Question

ournal Entry Part 2

For the second part of your journal entry, reflect on geriatric patients from your practicum site with disorders related to specialized areas of care, such as oncology, nephrology, urology, gynecology, and neurology. Describe a case of a frail elder patient who must make decisions related to specialized areas of care. Then, explain potential patient outcomes and include whether treatments would be beneficial and how they would impact the patient’s quality of life. Finally, describe the patient’s wishes in terms of treatments and interventions for the disorder (Was there an advanced directive?) and how the patient might want to spend any remaining time. Include how environmental factors, such as family, caregivers, ethnicity, culture, religion, and/or personal values, might impact decision making for treatments and interventions. If you did not have an opportunity to evaluate a patient with this background during the last 9 weeks, you can select a related case study or reflect on previous clinical experiences.

Answer 1

As the journal has a choise of the diseae condition related to various system here i m choosing the neurology and the condition is dementia . Dementia is a classic condition which we can see in the elderly group people widely across the globe.

Dementia is a age related irriversible degenerative disorder which often cause memory impairments. Dementia can be treated but can not be cured completely.

Symptoms: symptoms of dementia can vary from memory impairment to visual perceptions. Usual symptoms are

- forgetfulness

- anger

-aggitation

- inability to pay attention

- depression

- difficulty in daily living activities

- improper gaits

Dementia often combines with Alzheimer's disorder or a effect of it .

Potential outcomes: potential outcomes totally depends on the cause of dementia ex. Alzheimer's dementia , vascular dementia or Parkinson's disease. But prognosis of dementia is mostly poor .

Reseach have shown that in case of vasular dementia may seems to improve untill the next stroke ake away more brain functions.

Dementia also decrease the persons ability to cope with the infection and physical ability. So it also knows as 'life limiting' disease.

In case of Alzheimer's dementia there is no cure or treatment to slow down the process.

In pharmacotherapeutic aspect the alzheimer's drugs can be used to treat dementia inorder to achive a temporary improvements. Examples:

cholinesterase inhibitor (work by boosting chemical massenger involved in the memory and judgement.

Memantine which regulate the glutamate's activity which take part in brain activity of learning and memory.

In others treatment can be symptomatic.

Non-drug approaches: it includes psychotherapies . Therapies help the patient to bring some behavioural changes. Examples

Occupational therapy often help the person to over come the depression , modifying the enviroment provide a sence of independency and modifying the tasks reduce the confusions.

Role of the caregivers ( family & nurses):

1. Encourage the person's communications. The sudden changes in the memory often gives the depression and may increase the risk of suicide. Help the person to ventilate his/her feelings and help them to accept the disease process.

2. Encourage for exercises : yoga and meditation increase the mental peace and help in concentration in a better way.

3. Encourage the person to carry a calender and a note book : it helps the person to get oriented about the time place and person. They can easily follow their daily activity by cheaking with the note books and can write down the new things.

4. Establish the night time routine : tell the person to avoid use of any electronic gadget minimum 30 minutes before going to the bed. Night time prayer helps to full fill the spiritual need. Keep the night lamps on to avoid the confusions about the way to the bathroom or kitchen. Provide a bell to the patien and keep a note near by to use it in emergency.

5. Reseach have shown pet therapy, music therapy, art therapy and use of essential aroma oils in daily life lead to to a greater changes in quality of life of dementia patiens, the rate of suicide and cardiovascular diseases has reduce remarkably.

6. Spending time with family one helps the person to feel safe and loved .