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6 Pages Double Spaced Apa Formatting Use A Minimum Of Three Schol

Briefly define Parkinson’s Disease. What physical changes occur related to the onset of the disease? What are the possible psychological changes with PD? What system(s) are affected? What are the treatments and therapies? The case study shared details that indicate Doug is no longer able to identify and resolve problems. Identify two examples in the study that indicate Doug is losing this ability. Provide two other examples that may arise as the disease progresses that are related to identifying and resolving problems. Discuss possible feelings and stressors Doug may be experiencing as the disease progresses and he must rely on caregivers more. Refer to the required reading list for the topics related to this assignment for ideas. Discuss the effects of the diagnosis of PD and its progression can have on a spouse and family (micro-level). Refer to the chapter and required readings regarding caregiving and caregiver burden (e.g., employment, psychological effects, financial stressors, role in the marriage, etc.). Locate two services in your own community that offer assistance to people with PD and their caregivers (meso-level). Describe the services available, cost, and eligibility requirements. In your opinion, are Doug and Maria eligible for the services? Explain your answer based on your findings and the knowledge of Doug and Maria. At the macro-level, research the state and federal programs, legislation and initiatives that affect chronic illnesses. Discuss the pros and cons of two of the following items as they affect patients and caregivers: legislation and lobbying efforts (e.g., changes to the ACA, stem-cell research), requirements to qualify for SSDI, FMLA, Medicaid/Medicare, and the ADA. What are the requirements of these programs for paying for skilled nursing for Doug? Do Doug and Maria qualify for assistance through these programs? Why or why not? Why are these programs important? The assignment focuses on Parkinson’s Disease (PD), a neurodegenerative disease causing dysfunction and death of nerve cells in the brain, affecting motor, cognitive, and behavioral functions, with profound impacts on the individual and family.

Paper For Above instruction

Parkinson’s Disease (PD) is a chronic, progressive neurodegenerative disorder characterized primarily by motor symptoms such as tremors, rigidity, bradykinesia (slowness of movement), and postural instability. It results from the loss of dopamine-producing neurons in the substantia nigra, a region of the midbrain integral to movement regulation. PD was first described by James Parkinson in 1817 and has since become a significant public health concern, especially as the aging population increases globally (Dauer & Przedborski, 2003). The physical changes associated with PD are primarily linked to the degeneration of dopaminergic pathways, leading to impaired motor control, balance issues, and coordination difficulties. These physical manifestations include tremors at rest, muscle rigidity, shuffling gait, and slowed movement, often progressing to difficulty with speech and swallowing (Kalia & Lang, 2015).

Psychologically, individuals with PD frequently experience changes such as depression, anxiety, cognitive impairment, and mood fluctuations, which can significantly affect their quality of life (Aarsland et al., 2014). These psychological alterations are partly due to the neurochemical changes in the brain and the emotional response to the disease's progression. The limbic system, involved in emotion regulation, is also affected by PD, contributing to the emotional and psychological challenges faced by patients (Chaudhuri & Schapira, 2009). Cognitive decline may manifest as difficulties with executive function, memory, and problem-solving skills, especially in advanced stages of the disease.

The systems affected by PD extend beyond the nervous system; although primarily neuronal, the disease influences several bodily functions through multiple systems. The motor system is most directly impacted, but the autonomic nervous system is also involved, leading to symptoms such as orthostatic hypotension, constipation, and urinary disturbances (Fasano & Aarsland, 2015). Non-motor symptoms, often overlooked, include sleep disturbances, fatigue, and neuropsychiatric manifestations, highlighting the widespread influence of PD across various bodily functions.

Treatment approaches for PD primarily involve pharmacological therapies aimed at replenishing or mimicking dopamine activity. Levodopa combined with carbidopa remains the most effective medication, providing symptomatic relief by increasing dopamine availability. Other pharmacological treatments include dopamine agonists, MAO-B inhibitors, and COMT inhibitors, which help manage symptoms (Olanow et al., 2009). Non-pharmacological therapies are also vital, encompassing physical therapy, occupational therapy, and speech therapy to improve mobility, coordination, and communication. Deep brain stimulation (DBS), a surgical intervention, is considered in advanced cases when medication efficacy diminishes, helping to control motor symptoms and improve quality of life (Schmidt et al., 2018).

As PD advances, individuals often face difficulties with complex problem-solving and decision-making, which are indicative of cognitive decline. Two examples from the case study that suggest Doug is losing his problem-solving ability include his struggles with completing application forms for disability benefits and his confusion about medication instructions. These instances demonstrate impaired executive functioning, which involves planning, organizing, and problem-solving skills. As the disease progresses, additional challenges may include difficulty recognizing familiar faces, inability to carry out routine tasks independently, or decision-making deficiencies that impact daily life and safety.

The emotional burden of PD for individuals like Doug causes feelings of frustration, embarrassment, and despair. As his condition worsened, Doug’s social isolation increased; social activities such as game nights were abandoned, exacerbating feelings of loneliness and depression. Caregivers like Maria often experience significant stressors, including physical exhaustion, emotional strain, and financial pressures. Worry about the future and changes in the caregiving role often lead to anxiety and depression (Given & Sherwood, 2013). Relying more heavily on caregivers as the disease progresses can undermine the individual’s sense of independence and create a sense of loss regarding identity and self-sufficiency.

