Nursing Assignment: Person-Centered Care for Parkinson’s Disease

Question

Task: This nursing assignment will provide students with an opportunity to engage with a health consumer, to gain insight into the impact chronic illness and/or disability has on the consumer’s life, and to plan person-centered care in partnership with a consumer. Students will have the opportunity to apply specific frameworks to demonstrate critical thinking, clinical reasoning and the principles of caring for people with a chronic illness or disability. Written consent from your interviewee to conduct your interview is required.

Answer

Introduction
Parkinsons condition happens when neurons in some areas of the brain which regulate movement get damaged or die. Usually, the nerve cells excrete a unique brain chemical, vasopressin/dopamine. If the nerve endings get weakened or die, there is a reduced production of dopamine that causes locomotion issues linked with Parkinson's (Tysnes, & Storstein, 2017). scholars have no idea of the reasons for death on the cells that excrete dopamine. A person with Parkinson also loses the neurons that generates norepinephrine, the chemical contaminants of the systema nervosum, regulating various impulsive duties of the body like the pulse rate and blood pressure.

Though other cases of Parkinson come off as inherent, and some may be linked to chromosomal mutations, mostly the condition happens incidentally and does not appear to be hereditary. Many scientists so far conclude that Parkinson's disorder emanates from inheritable and ecological factors like susceptibility to toxicants. This paper will review planning of person-centered care with the old man using specific frameworks such as the RLT model and the CRC steps to provide appropriate care for the individual with Parkinson’s disease.

Developing a Care Plan for People with Parkinsons Disease
First and foremost, all care plans need to be developed in a person-centered manner, and it is significant to individuals with complex needs. This can be due to the dependance of caregivers in all respects. Examples of these dependence include, being fed, moved, and positioned (Hack et al,.2015). It is debated that person centered care is more appropriate to individuals with communication problems. Care plans are supposed to simple and easy to understand by people from different backgrounds. Being consistence in providing care is very important regarding the results as well as facilitating a sense of security for the person with complex needs. Both family and residential caregivers need to follow similar plans. Individuals with Parkinson’s disease have different needs. Dwelling on one need may lead to neglect with other areas that need attention. There are also threats of needs being disregarded when activities of the daily life happen in one place (Williams, 2015). Many people have their leisure, jobs and hobbies performed in various places. Individuals with complex needs there are likelihoods that all these events will happen in someone’s home. This can highly cause social exclusion, where being exposed to different surroundings can create a great, social and leisure opportunity thus having a more fulfilling life (Hanzen et al,.2018). There are many frameworks designed for support in developing care plans. This review will use the Ropher, Logan and Tierney model of nursing.

The Model of Living (RLT)
The RLT framework is one of the most commonly used models in the nursing profession. it embraces the fact that dependence and independence work together with elements linked with every activity of living differently. There are four stages of the nursing process in which the model can be put into practice. These include; assessment, planning, implementation, and evaluation (Holland, & Jenkins, 2019). Assessment, comprises of identifying the persons ability to do all the twelve activities of living involved in the RLT model. During planning, challenges are determined and recorded together with the objectives that focus on handling these challenges. With regards to complex needs, advancements might be small however the objectives determined should reflect this. The nursing process stresses that care plans need to be applied in the usual daily routines completely (Holland, & Jenkins, 2019). Evaluation is the last stage of the nursing process. It is a continuous process where the persons ability to perform the daily activities are analyzed to find out whether the objectives have been achieved.

For the RLT model to be effective, the nurses must have a clear understanding of the five (sociocultural, biological, politico-economic, environmental and psychological) elements that affect the activities of living (Holland, & Jenkins, 2019). Having made considerations on the effects these elements have on activities of daily living; the next section will demonstrate each of the activities of living. The case study of the old man is used to determine the process of care planning. There may be general issues that may show up while implementing the model will be considered.

Maintaining safe environment
Most people with complex needs suffer from inflexibility, that later could result in falls. Caregivers have an important duty in monitoring and regulating the inflexibilities and ensure the person gets relevant care from the physicians. The caregivers possibly see the seizures and it is important that they should have the ability to provide a comprehensive report which may help the doctor make precise diagnosis. The old man has been exhibited with Parkinson’s disease. It causes rigidity and stiff muscles in arms and limbs which makes him get support from the rail bars while experiencing the such. This can be very frightening to see however with proper training, complete care plans should allow caregivers to determine how to react to such situations whenever a patient experience it.

