According to this case study we find that Florence who is an 82 year old woman is suffering from the last stage of the Parkinson’s Disease which is regarded as a health condition coming up as a result of the loss of a number of neurons in the brain that have the responsibility of controlling the muscle movement. s a result of the loss of the individuals neurons the patient is normally characterized by the following symptoms such as tremors, shaking of the body, loss of the person’s memory, when these symptoms persist the person is put in a position of not performing any function such as moving around, communicating and even feeding just like in the case of Florence we find that she can not do anything in this case we find that Florence is reported to have been incontinent over night and she would seek for help from Hedley.

We also find out that her mobility had declined to the point where it was no longer safe for her to ambulate independently. This condition is commonly found in the elderly people who are over the age of fifty years, and carries a number of implications in the individual’s life that is the medical and psychosocial implications. (Khedr and Rothwell, 2006) Symptoms of the Parkinson’s Disease.

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Research indicates that individuals suffering from the late stage of this condition are usually reported to be disabled for a long time period which comes up as a result of them not being able to withstand the therapeutic drugs prescribed to them. It is also reported that the patients suffering from the late-stage PD are mostly prone to be attacked by hypotension which occurs as an effect of varying autonomic disturbances in the body, we also find that hypotension occurs as a result of the lowered blood pressure which is regarded as one of the side effect of the antiparkinson drugs.

Reports indicate that the decrease in the systolic blood pressure normally results to the patient facing dizziness and fainting. (Brin and Stewart, 1992) The symptoms in the late-stage of PD may actually lead an individual to lack body movement coordination, this is well proved in the case of Florence who can not do anything she is reported to have been incontinent over night and she would seek for help from Hedley.

We also find out that her mobility had declined to the point where it was no longer safe for her to ambulate independently, other patients may be reported to be suffering form emotional difficulties that is in terms of speech since they find it hard to coordinate their talking with gestures such as facial gestures, this symptoms have actually seen many patients face isolation in the society.

This condition is also found to be leading to various brain problems such as the slow brain functioning, the other effect of the condition is that it may lead to a poor digestive system in an individual that the digestive system may be slowed down resulting to a painful constipation. PD is also found to be leading to a number of sexual disfunctioning in an individual.

Lastly we also find that these individuals affected by the Parkinson’s disease are normally attacked by depression whereby research indicates that this depression is regarded as a widespread psychological disorder characterized by individuals affected low moods, lack of interest when accomplishing routine responsibilities and declined capability to experience happiness.

In essence, depression is an impermanent declined mood by persons when they are disgraced or disturbed in this case when an individual is suffering from the Parkinson’s disease. Depression develops to clinical depression which is a severe disorder and patients with this disorder normally exhibits symptoms like bad moods and deep thoughts that are difficult to avoid. (Gask and Usherwood 1997)

In this case study we find that the family is facing social stigmatization whereby it’s reported that the family has been provided with an Extended Aged Care also it is indicated that they had one child who died of a motor vehicle accident twelve years back and all these factor has made their friends to departed them and up to date they do not have communication with any member of their society, this clearly indicates that this family is already suffering from social problem. e also find that Florence is so much distressed, we find that in this case study their exist the psychosocial problem which is depression and this is well explained where Hedley says that his own health is deteriorating and that it has been long time since he had a two to three hour sleep This proves that depression disorder can mess about with the ordinary performance of an individual and regularly causes tribulations with occupational, societal and family units’ changes.

Depression not only causes pain and anguish to those affected but also to those who are responsible for taking care of the affected individuals and in most cases family members for example serious depression can lead to breakages of families and low productivity in the work place which may lead to sacking of the individual affected. (Gask and Usherwood 1997)

Depression has a lot of outcomes or effects such as causing marvelous emotional pains, declining of work efficiency, upsetting the lives of many persons particularly those affected and their next of kin, unfavorably influence the lives of acquaintances and relatives and in the long-term it causes negative consequences to the economic growth or expansion. Depression is a psychological disorder that alters a person’s way of thinking, feelings, distressing community conduct and tampering with bodily well being of the person.

