NUR272 Motor Neuron Disease Assignment Sample

• Subject Code : NUR272
• University : University of Sunshine Coast My Assignment Services is not sponsored or endorsed by this college or university.
• Subject Name : Nursing

Palliative Rehabilitation and Continuing Care

Introduction to Motor Neuron Disease

Motor neuron Disease is one of the rarest of all neurological diseases. this condition post-manifestation, progresses increasingly, affecting various neuromuscular structures in the person suffering from the same. Amyotrophic Lateral Sclerosis (ALS) is one of the common forms of motor neuron disease that is observed in general Australian population (Young, 2019). This condition tends to the manifestation of generalized muscle weakness as well as muscle wasting in the affected person. In progressing stages, the muscle wasting is quite evidently visible in the patient. The normal functioning of the neurons is mainly hampered in this condition, which then proportionately hampers the activities of daily living of the person. These activities can be inclusive of difficulty in swallowing, breathing, speaking, eating, gripping objects and so on.

The main issue with this condition is that there is no designated cure for this condition. The patient can only be maintained with the help of external medical assistance and by modifying the surroundings in which the person is living. Palliative care also plays a key role in managing the patient and thus, ensuring smooth facilitation of healthcare services required by the patient, to ensure care in their end of days of life. The patient in the given case study has been diagnosed with the condition at a very early age. Noting for the alternatives as well as early interventions are required in this case scenario so that the patient can be prepared beforehand to help with the possible disability of swallowing. Corbin and Strauss model of nursing can be helpful in evaluating the trajectory of illness and the manifestation of the condition in the patient. This will help in identifying and planning for interventions that will be able to help the patient. This will be helpful in improving the overall quality of life of the patient and improving the healthcare outcomes of the patient. Case study of Adena will be examined on the basis of this model of intervention for managing the same.

The Person

The person in the given case study is a 35-year-old female who has recently been diagnosed with Motor Neuron Disease. She resides in close vicinity of her family. She has a very supportive husband and two children. The diagnosis was discovered one year back and the condition has been progressing ever since. The patient is managing her daily activities with little external help of her mother and her husband. He is usually taking help in wheelchair transfers and activities like bathing, eating and so on. The patient is well aware of the repercussions of her condition. She knows that as her condition will progress, she might suffer from physical inability. In later stages of the condition the patient is anticipated to suffer from difficulty of breathing as well as swallowing. Along with her functional capacity she might also feel difficulty in speech and cognitive disabilities (Connors, 2019).

She might also develop respiratory issues leading to drastic decline in her health status. There is also a dire need of providing the patient and her family with counselling sessions to develop survival strategies to deal with her condition in a systematic manner. The patient is also depressed for the fact that she might not be able to see her children grow. These factors can hamper with the patient’s cooperation with the treatment interventions. However, the family is supportive for the patient’s condition and can be observed to be present for her in her difficult times. This can be an added benefit to help the patient in reliving her stress and misery. The role of the family of the patient is of vital importance in such case scenarios.

Close Interpersonal Relationships

In order to ensure smooth facilitation of the healthcare services to the patient, it is important for the nurses to develop a robust connection with the patient and her family. This connection will be helpful in understating the condition not only in a better manner, but will also be helpful in viewing the condition from the patient’s point of view. This will give an insight of the internal turmoil faced by the patient in respect with her physical and mental health in facing the condition. The role of family can also be evaluated from this point of view as it will be helpful in identifying where the family members can be helpful in providing support (Flemming, 2018). This is crucial from the point of view of keeping the morale of the patient high and maintaining her self-confidence as well. These interpersonal relationships will also be helpful in formulating a foundation for the promotion of positivity in managing the care for the patient. it will help in developing coping strategies to deal with the diagnosed condition, at every step of the way where help is required. The family of the patient can also be taught certain techniques, by which the patient can be helped as it will be useful in supporting the patient. Having a loved one around to cater to the needs of the patient, will be helpful in making the transition of care smooth for patient in her end of days of life.

The Organization

The organization of MND Queensland has been working in tis direction along with the government bodies and non-governmental bodies to help the families and individuals suffering from Motor Neuron Disease. It helps in providing them with the required care and support system in order to manage their condition in a groomed manner (MND Queensland 2019). The organization works on the motive of reducing the negative impact of the diseased condition on the patient’s and their families, quality of life. The organization also works on Information and Referral advisory. This structural approach is mainly used to help the patients with a specialized referral if and when needed, as per their medical needs. The nurses can work in coordination with the patient and their families, to get the required information on the various support groups that can help the patient in easing the process of transition of care for the patient (Cheng, 2017).

Nurses can also be an integral part of leadership role in ensuring multidisciplinary approach in treating the patient. They can work along with the physical therapist in helping the patient with maintaining her joint conditioning and strength. Occupational therapist and speech therapists can help the patient in maintain her strength of her oral muscles and the same can be helpful in training the patient for dysphagia management (Garand, 2018). The patient can also be trained for adapting as per her home environment, so that smooth facilitation of services can be carried out in later stages of disease progression. It will also be helpful for the patient, to be well-prepared beforehand for difficulties to be faced ahead in respect with her present clinical condition. Mental health along with physical health should also be promoted to ensure patient’s sound participation, mentally, in the process of care.