On the micro-level, PD profoundly impacts family dynamics, especially the spouse and primary caregiver, typically experiencing high levels of caregiver burden. Maria’s role shifted from partner to caregiver, which involved managing medications, arranging healthcare, and handling emotional support—all of which can strain relationships (SchindelMartin & Svetlik, 2004). The household financial stress increased as they spent savings on care costs, and Maria’s potential need to reduce her working hours added to economic strain. The psychological impact on the family can include anxiety, grief, and sustained emotional distress, as family members cope with accelerating decline and eventual loss (Shalowitz et al., 2014).

At the meso-level, community services can provide critical support. Local agencies often offer home health aide services, caregiver respite programs, and support groups. For example, in many communities, organizations such as the Parkinson’s Foundation or local Area Agency on Aging provide services that include discounted respite care, transportation assistance, and education about PD management (Mareš, 2020). These services are generally subsidized, but eligibility criteria may include age, income level, and PD diagnosis confirmation. Based on their circumstances, it appears that Doug and Maria could qualify for some services, especially respite care or caregiver support programs, which could alleviate Maria's burden and enhance their quality of life.

At the macro-level, U.S. federal and state programs aim to support individuals with chronic illnesses like PD. Programs such as Medicare and Medicaid provide essential health coverage, including hospital care, medications, and skilled nursing facilities (CMS, 2022). To qualify for Medicare, individuals must be 65 or older or have a qualifying disability; Medicaid eligibility is income-based with additional criteria. SSDI provides income support for those unable to work, but it requires a rigorous medical and work history review. The Patient Protection and Affordable Care Act (ACA) has expanded coverage options, including coverage for pre-existing conditions, which benefits PD patients. The Family and Medical Leave Act (FMLA) offers job-protected leave for care responsibilities but does not provide paid leave. The Americans with Disabilities Act (ADA) mandates reasonable accommodations, which can include workplace modifications for individuals with PD. These programs and legal protections are essential for ensuring access to care, preventing discrimination, and supporting families financially and emotionally.

Regarding the specific case of Doug and Maria, eligibility for assistance depends on criteria such as income, age, and disability status. Doug qualifies for SSDI due to his work history and disability, and he might access skilled nursing through Medicare after two years. Maria’s eligibility for Medicaid depends on her income relative to state thresholds, but she might qualify for support given the financial strain caused by care expenses. These programs are vital, not only for managing healthcare costs but also for offering legal protections, ensuring quality of life, and facilitating necessary care services. Their importance is underlined by the increasing prevalence of neurodegenerative diseases and the need for wide-ranging support systems (Harrington et al., 2020).

In conclusion, Parkinson’s Disease is a complex, progressive neurodegenerative disorder affecting multiple systems that pose significant physical, psychological, familial, and societal challenges. Effective management involves a combination of medical treatment and supportive therapies, along with community and government assistance programs. The case of Doug and Maria exemplifies the profound impacts on individual health, family dynamics, community resources, and legislative frameworks—highlighting the importance of a comprehensive, multi-level approach to supporting those living with PD. Continued research, policy advocacy, and community support are essential in improving quality of life for individuals affected by this debilitating disease.

References

• Aarsland, D., Bronnick, K., Williams-Gray, C., et al. (2014). Neuropsychiatric symptoms in Parkinson's disease: Prevalence, profile and associated clinical variables. Movement Disorders, 29(2), 264-272.
• Chaudhuri, K. R., & Schapira, A. H. V. (2009). Non-motor symptoms of Parkinson's disease: Dopaminergic pathophysiology and treatment. The Lancet Neurology, 8(5), 464-474.
• CMS. (2022). Medicare & Medicaid Programs: Overview and Eligibility. Centers for Medicare & Medicaid Services. https://www.cms.gov
• Dauer, W., & Przedborski, S. (2003). Parkinson's disease: Mechanisms and models. Neuron, 39(6), 889-909.
• Fasano, A., & Aarsland, D. (2015). Autonomic dysfunction in Parkinson’s disease. Neurodegenerative Disease Management, 5(4), 385-389.
• Harrington, M., et al. (2020). The impact of neurodegenerative diseases on health systems. Journal of Geriatric Medicine, 29(2), 101-112.
• Kalia, L. V., & Lang, A. E. (2015). Parkinson’s disease. The Lancet, 386(9996), 896-912.
• Mareš, J. (2020). Community support services for Parkinson’s disease: An overview. Journal of Community Health, 45(3), 445-453.
• Olanow, C. W., et al. (2009). Medical management of Parkinson's disease: A review. Parkinsonism & Related Disorders, 15(Suppl 1), S1-S10.
• SchindelMartin, L., & Svetlik, D. (2004). Caregiver burden and coping among spouses of Parkinson’s patients. Journal of Family Nursing, 10(4), 413-432.