Table of ContentsIntroductionPathophysiologyRisk FactorsAgeGenetic FactorsEnvironmental FactorsTheory of AgingImpact on the Person and Ethical ConsiderationModel of CareConclusionReferencesIntroductionThis case will examine a resident of a residential care facility elderly, their state of health and associated comorbidities. The pathophysiology of their pathology will be discussed and we will examine how their pathology relates to theories of aging. Models of care will also be discussed and we will see how this condition affects residents' daily lives. This case study concerns Mr. A, a resident of ABC Aged Care Facility. Mr. A is 78 years old, has lived with Parkinson's disease for 18 years and is at constant risk of falling, has a suprapubic catheter, a constipation problem. According to Mr. A, he first experienced symptoms of his illness at the age of 60 and these symptoms worsened with age. He has difficulty walking and performing daily activities because he requires constant assistance and supervision. Mr. A's wife, who cared for him, died a few years ago and he decided to come to a nursing home because he was not able to manage on his own. He has a son who works and lives on the highway. Mr A said it wasn't as big a shock to him when he was diagnosed with the disease as his father suffered from Parkinson's disease. Mr. A's health condition has dramatically changed his life as he has to make various changes in his daily life to better manage his condition and associated comorbidities. Say no to plagiarism. Get a tailor-made essay on “Why Violent Video Games Should Not Be Banned”? Get the original essay PathophysiologyMagrinelli et al., (2016) explain that traditionally, Parkinson's disease has been considered a purely movement disorder that has a relationship with the degeneration of dopaminergic neurons, but, in recent years, the definition clinical practice has changed and defines Parkinson's disease as a multisystem neurodegenerative disease characterized by non-motor and motor features. Motor signs and symptoms, including tremor, bradykinesia, and rigidity, are attributed to loss of dopamine neurons, and problems with gait and balance are linked to degeneration of the dopamine pathway. Nonmotor features include depression and delusions, constipation, urinary and genital disorders, memory, olfactory dysfunctions, and sleep disturbances, which are the result of multiple neurotransmitter deficiencies in the peripheral and central nervous system. Each of these symptoms, alone or together, contributes to a reduction in the patient's quality of life and disabilities. The Australian Brain Foundation explains that Parkinson's disease is caused by low levels of dopamine production, due to the death of the nerve cells that produce them (Brain Foundation, 2019). Dopamine is the chemical that helps transmit messages between the brain and body. DeMaagd and Philip (2015) explain that the progressive degeneration of dopamine-producing neurons in the pars compacta (located in the middle of the brain), which project signals to the striatum (which governs voluntary motor commands in the body), leads to the loss motor functions in people suffering from Parkinson's disease. They further explain that two types of dopamine receptors, D1 and D2, influence the motor activity of the extrapyramidal system, which includes the pallidal segment of the globus and the substantia nigra (SN). These components are infurther connected to the thalamus and cortex and loss of dopamine results in a decreased ability of the thalamus to activate the frontal cortex, leading to a reduction in motor activity characteristic of Parkinson's disease. However, non-motor symptoms associated with Parkinson's disease are due to progressive and widespread aggregation of alpha-synuclein in specific nuclei of the peripheral nervous system and the central nervous system and these changes could become visible to the naked eye years before motor symptoms begin to appear. .Risk FactorsAgeAging remains the most important risk factor for developing Parkinson's disease, because with age, a number of processes crucial for the proper functioning of the substantia nigra begin to decline. In a study conducted in 2016 to find the relationship between age and Parkinson's disease, it was found that Parkinson's disease was rare in people under the age of 40, but its frequency tended to increase with age. following. Another study concluded that men are 1.5 times more likely to develop this condition than women. Rodriguez et al.; (2015) explains that Parkinson's disease is a neurodegenerative disease in which aging is the main risk factor and whose incidence increases exponentially in people over 60 years old. Genetic factorsHaving a family history of Parkinson's disease increases the risk by almost 10% and a key factor in the disease is Alpha synuclein and mutation of the SNCA, LRRK2 and DJ 1, PINK1 genes are a common cause of Parkinson's disease. Parkinson's. These mutations can be passed down through family members and increase a person's risk of developing Parkinson's disease. Another similar study aimed at identifying major risk factors for Parkinson's disease found that having a family history of Parkinson's disease significantly increases the risk. Environmental Factors Certain environmental factors can significantly increase the risk of Parkinson's disease, including exposure to pesticides, certain heavy metals, head trauma, and A number of medications have also been linked to Parkinson's disease, including calcium channel blockers. , non-steroidal anti-inflammatory drugs and statins. Chen and Ritz (2018) state that risk factors for Parkinson's disease are increasing due to genetic and environmental factors, including pesticide exposure and head trauma. Theory