Pakinsons Case

Within this essay this will look into the long term condition/illness from the perspective of the individual and their family. I have chosen Parkinson's disease (also known as Parkinson's or PD).Parkinson's disease affects the part of the brain that is responsible for the control of movement (Griffiths & Coene 2000). Griffiths &Coene (2000) describes Parkinson's disease as follows, normally the brain acts like the automatic pilot on an aeroplane, organising and controlling our movements without being aware of it. Generally all aspects of movement are carefully attuned to each other as a matter of course. Sometimes as with Parkinson's something go's wrong with the automatic pilot, which means that movement is no longer simple not straight forward". Trail, Rotas & Lai (2008) describes Parkinson's as follows a syndrome manifested by part or the entire syndrome of rest tremor, rigidity brady kinesia and postural instability, Parkinson's disease therefore is a specific chronic progressive neurodegenerative disease.

The rationale for the choice of this subject is that Parkinson's disease is on the increase, This influences both me and my career because it is becoming increasingly likely I will be looking after this type of patient in my future career, as The National Centre for Health Statistics (a division of the centre for health control) cited in Tagliati, Gulen & Horne (1997) reported that approximately one percent of all Americans over the age of 65 receive a diagnosis of Parkinson's disease every year, as this is in America I feel that this reflects the same scenario in the UK and the increase of Parkinson's is universal. I am interested in Parkinson's disease because it is a complicated disease in which patients have combined mental and physical needs. I have cared for many Parkinson's patients which given rise to the opportunity to choose it as a suitable subject. National Health Service choices (2008) stated at the statistics for the UK in 2008 were that Parkinson's disease affects about 12,000 patients over the age of 50 and that there has been an increase of 14% over the last decade. As I have cared for patients that were younger than 50 years old, my interest increased. Patients who are diagnosed with Parkinson's are becoming younger with as many as one in twenty being under the age of 40 (Primary Health Care 2010). In a 2006 interview Michael. J. Fox the actor reported that as many as 40 percent of the 60,000 new Parkinson's cases each year involve someone who was younger than 50 years old (Tagliati, Guten &Horne 2007). This figure alone contradicts the myth that only elderly people get Parkinson Disease, as Mr Fox was diagnosed in his 30's (Tagliati, Guten &Horne 2007). Lieberman (2002) who suggests that Parkinson's is a disease of ageing, the greatest risk factor for Parkinson's is growing old. At 70 years old the risk for Parkinson's disease is much greater than at 35 years old, since the perpetually young actor Michael J Fox was diagnosed with Parkinson's disease before the age of 35 Parkinson's is no longer seen as a grandfathers disease. Instead of children being concerned with Parkinson's in their parents, parents are now concerned at Parkinson's disease in their children. Lieberman (2002) also said that doctors who never diagnosed Parkinson's disease below the age of 35 now must consider it possible. Furthermore the rationale for my choice is to have a clearer understanding of Parkinson's disease and the impact it should have on my own personal development as a nurse. Noble (2007, p34) describes the complexities of medication management and the problems of concordance with treatment. Also Bartlett (2007 ,p51) agreed that this was a major issue with patients with Parkinson's disease as well as Nelson (2008, p59) This made me want to question why patients find it hard to take their medication.

According to Tagliati, Guten &Horne (2007) males are more likely to get Parkinson's than females, the ratio of men to woman I seen was 2-1 On my placements I have only nursed males. Sagar (1991) stated Parkinson's disease is equally common in men and women, which made me think that the statement from Sagar (1991) may have been true in 1997 but in 2007 Guten & Horne (2007) statement could be also true, in addition Swinn (2005) maintained that most studies have found a slight excess of male to female cases.

Within this essay I will examine into a patient and his wife (who was his main carer). In order to maintain the confidentiality of the patient a fictitious name will be used as keeping within the code of professional conduct 2008, (National midwifery council N.M.C 2008), which I will call patient A. Patient A was a male aged 57 years old. Patient A was diagnosed with Parkinson's at the age of 49 years old. He was admitted to hospital due to a fall in his home. Patient A was a heavy man and his wife found him on the floor in his home and had to call an ambulance as she could not lift him. Patient A was sent to a rehabilitation ward, where this was the ward I was on placement. Within my time on placement Patient A was successfully discharged from hospital, with the help of a multi-disciplinary team, patient A was later re-admitted within three weeks of going home with another fall. Patient A lived with his wife in a three bedroomed house with no carers. Within this essay I will explore at the NMC guidelines and the Nice guidelines on Parkinson's disease.

Due to the restriction of the word count I am only going to concentrate on a few areas related to Parkinson's disease. The research reviewed includes communications, the risk of falls and medicine management. Which I will critically analyse the role of a nurse in the management of care delivered to patient A and his wife. I will reflect upon the analysis and how it may be used to enhance nursing practice.

Patient A came into the rehabilitation ward from a medical ward due to falls at his home. The greatest risk from Parkinson's disease as it advances is the danger of falling (Tagliati Guten & Horne 2007). Sharma (2008) also stated that danger of falling was greater in the later stages of the disease. This was confirmed with Trail et al (2008) as they conducted a study on 548 patients with neurological diseases which concluded that 62% of Parkinson's disease patients had one or more falls than those with any other neurological diseases. Patient A's wife was very anxious about him falling and this was her major concern, she did not want to leave him alone for any appreciable time, accordingly this affected her social life. Patient A also said he had difficulty with his feet which caused him not being able to walk properly, Sharma(2008) suggested that this was