Such feelings like sadness, being exhausted or being in mood of despair may adversely affects employment issues, schooling and family duties and may lead to one being attacked by depression. This is indicated in the case Hedley who shows his fear by not allowing Florence to be admitted permanently to an aged care facility since he knew that she will be devastated, the case study also shows that Hedley is suffering from depression when he collapsed and remained in a semi-conscious floor beside the bed that Florence was sleeping in. Gask and Usherwood 1997)

In this case we can therefore deduce that major depression disorder can attack anyone although it is most common on people who usually feel desperate and on those who have a record of hospitalization in the past. Major depression has been reported to be lacking official analysis of what doctors refer to reasonable depression. (Copeland, M 1992) Social and Environmental Factors Affecting Hedley

From the case study we find that Florence and her family is suffering from lack of medical attention from the health sectors, since his family it is indicated that the only high care respite bed available was in a residential aged care facility that is situated 30 Kms from Hedley and Florence’s home. This has made him to be vulnerable to ill health including the mental problems such as stresses and depression, and he is seen living in an environment that have high risks of causing such illnesses under which, they experience difficulties in gaining access to treatment.

Social stigma has also contributed to the family being unable to get proper treatment in that Florence and Hedley fear to go to medical doctors or counselors for help and thus they end up suffering for a long time. This is well shown in the case study when it reported that Hedley have been taking care of Florence himself until he stated to the nurse that it was becoming unsafe for them to continue taking care of themselves.

He told the nurses that it had been months since he had managed to get more than 2 or 3 hours of sleep at any one time Sometimes the reason for lack of proper treatment may be that of those attacked particularly those diagnosed with PD may not have the opportunity to see medical doctors since they may be severely affected that they cannot do anything. The other reason of lack of proper treatment is that of many indications of depression disorders being misdiagnosed as physical tribulations that can be solved easily which may not be true.

Also lack of containing depression disorders may have been aggravated by curing the person’s indications instead of the fundamental cause of the depression The case also indicates that Hedley has been suffering from Anxiety which is a psychological disorder that is said to make a person some times to feel anxious with no noticeable cause. Medical practitioners also argue that such a disorder sometimes is accompanied by uncomfortable feelings of which it is difficult to stop such feelings once it occurs.

An individual with anxiety disorder may suffer from irregular bouts that are reported to be severe and in many occasions results to frightening and immobilizing the individual diagnosed with it. Anxiety disorder is the most common disorder associated with human beings and usually it is associated with psychological health disorders i. e. mental disorders.

According to the case study we find that both Hedley and Florence are also suffering from the most common type of anxiety disorder is known as generalized anxiety disorder commonly abbreviated as GAD and it is considered to be severe than the usual anxiety encountered by human beings in their daily lives. It is also persistent and it is characterized by overstated anxiousnessness and nervousness and such characteristics can just occur without aggravation by anything. GAD usually attack persons when they are at teens and at sometimes when they are still infants in the society.

In the case study we find that this disorder is characterized when Hedley pays Florence a daily visit at the hospital (Lee and Cleghorn, 1991) Individuals suffering from GAD may also exhibit behaviors such as being dizzy, regularly taking shower, easily startle when contrasted to other persons, have tendency of always feeling tired despite the fact that they have done nothing, experience lack of concentration, exhibits depression signs and in some other cases experience some funny feelings of thinking that they have swelling in their throats.

This is well indicated in this case when there is a report claiming that after Florence being taken to an emergency respite care she seemed to have improved in the performance of her daily duties this was only done under supervision of the care staff but after some few months, she did not attempt to perform the activities on her won, this shows that Florence lacks concentration which is found to be one of the symptoms of anxiety the psychological disorder. Lee and Cleghorn, 1991) General anxiety disorder can be treated in different ways but it has been recommended that the best way is utilization of a method that integrates both cognitive and behavioral involvements and commonly preferred method depends heavily on the harshness of the disorder. Management of Older People Suffering From Parkinson’s disease Rehabilitation

The management of such people like Florence will only require them to be taken to a rehabilitation centre where they will able to be given different types of health care by the health practitioners which include the following practices, In the case of the PD patient suffering from depression we find that there are two major types of treating depression disorders that is medication and psychotherapy and has proved to work quickly in healing those attacked by the disorders. Psychotherapy involves psychological management of individuals attacked by depression in deferent ways.

