parkinson diseases as the

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CASE STUDY OF MR. RATHIN BHAI
nurses follow the Miller’s functional consequences theory. The theory would help nurses take
strategies like clinical reasoning cycles to get to the stage of a quality provision of health care to
only one patient. The clinical reasoning cycle has identified the problems of Ratin like a financial
crisis, he lives alone he has Parkinson disease and is also having problems regarding medicinal
management. The interventions and goals would be set accordingly to increase the
coordination and integration of clinical care.

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CASE STUDY OF MR. RATHIN BHAI
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