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Parkinson’s disease (PD) is a condition in which the dopamine levels in the brain drop because of nerve cell damage resulting in symptoms of Parkinson’s (Clael et al. 2018). It is also associated with many functional complications and impairments. According to Davis and Racette (2016), cognitive functioning is brain-based skills like how people think, solve problems, and make decisions. However, this functioning is affected in the PD patients as the patient suffers from confusion and body misbalance issues. Physical functioning is both instrumental and basic activities of daily living like bathing, cooking, dressing, or others. These are impacted if the individual is suffering from risks of PD. Such an individual finds it difficult to balance the body and perform running, exercising mobility, or related activities.
According to Hermanns et al. (2015), social functioning like involvements in social gatherings, meeting up with friends, or going outside the house, these functions of the affected individual are also impacted. As the individual feels fear, depression, or anxiety and avoids going to the outside house for social functions, even his relationships with family, peers, or friends also get impacts due to the development of PD. Moreover, the sensory functions of such individuals like visual capacity, senses from the skin, hearing, or other related functions get affected (Hermanns et al. 2015). The life of such an individual is so challenging because with time if not controlled the disease becomes worse affecting both non-motor and motor functions and symptoms like sleep, depression, dysfunction, and pain progresses. Although, impacts of PD on life is high and adjusting with the changes is also difficult but many ways help in supporting a healthy and happy life like proving quality care by care worker (Clael et al. 2018).
From the case study of Frank it is clear that his kitchen was also dirty, he feels like stale urine, he needed help while bathing and he also did not respond to door knocking. This confirms that his physical, sensory, cognitive, and social functioning is affected. To attend such an individual, a care worker is appointed who can assist them in their daily activities. A care worker is the one who provides regular and complete care to the one who needs it. Caring an individual who is developing or had developed Parkinson's is a very energetic and time-consuming activity, but a care worker maintains understanding with the individual and copes him/her up to provide quality care and improve quality of life. According to Davis and Racette (2016), a care worker conducts a mini-mental state examination and a clock-watching test for assessing the cognitive functioning of the patient. In mini-mental state examination, is a popularly used test in research and clinics to assess cognitive functioning in patients with PD. This test includes a 30 point questionnaire that calculates the candidate’s language, orientation, attention, and motor skills. A clock test is one in which the candidate watches the clock and make the hand positions accordingly on the paper.
According to Clael et al. (2018), for social function assessments, the care workers develop courage and motivate the patient/individual to join social gatherings. A care worker conducts sessions for him/her, encourage him to talk to friends, and participate in family functions or social or cultural functions. For sensory assessments, the care worker provides the patient/individual with glasses for clear vision, shades, or hearing kits. Moreover, he conducts appointments with eye specialists or ear specialists to get a regular check-up and track the progress reports. According to Davis and Racette (2016), the physical assessments are also done by a care worker that includes setting up a target of steps to be covered per day, exercises, or body balance activities, with a regular, follow up to check whether the set targets are achieved or not.
Frank looked dishelleved, did not respond to the door knocking by his friend at his house, did not respond to the questions of his friend in a normal way that he used to do before, he looked in as if he is in a situation of illness, and it appeared as he had lost weight. He was holding a photo frame in his hands and was roaming around with that photo frame in his hands. He smelt like stale urine with stains on his dressing gown, was a bit confused too and his pajama top and bottom were also different. His kitchen and house looked as messy, he walked slowly and need more assistance than before in walking and bathing. He murmured ‘would be 30’ again and again after looking at the photo frame. He had also not attended his friends for 2 weeks, all these factors are of major concern as these are related to a Parkinson’s disease patient. Many risk factors are contributing to PD like age, genetics, sex, and many others. The risk of developing this disease is more in the elderly population and Frank being an old man is having an age factor as a risk for developing the disease. According to Zham et al. (2017), the changes in the development of PD are also more in males than in women. Frank being an old man showing issues with physical, social, sensory, and cognitive functions is at a high risk that he might develop Parkinson or might have developed the diseases but in an early stage only. All these health issues or factors can lead to serious health problems in Frank if left unattended.
