Case Study Analysis: Chronic Illness Management in Healthcare

This case study examines the chronic illness of Mr. Smithton, who is diagnosed with Amyotrophic Lateral Sclerosis (ALS). The analysis explores whether the uncertainty surrounding his condition presents a danger or an opportunity, concluding it is primarily a danger due to the lack of effective treatments and the ethical and legal implications. The study investigates the use of Gold treatment for ALS, evaluating the credibility of information found in literature and online databases. It identifies factors contributing to Mr. Smithton's powerlessness, including his physical limitations, knowledge of his prognosis, and family stressors. Finally, the case study discusses actions a healthcare team can take to address Mr. Smithton's powerlessness by creating a supportive environment, promoting family involvement, and ensuring continuous evaluation and coordination of care. The analysis references various scholarly articles and emphasizes the importance of psychosocial support and a conducive physical environment for patients with chronic illnesses.

Running Head: CHRONIC ILLNESS MANAGEMENT 1
Chronic illness management
Name
Institutional Affiliation

CHRONIC ILLNESS MANAGEMENT 2
Chronic illness management
Question one
In reference to Mr. Smithton's Amyotrophic Lateral Sclerosis case in Kramer-Kile et al.,
(2014), it is not wise to conclude whether the associated uncertainty is an opportunity or a
danger. However, to a large extent, it can be regarded as being a danger because of the associated
complication, whose treatment and cure are medically not a possibility according to (Noh et al.,
2010). The uncertainty associated with Mr. Smithton's disease leaves him with no practical
solution to overcome the disease and places Ms. Mason into a position where she has to go
against the nursing code of practice to sanction a Gold treatment given the close relationship that
she has with the family (Wigert & Bry, 2018). Moreover, any action would be associated with a
legal implication in the case of third party intervention. His wife Patricia is further placed in a
situation where she has requested for a leave to take care of the husband given his condition. Any
attempt to avail Mr. Thomas with treatment that would improve the quality of his life presents
with dangerous implication for Ms. Mason. Therefore, all the ethical issues, legal, financial
implications, and family tremors that are as a result of Mr. Thomas's uncertainty create danger
for the associated parties. It is therefore wise to note that the case is not an opportunity but a
danger. The feasible opportunity, in this case, is applying a Gold treatment, which would offer a
better life even though to be administered, it present quite a number of ethical and legal
implications. Thus, concluding that the uncertainty creates more danger that opportunities in the
above case. In comparison with the current literature, Bojanowska, Zatorski, Gazdowska &
Durlik, (2017) assert that, uncertainty is a common characteristic among most of the chronically
ill patients. Moreover, mist if the associated complications or uncertainties present with negative
impacts on the victims.

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Question two
According to Gordon, (2013), ALS is a disorder the comes with age and results in motor
neuron degeneration. Most patients die in about 3 years after the onset of the disease due to the
weaknesses associated with the respiratory system. The disease has no cure, but there are
therapies that are symptomatic aimed at improving the quality of the patient's life and having it
extended. However, one of the treatments that are widely considered to correct some of the
disabilities in ALS is Gold treatment (Gordon, 2013). It is asserted that lack of Gold in the body
renders it unable to effectively replenish all the muscle forces associated with the nerves.
Moreover, according to the author, Gold deficiency makes the body unable to nourish the inside
of the horn cells associated with the brain. Therefore, with the Gold treatment for patients with
ALS may somewhat correct the neurological disorders it present with among the patients. Keaton
(2012), further recommends that Gold treatment has somewhat proved to be one of the
treatments for ALS. Therefore, it is clear to note that the information found in the above articles
emphasizes the fact that Gold treatment is a practical therapy that helps to correct some of the
neurological conditions that are associated with ALS patient (Sakowski, Schuyler & Feldman,
2009). Most of the information provided is credible given the experimental design of the
provided information along with the number of scholars that have been consulted to reach the
different conclusions in the articles.
Question three
Smithton's powerlessness is largely associated with quite a number of factors that range
from his inability to perform the different duties that he used to engage in before being attacked
by the illness. The first factor is being unable to perform his normal duties like he used to before

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being attacked by the disease. Being unable to feed by himself, using a motorized wheelchair,
closing of his business, being on quite many treatments and rehabilitation endeavors, among
others create an undesirable environment for him and thus leading to powerlessness (Foley,
2011). Secondly, knowing that the chances of surviving death are very minimal to none, no
matter all the involved struggles. The above leads to depression which is the main causes of
powerlessness that Mr. Smithton presents within his current medical condition (Foley, 2011).
The above weakens a patient that never had a record of illness and complied effectively with the
medical examination. Thirdly, as a family head, the stress of his close children, wife, and
relatives and the kind of model life that he left up the time when he could no longer perform his
daily activities are some of the other factors that increase his powerlessness(Foley, 2011). His
thoughts of being unable to fend for his family is an issue that creates a depression state, leading
to powerlessness. In comparison with the current literature, Simukoko, Mulenga &
Mwanakasale, (2017) assert that powerlessness is common characteristic that is associated with
most chronically ill patients. Moreover, it is a common characteristic among most chronically ill
patients due to the stress and depression associated with the recovery process.
Question 4
One of the most severe characteristics of patients that are associated with chronic illness
is exhaustion, being overwhelmed, and feeling discouraged. It is therefore important that as a
healthcare team, strategies the help to overcome powerlessness feeling are formulated.
Therefore, relevant and appropriate interventions which are based on the current observations
and assessments of the patient in his environment. This needs to be done in the manner that helps
the patient to cope and manage the illness. Therefore, the first action is ensuring that
psychosocial life dimensions are availed along with a very conducive physical environment for

