Question

13. Refer to case study 1 to answer the following question: What are some things that Thomas's family and carers should consider when interpreting his individual care plan? Case study 1 Rhonda works in the community as part of a team that assists with showering people in their own homes. Thomas is an 88-year-old man with Parkinson's disease and moderate dementia. Thomas lives at home with support from Rhonda and some other home services. He has a son who comes over every evening to provide him with a hot meal and help him change for bed. Thomas has significant memory loss, becomes agitated by background noise, cannot express his emotions and is at high risk of falls. Thomas previously played violin in an orchestra, so he loves the sound of the violin, BIU X Styles

Answer 1

13. Everyone is different and unique and they have different likes and dislikes . Before we plan care for Thomas ,some of the things to be considered are :-

- His likes and dislikes, so that we plan care according to that.

- Assess for his needs , prioritise it and plan care .

- Look for the equipments needed for providing care

- Assess for any added assistance is needed or not ?

14. Five signs of moderate dementia are : -

- Behavioural and personality changes

- Unable to learn or recall new information

- Long-term memory affected

- Wandering, agitation, aggression

- Require assistance with daily living

15. Motor and non - motor symptoms of Parkinson's disease are :-

4 classic symptoms of PD:

-Tremor: Trembling at rest is an early sign of PD; it may be accompanied by a "pill-rolling" motion of thumb and fingers.

-Rigidity: Resistance to movement, especially "cogwheel" rigidity (jerky movements of arm), is a characteristic symptom.

-Bradykinesia: Slowed movement of voluntary and automatic movements increases the time it takes to perform activities of daily living (ADLs).

-Postural instability: Stooped posture can lead to instability and falls. Affects later in PD life

Motor symptoms often begin unilaterally and progress to both sides of the body,

Major non-motor symptoms of PD are:

-Cognitive deficits: Slowed thinking, confusion, memory loss, and (later) Parkinson dementia

-Emotional changes: Depression, fear, anxiety, panic attacks, social withdrawal, and apathy

-Sleep problems: Insomnia, daytime sleep attacks, restless leg syndrome, parasomnias, and rapid eye movement.

The motor manifestations of PD :-

-Motor:

Related to bradykinesia:

Excessive drooling

Difficulty eating

Slurred speech

Lengthy pauses during speech

Hypophonia (lower voice volume)

-Related to postural instability:

Parkinsonian gait (small, shuffling steps)

Retropulsion (tendency to topple backward when movement is disturbed)

Festination (rapid steps)

Freezing (an inability to move)

-Micrographia (small, cramped writing)

Lack of affect

Muscle cramps

Dystonia (twisting and repetitive movements)

Oculogyric crisis

The the non-motor manifestations of PD are :-

Nonmotor:

Constipation

Bladder problems (hesitation or frequency)

Sexual dysfunction

Skin problems (seborrhea, hyperhidrosis)

Anosmia (decreased ability to smell)

Orthostatic hypotension

Pain/discomfort

17. Thomas family can increase his safety when they take him out into the community by ensuring that he is not send alone , one person is always with him while going out and also while doing the daily activities . Applying a hand band on his arm so that he can be identified by the information provided in it .

Answer 2

13. Everyone is different and unique and they have different likes and dislikes . Before we plan care for Thomas ,some of the things to be considered are :-

- His likes and dislikes, so that we plan care according to that.

- Assess for his needs , prioritise it and plan care .

- Look for the equipments needed for providing care

- Assess for any added assistance is needed or not ?

14. Five signs of moderate dementia are : -

- Behavioural and personality changes

- Unable to learn or recall new information

- Long-term memory affected

- Wandering, agitation, aggression

- Require assistance with daily living

15. Motor and non - motor symptoms of Parkinson's disease are :-

4 classic symptoms of PD:

-Tremor: Trembling at rest is an early sign of PD; it may be accompanied by a "pill-rolling" motion of thumb and fingers.

-Rigidity: Resistance to movement, especially "cogwheel" rigidity (jerky movements of arm), is a characteristic symptom.

-Bradykinesia: Slowed movement of voluntary and automatic movements increases the time it takes to perform activities of daily living (ADLs).

-Postural instability: Stooped posture can lead to instability and falls. Affects later in PD life

Motor symptoms often begin unilaterally and progress to both sides of the body,

Major non-motor symptoms of PD are:

-Cognitive deficits: Slowed thinking, confusion, memory loss, and (later) Parkinson dementia

-Emotional changes: Depression, fear, anxiety, panic attacks, social withdrawal, and apathy

-Sleep problems: Insomnia, daytime sleep attacks, restless leg syndrome, parasomnias, and rapid eye movement.

The motor manifestations of PD :-

-Motor:

Related to bradykinesia:

Excessive drooling

Difficulty eating

Slurred speech

Lengthy pauses during speech

Hypophonia (lower voice volume)

-Related to postural instability:

Parkinsonian gait (small, shuffling steps)

Retropulsion (tendency to topple backward when movement is disturbed)

Festination (rapid steps)

Freezing (an inability to move)

-Micrographia (small, cramped writing)

Lack of affect

Muscle cramps

Dystonia (twisting and repetitive movements)

Oculogyric crisis

The the non-motor manifestations of PD are :-

Nonmotor:

Constipation

Bladder problems (hesitation or frequency)

Sexual dysfunction

Skin problems (seborrhea, hyperhidrosis)

Anosmia (decreased ability to smell)

Orthostatic hypotension

Pain/discomfort

17. Thomas family can increase his safety when they take him out into the community by ensuring that he is not send alone , one person is always with him while going out and also while doing the daily activities . Applying a hand band on his arm so that he can be identified by the information provided in it .