The working hypothesis is - Frank is having or will develop Parkinson's disease soon. This is so because of the underlying issues like Frank cannot walk like a normal, he needs assistance for bathing, kitchen activities, dressing, and other daily personal or household chores. He looked a bit confused and his body is not in his control as he suffers from physical functioning impairment. Even his body is not balanced properly while he walks; he seems confused and smelt like stable urine. All these issues show that he is developing stage 1 of PD or has already entered the stage 1 of the disease. According to Schwartz and Pell (2017), PD has 5 stages: stage 1 – show mild symptoms with only one side of the body affected, stage 2 – both sides of the body get affected. Stage 3 – impaired balance with functional impacts and progression of disease occurs, stage 4 – serious complications like walking and standing issues. Stage 5 - highly serious symptoms with wheelchair-bound or bed-ridden, it is advanced. Moreover, like a PD person, Frank also cannot do his social functioning like he used to do before in a normal manner. The rationale is – he might also develop a disease similar to that of PD. For this, the care worker has to conduct more specific tests or appointments for Frank in a hospital or with the health professionals.
The immediate and follow up actions include: as a care worker for a PD patient, the patient should be treated with love, care, patience, and sympathy. It is required to manage his dressings, bathing, cleaning, making his meals, and assist him/her with daily activities. According to Schwartz and Pell (2017), the care worker should repeat the statements as the PD patient has a weak memory, encourage social activities, supporting, and teaching the patient during self activities. Provide the patient with assistive or adaptive devices and a homely environment to compensate for functional disabilities. Make appointments with health professionals to track the progress and report the symptoms so that a patient-centered care plan can be made. According to Zham et al. (2017), the care worker can set targets to achiever for the patient like several activities to be done a day or form of exercise to be done per day, so that after achieving these goals the patient feels encouraged and happy. The care worker should regularly check for his vision, physical function, memory status, and social functioning.
This is so because PD progresses with time if not treated properly and make the individual worse. To provide a quality life to such individuals, it is also required that a care worker should provide patient-centered care with effective care plans (Mueller et al. 2018). Moreover, the care worker should keep on providing medications to the PD patient to combat the signs and symptoms. Such an individual should be provided with foot massage, encourage him to communicate with his loved ones, neighbors, and go outside his/her house (Hermanns et al. 2015). As such patients/individuals might get depression so it should be ensured that they get proper sleep and attention. The care worker is thus of great importance in a life of a PD patient/individual as he/she takes the necessary actions required for the betterment of the affected patient/individual (Bramley and Eatough, 2005).
Bramley, N, and Eatough, V. 2005. The experience of living with Parkinson's disease: An interpretative phenomenological analysis case study. Psychology & Health, vol, 20, no. 2, pp. 223-235. https://doi.org/10.1080/08870440412331296053
Clael, S., Brandão, E., Caland, L., Techmeier, R., de Paiva, T., Rodrigues, J., Wells, C., and Bezerra, L. 2018. Association of strength and physical functions in people with parkinson's disease. Neuroscience Journal. https://doi.org/10.1155/2018/8507018
Davis, A. A., and Racette, B. 2016. Parkinson disease and cognitive impairment: Five new things. Neurology. Clinical practice, vol. 6, no. 5, pp. 452–458. https://doi.org/10.1212/CPJ.0000000000000285
Hermanns, M., Greer, D. B., and Cooper, C. 2015. Visions of living with Parkinson’s disease: A photovoice study. The Qualitative Report, vol. 20, no. 3, pp.336-355. http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.817.8284&rep=rep1&type=pdf
Mueller, C., Rajkumar, A. P., Wan, Y. M., Velayudhan, L., Chaudhuri, K. R,. and Aarsland, D. 2018. Assessment and management of neuropsychiatric symptoms in Parkinson’s disease. CNS Drugs, vol. 32, no. 7, pp. 621-635. https://doi.org/10.1007/s40263-018-0540-6
Schwartz, R., and Pell, M.D. (2017). When emotion and expression diverge: the social costs of Parkinson’s disease. Journal of Clinical and Experimental Neuropsychology, vol. 39, no. 3, pp. 211-230. https://doi.org/10.1080/13803395.2016.1216090
Zham, P., Kumar, D. K., Dabnichki, P., Poosapadi Arjunan, S., and Raghav, S. 2017. Distinguishing different stages of Parkinson’s disease using composite index of speed and pen-pressure of sketching a spiral. Frontiers in Neurology, vol. 8, pp. 435. https://doi.org/10.3389/fneur.2017.00435
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