Person-Centered Care - PDF

Person-centered care
Student’s name
Professor’s name
Institution affiliation
Date
Relevance of Issue PHC Nursing Ix Evidence Based Practice Rationale Referral
Issue One: Impact of Diagnosis
Parkinson's disease (PD) is 1a. The nurse has to stay close to 1b. For example, the patient would relate WHO: A GP and pharmacist.
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a debilitating and a complex
condition that needs an
individualised nurse care fitted to
symptoms and improves the life.
The disease affects mostly old
people of over 60 years old. The
effect of Parkinson's disease are
both motor and non-motor
symptoms makes it difficult for
the patient to undertake his or her
daily living activities. Parkinson's
disease is known to be a
movement disorder as it impairs
movement. What it causes is
known to be a result of
insufficient dopamine which is
produced by the death of nerve
cells in the brain. Change
becomes slower in the absence of
Patrick's environment to monitor
and manage instances like sleep
disorder. At early stages of the
disease, sleeping disorders have a
significance on caregivers and also
to the patient's nurse. The moods
and other influential effect reveal
the fundamental issues of distress
and depression which interferes with
quality sleep.
Clear communication is a
factor to consider when handling a
Parkinson's disease patient. Asking
the patient about rigidity, stiffness,
balance, tremor and slow movement
is very important. The language in
which a nurse uses in asking such
questions matters a lot (Wildevuur
& Simonse, 2015).
the term "shake" with the term tremor of
"feeling dizzy" with "falling backward".
Old people like Patrick lose their balance
quickly especially when they stand up or
stand for too long. It is the role of the
medical practitioner to know if the patient
feet become stuck when he is trying to
walk if he feels stiff, achy or is
experiencing any pain while moving.
Asking readily obvious questions assesses
the motor symptoms and provides
significance effect on daily functions.
Referring a patient for further medical
treatments and instructing him and his
family to prefer shoes with even gliding
soles to shoes that are tricky and sticky to
the floor (Olde-Rikkert, Long, & Philp,
2013). Good communication enables both
the patient and family members to
WHY: For Patrick’s clinical management.
Accurate diagnosis, initiate treatment and
devise a treatment plan. A pharmacist to
help Patrick on the medicinal prescription
and advice on any change in dosage
according to the disease conditions.
WHEN: At the early stage of Parkinson’s
disease.
HOW: Booking an appointment as the
patient’s condition is not too severe.
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dopamine. Such a case affects the
patient's personal and social duties
a lot (Halter, 2017).
Medication is the best
option of treatment in such a
situation in which Patrick has just
commenced to medicines like
levodopa 500 grams three times a
day and clonazepam 0.5 grams
nocturnal. The disease affects
person's emotional, mental and
physical wellbeing and it brings
impact to one's lifestyle. Due to a
wide range of service needed for
Patrick's care regarding his age
and the disease condition, a nurse
specialist is required to act as a
coordinator of Patrick's hospital
understand and have a knowledge of
disease progression.
2a. In medication considerations,
registered nurse should ensure the
patient take medicine prescribed by
the pharmacist and guide him to
avoid the risk of forgetting. The best
way for Patrick to prevent further
complications or side effect is to
follow the pharmacist medical
instructions.
2b. The nurse should adjust the
medication timing to help in eliminating
troubling symptoms. It's always
recommended to ask the patient about the
type of medications that useful in
managing rare case like trembling for
example levodopa (Kuntz et al, 2014).
3a. The nurse is supposed to
evaluate and examine the feeling of
Patrick after his physical exercises
(Young, Miyamoto, Ward, Dharma,
Tang-Feldman, & Berglund, 2014).
Running 5 kilometres a day is a
3b. The timing of a PD medication about
physical health exercises according to the
age of the patient helps in achieving
maximum benefits from the program. As a
nurse, one's supposed to seek for a senior
exercise program in the community
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and community services. Patrick
needs a GP and pharmacist
intervention to provide with all
essential primary healthcare
services.
good physical exercise to Patrick.
The nurse has to find some
companions or some people most
probably his husband or age mates
to encourage and accompany him in
such running activities. The purpose
of running mates is to help Patrick
on the way in case of any arising
complications. A particular study
showed that in the middle if
Parkinson's disease moods and
motor functioning can be improved
through sports activities.
recreation centres to promote specialisation
and give the caregivers and the family a
relief. The referral is necessary to a
Parkinson's patient if the symptoms
management are at optimum and are not
easily controlled through nurse close
contact interventions with the patient.