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the patient (Soundy & Condon, 2015). The patient needs to be evaluated continuously in order to
modify the interventions being used to cope with the current requirements of the patient.
Secondly, it is also important that loneliness is avoided by advocating for an increased family
bond from the rest of the family members to help the patient cope with his sickness with limited
thoughts of agony(Soundy & Condon, 2015). As member of a healthcare team, it would be
prudent to ensure that all the factors that could lead to powerlessness in the patient are
eliminated. Thirdly, Soundy & Condon, (2015), further assert ensuring that continuous
evaluations to modify the patients needs effectively is done and ensuring proper coordination of
all the healthcare team to ensure that they perform their due task, it will, in the end, help the
patient to effectively cope with the illness. This would help the patient to cope with the illness
with no much stress and psychological depression. The current literature on the support needed
for chronically ill patients,Teston, Silva, Garanhani & Marcon, (2016) stipulate that it is vital to
critically conduct assessment of the patient from time to time in order to avail the best therapy
and recovery environment. Moreover, it is prudent that the patients are provide with psycho-
support and the best physical environment, along with ensuring that they are not left to be lonely.

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Reference
Noh, E. J., Park, M. I., Park, S. J., Moon, W., & Jung, H. J. (2010). A Case of Amyotrophic
Lateral Sclerosis Presented as Oropharyngeal Dysphagia. Journal of
Neurogastroenterology and Motility, 16(3), 319–322.
http://doi.org/10.5056/jnm.2010.16.3.319
Teston, E., Silva, J., Garanhani, M., & Marcon, S. (2016). Early hospital readmission in the
perspective of chronically ill patients. Revista Da Rede De Enfermagem Do Nordeste,
17(3), 330-337. doi: 10.15253/2175-6783.2016000300005
Wigert, H., & Bry, K. (2018). Dealing with parents' existential issues in neonatal intensive care.
Journal Of Neonatal Nursing, 24(4), 213-217. doi: 10.1016/j.jnn.2017.09.002
Kramer-Kile. M, Ousuji. J, Larsen. P, Lubkin. I. (2014). Chronic illness in Canada Impact and
Intervention, Jones & Bartlett Learning.
Keaton E. (2012).ALS Potential Cure? The Effects of Cayce Alternative Medicine Treatment
and Other Treatment on the Neurological Problems of One Person: Possible Implications
for ALS and Other Neurodegenerative Diseases[Internet]. Version 25. Available from:
https://alternativemedicineinformational.wordpress.com/article/als-potential-cure-the-
effects-of-alternative-medicine-treatment-on-the-neurological-problems-of-one-person-
possible-implications-for-als-and-other-neurodegenerative-diseases-2/.
Gordon, P. H. (2013). Amyotrophic Lateral Sclerosis: An update for 2013 Clinical Features,
Pathophysiology, Management and Therapeutic Trials. Aging and Disease, 4(5), 295–
310. http://doi.org/10.14336/AD.2013.0400295

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Simukoko, D., Mulenga, D., & Mwanakasale, V. (2017). Prevalence and correlates for stress
among caregivers for chronically ill patients at Ndola teaching hospital. Asian Pacific
Journal Of Health Sciences, 4(3), 107-111. doi: 10.21276/apjhs.2017.4.3.18
Soundy, A., & Condon, N. (2015). Patients experiences of maintaining mental well-being and
hope within motor neuron disease: a thematic synthesis. Frontiers in Psychology, 6, 606.
http://doi.org/10.3389/fpsyg.2015.00606
Bojanowska, A., Zatorski, M., Gazdowska, J., & Durlik, M. (2017). Adherence to treatment
among chronically ill patients. Polish Psychological Bulletin, 48(3), 380-387. doi:
10.1515/ppb-2017-0044
Foley, G. (2011). The complexity of care in amyotrophic lateral sclerosis. Amyotrophic Lateral
Sclerosis, 12(3), 160-161. doi: 10.3109/17482968.2011.554556
Sakowski, S., Schuyler, A., & Feldman, E. (2009). Insulin-like growth factor-I for the treatment
of amyotrophic lateral sclerosis. Amyotrophic Lateral Sclerosis, 10(2), 63-73. doi:
10.1080/17482960802160370