Communicating
People with Parkinson’s condition may find it hard to communicate formally thus depend on others to do interpretations for them. Enhancing communications with people who have this condition is an essential role of the nurse and ensure that attention is administered to facet of care in the care planning process (Deravin-Malone, 2016). In our case study, we can tell that the old man experiences a problem in communication, where he communicates slowly. Introducing intensive interaction strategy can be very helpful in improving his communication. Hence with time it will be easier to establish different preferences for the old man and include in his care plan.

Eating and Drinking
Difficulties in chewing and swallowing is a very severe condition that can lead to choking. It is mostly common wit people who have cerebral palsy who have poor reflexes and weak muscle tone. Problems with swallowing can cause dehydration that can be prohibited by observing food and fluid consumption. The old man has issues with feeding since he mostly feeds on thin fluids and porridge, however even with these hardships he is not supposed to miss any shared meal time with the family friends since this can be an opportune time for meals as well as company and conversation.

The Clinical Reasoning Cycle (CRC)
CRC is the process where the nurse’s data and analyze the problems the patient could be having. Depending on the results they strategize and instrument medications gauge results and see through the whole process. This process is also based on disposition and affected by different factors such as personal attitudes and biasness.

Steps in Clinical Reasoning Cycle
There are eight steps involved in CRC which are linked to one another. The steps include; Determining the patient’s situation,Nurses have the duty to tell the patients detail, for example, this is Parkinson old man who has been diagnosed with Parkinson’s condition in the past months. The CRC nursing experts encourage the students to keep this part clearly. Collecting cues; This step requires nurses to review the data from the reports and the patient’s history and related information about the patient. New data about the patient has to be collected and hence nurses should recall their terminologies like epidemiology. Processing information; As the nurse processes data, they need to interpret, relate and match the conditions while anticipating the results. This is one of the toughest step in CRC because it comprises of many factors.

Determining the problem; Analyzing the data and facts from the patient then reference to come up with a precise diagnosis for the patient. The problem has to be correctly identified during this stage so that it can be diagnosed well. Establishing goals; Just like any other person, nurses work with time frames, hence they set the objectives they want to achieve and the specific time frame they want to work on to achieve the set goals.

Taking relevant measures; Being a nurse, one is responsible for taking desirable actions which are in place so as to achieve desirable results. Evaluation; Apart from providing intensive care to patients, nurses also evaluate on the efficiency of the results and actions.

Reflecting on the process; The final step is to reflect on the benefits gained from this. It comprises of talking of the lessons learnt and what you can do differently as an individual from knowledge acquired.

Conclusion
In summary, Parkinsons disease are a therapeutic diagnosis with mobile and immobile signs and symptoms. The immobile symptoms forerun the diagnosis for a long time. The medical tests are hardly important; hence, reviewing and doing follow-ups is the main part of management just as response to medication. It is emphasized that person-centred care using the RLT model in relation to fostering a patient care plan, needs to be the basic aim on handling the wants, interventions and preferred results the patient has. Though this method may not be suitable for people with dementia since its regarded to be time consuming, and disappointing during the early phases since they may avoid socializing and interventions. An individual should be permitted to have their aptitude, preferences and dignity honored since it is the fundamental aim of the person-centered care, hence due to this patient support may be very hard to facilitate.

References
Chang, E. (2017). Living with Chronic Illness and Disability-EBook: Principles for Nursing Practice. Elsevier Health Sciences.

Deravin-Malone, L. (2016). Chronic Care Nursing. Cambridge University Press.

Hack, N., Akbar, U., Monari, E. H., Eilers, A., Thompson-Avila, A., Hwynn, N. H., ... & Okun, M. S. (2015). Person-centered care in the home setting for Parkinson’s disease: operation house call quality of care pilot study. Parkinson’s Disease, 2015.

Hanzen, G., Waninge, A., Vlaskamp, C., van Nispen, R. M., & van der Putten, A. A. (2018). Participation of adults with visual and severe or profound intellectual disabilities: analysis of individual support plans. Research in developmental disabilities, 83, 132-141.

Holland, K., & Jenkins, J. (Eds.). (2019). Applying the Roper-Logan-Tierney Model in Practice-E-Book. Elsevier Health Sciences. Tysnes, O. B., & Storstein, A. (2017). Epidemiology of Parkinson’s disease. Journal of Neural Transmission, 124(8), 901-905.

Williams, B. C. (2015). The Roper-Logan-Tierney model of nursing: A framework to complement the nursing process. Nursing2020, 45(3), 24-26.