Community Networks/ Community Support

In patients suffering from MND, the participation of community is equally important for the patient’s well-being. Nursing professional can help in working with various support groups, that can help in transition of care for the patient. The role of family working with the patient is very crucial as it will be helpful in re-assuring the patient in difficult times. By interacting with the patients dealing with same medical crisis the patient can relate with her own misery. This will help her in getting ideas and insights as to how to deal with the stress in more methodical approach. Community networks can also be helpful for the patient, as they can provide with sources and arrange for assistive devices that the patient might bet requiring in her later stages of the disease condition (Meijer, 2017). The role of family therapy is also very crucial in the process, as the family is bearing equal stress along with the patient.

Providing the family members with the required support is very necessary as it will help the patient largely as well. The patient will be more confident in a family member being by her side, rather than having any other medical professional. The family can also work in close coordination with the nurses in assisting care management for the patient. Emotional support groups can be involved in this process (Anderson, 2019). They can be helpful in addressing the stress factors that might lead to disruption of facilitation to the services to the patients. Help of liaison officers can also be taken in order to amend the gap between the healthcare providers and the patients. They can also help in keeping a close monitoring on regular patient follow-ups, required to keep a track on patient’s health condition both mental as well as physical.

Equipment & Other Services

The movement of the patient will be more restricted with the manifestation and progression of the disease. The patient will be in dire need of additional assistive equipments that can help in smooth transition of care in her later days of life (Murray, 2016). The nurses can impart education to the patient as well her family members as to what all possible risk factors she might eb exposed to. The MND Queensland, can help the patient by helping them with arranging the required equipments such as air bed mattress, power wheel chairs for better mobility and with limited use of the body muscles and so on (MND Queensland, 2019). This can also be provided with due assessment of the patient’s muscular as well as functional capacity. Diet alterations and rehabilitation of the oral muscles can be made in order to help the patient with her dysphagia management and preparing her for the worst possible circumstances. Diet regulation is also important form the point of view of ensuring supplement provision for the dietary loss faced by the patient. Early signs of stress should also be noted for early interventions management.

Conclusion on Palliative Rehabilitation and Continuing Care

There is a dire need of additional assistance required for treating patients with motor neuron disease. The condition not only impacts on physical health, but also hinders with the mental health of the patient. The severity of the disease increasing along with the progression of the condition. This might give rise to complex situations as well, leading to difficulty in tackling the condition. Through constant monitoring and examining of the condition, early interventions can be administered for the patient. It is crucial from the point of helping the patient from an early onset of age, so that the deconditioning can be reduced for the patients. It is also helpful in reducing the added stress to the patient, as they are well prepared beforehand, mentally as well physically in dealing with their limitations. Nurses can play a vital role in this process, by working in close coordination with the family members as well as the patient, helping them in provided advanced healthcare solutions. Nurses can also play the role of advocates for the patients, assisting them in the process of decision-making process and thus, helping them with a better understanding of the condition. This is important for the nursing practioners to help providing the patient with the required care, in a professional manner and within full capacity.

Reference for Palliative Rehabilitation and Continuing Care

Anderson, N. H., Gluyas, C., Mathers, S., Hudson, P., & Ugalde, A. (2019). “A monster that lives in our lives”: experiences of caregivers of people with motor neuron disease and identifying avenues for support. BMJ Supportive & Palliative Care, 9(4), 27-29.

Cheng, B. H. W., Chan, K. Y., Chung, Y. K. J., Choi, C. W., Chan, C. H., Cheng, S. C., ... & Man, C. W. (2017). Supportive & palliative interventions in motor neuron disease: what we know from current literature. Palliative Medicine, 7, 320-331.

Connors, K. A., Mahony, L. M., & Morgan, P. (2019). Adaptive equipment uses by people with motor neuron disease in Australia: a prospective, observational consecutive cohort study. Disability and Rehabilitation: Assistive Technology, 14(1), 62-67.

Flemming, K., Turner, V., Watt, I., Hulme, B., & Bolsher, S. (2018). The Palliative Care Needs of Adult Patients and Their Informal Carers Living with Motor Neuron Disease (MND), or Bereaved Carers of People with MND: A Systematic Review of Qualitative Research. Journal of Pain and Symptom Management, 56(6), 39-40.

Garand, K. L., Schwertner, R., Chen, A., & Pearson, W. G. (2018). Computational analysis of pharyngeal swallowing mechanics in patients with motor neuron disease: a pilot investigation. Dysphagia, 33(2), 243-250.

Meijer, R., Wolswijk, A., & Eijsden, H. V. (2017). Prevalence, impact and treatment of spasticity in nursing home patients with central nervous system disorders: a cross-sectional study. Disability and Rehabilitation, 39(4), 363-371. MND Queensland 2019 https://www.mndaq.org.au/Find-help/Regional-Advisor-Service.aspx

Murray, L., & Butow, P. N. (2016). Advance care planning in motor neuron disease: A systematic review. Palliative & Supportive Care, 14(4), 411-432.

Young, C. A., Ealing, J., McDermott, C., Williams, T., Al-Chalabi, A., Majeed, T., ... & Harrower, T. (2019). The relationships between symptoms, disability, perceived health and quality of life in amyotrophic lateral sclerosis/motor neuron disease. Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration, 20(5-6), 317-327.

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