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This case study is based on a topic that is frequently related to nursing the older person. Choose a person from the in the student guide community that you are interested in investigating further. These are on page 2 and 3 of this file. You will need to refer to the community guide for the social context.
Goal
The aim of this exercise is to assist you in preparation for your WIL experience. You will apply your knowledge of healthy ageing and challenges to health for older persons to assess the health needs and inform decision making for care planning to support the health of the older person in diverse health settings.
Your case study will highlight challenges, factors influencing care; enhancing and/or empowering older persons through your demonstration of clinical reasoning and ethical communication. You will undertake an analysis, assessment and care planning of one of the provided case studies.
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The presented case study reveals the psychosocial and biophysical issues experienced by 78 years old female (Sharon) who is supported by her granddaughter and experiences the pattern of Alzheimer's disease, hypertension and hypercholesterolemia. Alzheimer's disease (AD) is manifested by gradual memory failure that leads to the psychosocial and biophysical incapacitation of the affected individual (Bird, 2017). The manifestations of Alzheimer's disease adversely influence mental health and language and lead to the development agitation and withdrawal. Alzheimer's disease exhibits the pattern of dementia leading to the development of memory failure, poor judgement and confusion. AD is regarded as an irreversible condition that results in the establishment of dementia and associated cognitive decline. AD is a potential risk factor for the development of psycho-socio-somatic deterioration and associated debilitating manifestations (Bekris, et al., 2010). AD influences 24 million elderly individuals across the globe (Mayeux & Stern, 2012). The risk of AD occurrence increases reciprocally with age advancement. Alzheimer's disease appears with the progressive development of neuritic extracellular amyloid plaques under the periphery of intraneuronal neurofibrillary tangles and dystrophic neurites (Mayeux & Stern, 2012). The regions including Western Europe, China, Latin America and North America exhibit greatest prevalence of AD and associated clinical manifestations. AD influences most developed regions of the world in comparisons to the developing nations of Asia and Africa. The risk factors that evidentially elevate the prevalence of AD include, hypertension, diabetes mellitus, cerebrovascular disease, low body weight, brain trauma and smoking habit (Mayeux & Stern, 2012). Contrarily, the protective factors that reduce the predisposition of individuals in terms of acquiring AD include physical activity, cognitive elevation measures and dietary management measures. AD considerably influences the behavior of elderly individuals, thereby leading to the deterioration of their emotional state across the community environment (Reitz, et al., 2011). In the presented case study, the patient is affected with the pattern of hypercholesterolemia. Evidence-based research literature reveals the predisposition of elderly individuals (affected with hyperlipidemia) towards acquiring Alzheimer's disease and associated clinical manifestations (Reitz, et al., 2011). Patients affected with metabolic syndrome also experience high-risk of developing AD across the community environment. AD is diagnosed through clinical examination. No definitive diagnostic evaluation mechanism is yet available for tracking the pattern of AD in the affected patients. The heritability pattern of AD ranges between 58%-79%. The genetic mechanisms involved in the causation of AD require further exploration through prospective research interventions (Reitz, et al., 2011).
Multiple factors including aging exacerbation, exposure to toxic substances, malnutrition, brain injury, degeneration of cortico-cortical and cholinergic pathways lead to the establishment of AD across the community environment (Armstrong, 2013). Exposure to volatile anesthetics, organic solvents, electromagnetic field and pesticides increases the risk of individuals towards the acquisition of AD (Jiang, et al., 2013). Indeed, the pre-existing disease states including cancer, depression and hypertension induce the biochemical pathways that evidentially lead to the development of Alzheimer's disease. The lifestyle factors including the regular consumption of coffee and alcohol, nicotine addiction and sustained reduction in cognitive and physical activities facilitate the establishment of AD across the community environment. The carriers of APOE ε4 allele remain at elevated risk of acquiring AD following the consistent consumption of alcohol (Qiu, et al., 2009). The sustained elevation in blood pressure in elderly individuals results in the development of atherosclerotic plaques that subsequently lead to the configuration of cerebrovascular lesions and deterioration in cerebral perfusion. This neurodegenerative process results in the development of AD in the affected patients. The two-hit theory advocates the concomitant influence of environmental and genetic risk factors on the epigenetic pathway of younger individuals that determine their risk of developing AD over the course of time (Manivannan, et al., 2015). The progression and establishment of AD evidentially consumed 10-30 years under the influence of triggering events. Findings of selected research interventions reveal the attribution of tau protein and amyloid beta-protein on the causation of AD across the community environment (Manivannan, et al., 2015). The gradual and sustained exposure of environmental aluminum to human results in the development of an inflammatory response, oxidative stress and neurofibrillary degeneration that facilitate the development of AD in elderly predisposed individuals (Manivannan, et al., 2015). Similarly, exposure to environmental copper leads to the induction of amyloid-β plaques in brain, thereby resulting in the establishment of dementia and associated learning deficits (Manivannan, et al., 2015).