The first step in this depression treatment is supportive counseling which is aimed at reducing the pain associated with depression thus in the process dealing with the feelings of despairs that go along with depression. Since nursing for the old people who are diagnosed with the PD follow a number of patterns in order to prove successful in its operations and they include the following; Aesthetic Pattern of Nursing In many cases we find that the aesthetic pattern is always considered as one of the patterns that majors in the mediation of and expression by nurses towards the patients they attend to.

It is therefore regarded as the perception which is imposed directly on the significance of the nursing practices towards the treatment of their patients, that is they are expected to perform their duties in a manner that will enable the patients recognize that the nurses in a particular organisation value their patients and treat them with respect and also go a long way to satisfy their demands and need thus making them succeed in their professional operations as they attract more patients and retain the old ones. Sullivan and Decker, 1997) Ethical Patterns of Nursing Ethical pattern in nursing is always defined as the norms or standards of behaviour that guide moral choices about the conduct of the nurse in any health organization basing on the conduct of the nurses in relation with their patients. The goal of medical ethics is to ensure the safety of the patients is guaranteed to avoid suffering the consequences from the unscrupulous nursing practices.

The following are some of the important values in relation to nursing ethics. For example the nurses should follow their code of conduct while performing their duties, which is they should have the following factors while performing; Dignity- every patient and the nurse has a right to dignity Justice- this is in relation to the distribution of health resources that are scarce and in relation to who is gets a specific treatment. Honesty and truthfulness- this is whereby a nurse is required to have an informed consent

All these are important aspects in the nursing profession and they actually provide a framework that is useful in understanding the various conflicts in this health organization. (Sullivan and Decker, 1997) Counseling In Taking Care of Old Patients with PD Counseling is regarded as an essential factor in dealing with people who have been affected by these psychological disorders or any type of disease such as PD. This practice is usually used in helping this people to handle issues which are found to be causing factors of the psychological disorders.

Occasionally, this practice requires skilled professionals who can deal with issues ranging from education, marriage, individuals and families. To do this the health care providers are therefore required to have the following in their practices in order to understand the person’s problems. The counselor should have good listening skills, empathy, and be genuine which will require the practitioner to tell the truth even if the subject matter is not that good to the patient.

Therefore one is required to bring out the truth in a way that the patient will be able to handle and understand his situation; the counselor should give unconditional positive regard and also should have concreteness in providing any information about the psychological disorder. We find that many counselors indulge in a number of activities that usually assist the sick person to come back to the normal status. The following are the methods that are used by counselors in order to resolve such issues; Therapeutic relationship; under this we find that a better relationship between the client and the counselor is established.

The client is therefore required to build trust and safety on the counselor although sometimes it is argued that the patients finds it hard to build trust on the counselor thus they end up not giving full information about the causative factor of the illness. In the case study we find that Hedley and Florence have created a good relationship with the health professional whereby Hedley is given the opportunity to express himself and explain what is going on regarding his wife’s health.

According to the counseling practices safety is considered as a leading factor to a safety therapeutic trauma work. In this case the patient may be found to be having a number of characteristics that may hinder him from building trust and safety on the counselor. These factors may include personality temperament. We may also find that when the patient is found to have undergone a number of traumas, the chances of him or her building his trust on the counselor are always high.

This is indicated in the case when we are told that when Florence was transferred to her new 65-bed ethno-specific aged care she appeared to be settling in well. Hedley visited daily and the couple seemed to be adapting to their new arrangement. But after a few months stay in the aged care center she was in a position performing many daily activities under the supervision of care staff this indicates that she created a high dependency on the staff to help her perform the stated activities. (Chopra and Kulhara, 1996)