Patrick's husband who is very supportive is
made aware of the referral to be
responsible (Hibbard & Greene, 2013).
4a. In such a case of Patrick
condition, the role of the nurse to
use Parkinson's disease Rating Scale
for assessment and plan and
document on the care required. It is
the nurse specialist to have direct or
4b.. A nurse plays a role in primary
healthcare intervention by providing
emotional support and when necessary see
the patient to a professional counsellor.
Well, documentation and planning
strategies help the nurse in planning the
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indirect contact with Patrick
behaviours from the time of
diagnosis to the time of palliative
care.
essential care and quality healthcare
services. Treatment starts with accurate
assessment (Entwisted & Watt, 2013).
Issue Two: Safety Considerations for Patrick
In helping a Parkinson's patient,
the health professionals need to
work and be collaborative as a
multidisciplinary team. The
condition of Patrick where he is
experiencing symptoms of slight
tremor, poor sleep quality and
decreased the sense of smell
require a registered nurse for
proper monitoring and medication
purpose. Other effect that a PD
patient experiences are
depression, anxiety and cognitive
impairment and they require a
5a. A Parkinson's disease patient
experiences depression. It occurs
both at early and advanced stages of
the disease resulting in significant
disability. The fundamental way of
managing depression in a PD patient
include; counselling of both
caregivers and the patient and
involving non- pharmacological
interventions. Use of Parkinson's
disease (PD) medication with the
antidepressant ability is
recommended.
5b. In a randomised study, it was
shown that dopamine agonist pramipexole
evaluated in a 12- week control PD patient
depression conditions. Nefazodone and
venlafaxine are some of the antidepressants
that are recommendable to Patrick
condition. If the situation becomes severe
or resistance to depression, he is referred to
higher medical practitioners.
WHO: Psychiatrist
WHY: Psychiatrist helps the Parkinson’s
patient who has mental problems such as
dementia, depression and anxiety.
WHEN: The best time to refer the
Parkinson patient to a psychiatrist is when
a nurse notices some change in cognitive
behaviour and emotional effect.
HOW: The patient has visit the doctor so
transport arrangement are done through a
local transport vehicle according to
financial capability of the family.
6a. Anxiety experiences of 6b. Exercise daytime napping is
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specialist care such as registered
nurse to help the patient in
management and control.
Parkinson's disease range in
seriousness from mild to full-blown
attacks. As in Parkinson's patient
with depression, non- pharmacology
intervention such as cognitive,
counselling and behaviour therapy
are given the considerations.
discouraged. Little exercise programs the
PD patient with insomnia. The condition of
Patrick as it advances to Excessive
Daytime Sleepers (EDBS) and sudden-
onset slumber hurt the quality of his life.
There is a need to encourage him and his
family to seek constant assistance advice
from consulting neurologist. The presence
of several disorders alarms Patrick to halt
his job as a primary school teacher to
maintain his health. It is because PD
patient does not require strenuous exercises
(Brownie & Nancarrow, 2013).
Referring the patient a psychiatrist
counsellor to help Patrick in cognitive
behavioural therapy such as anxiety is the
best way of handling the emotional effect.
This can be achieved through assessment
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of the carers needs.
7a. Cognitive impairment and
dementia which are likely to affect
Patrick brought significance effect
on occupation and social activities
and increased a burden to the
caregiver.
7b.One research has shown that dementia
of PD is heterogeneous which reflect a
wide range of cognitive deficits. Art
therapy, music and cognitive therapy in
connection with physical activity are some
of the non-pharmacological interventions.
The study report showed that 50-mg dose
in nocturnal sleep time improves the
overall sleep quality by 5-mg dose. No
taking of caffeine at evening and after
menus (Olsson, Jakobsson, Swedberg, &
Ekman, 2013).
8a. Patrick tremor condition can be
execrated by Acetylcholinesterase
(AChELs). While offering treatment
with (AChEIs), a Parkinson’s
practitioner has to ensure careful
monitoring of some adverse events
8b. The Parkinson's condition includes
problems with planning, working
memories and learning. Patrick does
experiences sleep disorders, ocular
movement and acting out of dreams (Gil-
Montoya, de Mello, Barrios, Gonzalez-
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and worse motor symptos. Patrick's
neurologist recommended his to
start using levodopa 50mg three
times a day, and clonazepam 0.5 mg
nocturnal carbidopa and placebo are
both administered during bedtime
improves nocturnal akinesia and
increase sleep time.
Moles & Bravo, 2015). In a study non-
significance increase in the sleeping period
due to hypnotic agent eszopicion and
placebo. It was found that the quality of
sleep and the number of awakening were
improved by eszopiclone group.
Issue Three: Maintaining Patrick’s Dignity
. The disease lowers the dignity of
an individual as it results in
different family problems of life
such as loss of occupation, marital
conflict, social isolation, low
income and early retirement.
Also, the PD progress brings
about a burden to the patient and
the caregivers. Relevance
databases have been assessed to
9a. Parkinson's disease is involves
several management actions: self-
centred care, interdisciplinary and
multidisciplinary care, palliative,
patient-centred care and
personalised care. It is advisable to
engage the patient of social media
groups such as Facebook that
discusses about Parkinson’s disease
for him to be more aware. The nurse
9b. Motor disabilities can restrain
the patient from physical activities together
with motor symptoms they worsen the
quality of someone's life. In case of
Patrick's sleep disturbances, studies shown
that melatonin supplement is used to the
treatment of Patrick ( Quill & Abernethy,
2013).
WHO: Dietician and occupational
therapist.
WHY: Dietician encourages the patient on
measures and nutrition-related challenges.
Occupational therapist advises the patient
on the way that Parkinson’s disease affect
one’s everyday life. He or she provides the
carers of patient on support information
and advices.
WHEN: Dietician is important when the
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investigate the appropriate
document on active aging in
neurogenerative disease notably
Parkinson's disease. PD symptoms
such as depression, anxiety and
stigma affect social interaction
and communication of the patient.
should encourage Patrick to
Participate in planned senior
community recreation activities. The
nurse has to direct and give
instructions on how the patient
engages in sport activities to avoid
any harm (Hiremath & Mankodiya,
2014, November)..
patient age requires more clinical
intervention and has shown eating or
swallowing difficulties.
HOW: Booking an appointment with such
professional is the best way due to the age
of the patient. A Parkinson’s disease has to
request for therapist and organize on
transportation means for the required
therapist.10a. As a community nurse it is
important to consult some
community organisations that deals
with activities of chronic disease
management like In Patrick's
situation (Ballard, Aarsland,
Francis & Corbett, 2013).
Organising with men’s community
groups or Parkinson’s clubs to help
Patrick in socialising activities.
10b. According to the notion of old age it
is revealing to have a well-planned,
protected and secure evidence-based care
for PD patient whenever they need. The
healthcare system is supposed to have well
planned, protected and reliable evidence-
based care for PD patient to assist them in
improving the potential physical activities
(Dorsey et al, 2016).
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11a. As a nurse, it is essential to
encourage Patrick and his family to
believe in religious guide power.
11b. Spirituality can give a PD patient
strength and hope of improvement to their
mental wellbeing. Recent research has
shown that patient with PD often relies on
religion and spirituality to aid them in
coping with physical illness (Reuben et al,
2013).
12a. The nurse should refer Patrick
to a dietary specialist for diet
consultation to give a guide and
recommend the best diet that
improves his life. The dietician will
identify on how to minimise some
cases like difficulties in swallowing
and eating. Dietician will educate
Patrick on the importance of foods
12b. Malnutrition is a prevalent factor
shown in PD patient and patient is at high
risk of being malnutrilised. At a time of
severity in PD patient where the patient
lacks supports at the workplace chances of
retirement lead to the early retirement of
Patrick. Patrick's family and employer at
early stages of the disease had to cope with
his condition as he intends to continue with
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like increasing vegetables, fibre,
fruits and fluid intake which reduces
constipation.
his job before advised to retire by the
neuropsychiatric (Tan, Vehviläinen‐
Julkunen, & Chan, 2014).
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Running head: PERSONAL-CENTERED CARE
12
References
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PERSONAL-CENTERED CARE 13
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PERSONAL-CENTERED CARE 14
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