of Aging Theories of aging have been proposed to try to explain why we age and what the process is. of aging and the two main categories of modern theories are based on programmed theories and the theory of damage and errors. Jin (2010) explains that the programmed cell death theory has other subcategories, including programmed longevity, endocrine theory, and immunological theory, and the damage and error theory is divided into five categories. Venderova & Park (2012) assert that cells can decide and control their fate using multiple functions and mechanisms and that these functions are usually genetically programmed, leading to programmed cell death (PCD). They further say that these cell deaths require the use of energy in the form of ATP and genetic changes and are generally of two types, namely apoptosis and autophagy, and these processes have great importance in Parkinson's disease due to the similarity of gene involvement. Apoptosis, the most common form. Cell death is strongly linked to Parkinson's disease and inThis process, the cell membrane remains intact, while various bodies begin to die inside the cell and are not released into the extracellular fluid. Levy, Malagelada, and Greene (2009) state that overproduction of certain mutated alpha-synucleins causes cell death by apoptosis. Venderova & Park (2012) state that overexpression of certain genes including SNCA, PINK1, some DJ1, LRRK2 is a major trigger of apoptosis and increases susceptibility to apoptotic cell death and that these genes are also common in the pathogenesis of Parkinson's disease. as defined by Glick, Barth, and Macleod (2010), is an important process for balancing energy sources in response to nutritional stress and it also plays a role in the removal of aggregated proteins and damaged cellular organelles. The pathogenesis of Parkinson's disease shares some common themes, including oxidative stress, mitochondrial dysfunction, and protein aggregation, and all of these themes are closely related to autophagy. Michel, Hirsch, and Hunot (2016) explain autophagy as an adaptive response when the body lacks nutrients and state that several genes linked to Parkinson's disease, namely DJ-1, alpha-synuclein and LC3, are linked to a dysregulation of autophagy that can lead to neurodegeneration and Parkinson's disease. .Personal Impact and Ethical ConsiderationParkinson's disease dramatically changed Mr. A's life, as evidenced by the deterioration in his physical functioning. Rizek, Kumar, and Jog (2016) explain that some of the classic symptoms of Parkinson's disease include tremors, soft voice, decreased facial expression with reduced blinking, bladder or bowel problems, muscle stiffness. These symptoms can be seen in Mr. A and greatly affect his life. Due to the tremors, he also needs constant monitoring in all his activities of daily living and mobility. He presents a high risk of falling. His eyes don't blink and need regular eye drops because they are always red and the water continues to leak. Mr. A feels isolated because his social interactions have been significantly reduced due to his speech and expression problems. Mr. A has a suprapubic catheter due to loss of bladder control. He says that as his symptoms began to worsen with age, he lost voluntary control of his bladder and the doctor suggested the catheter. Mr. A, in the presence of his doctor, his son and his nurses, wrote his advance care plan (ACP). a few years ago. Carr and Luth (2017) define the advanced care plan (ACP) as a tool that allows patients to convey their treatment preferences and is a means of respecting and achieving the priorities of the patient and their family members. He does not wish to undergo any surgical intervention in the event of an injury or fall, nor to be resuscitated. He has designated his son as his primary decision maker when he is unable to communicate his needs in the future. Their ACP clearly states their care priorities in the event of an incident and provides the elderly, the doctor and the caregivers with a clear view of their care needs and thus respects their autonomy.Care modelAgency for Clinical Innovation -NSW Ministry of Health (2014) explain that a model of care must be person-centred, efficient with the use of resources, support safe and quality care for patients at the right time and that it has two types , a financial care model and clinical care. The financial model of care can be either consumer-directed care orresidential care. Bally and Jung (2015) assert that people living in residential communities have better access to doctors and other care teams and face a lower risk of hospitalization, thereby increasing their access to health care. Mr A lives in an aged care facility and this has been very helpful to him since the death of his wife. Mr. A has caregivers who regularly assist him with his needs, particularly with regard to ADLs and ambulation. Nurses are available day and night to provide ongoing medication and other relevant care, and doctors can visit if necessary. Mr. A is always encouraged to participate in activities with other residents of the facility to increase his social interactions. Therefore, the residential care model is the best option for Mr. A in terms of health and safety. Keep in mind: this is just a sample. Get a personalized document from our expert writers now. Get a Custom Essay Conclusion Mr. A's current health condition has been discussed in this document. We discussed the link between Parkinson's disease and the programmed theory of aging and the genes commonly involved in them. Parkinson's disease has had a huge impact on his life and because of this he faces many problems in his daily life. With his age, it became difficult for him to get by and after the death of his wife, it was almost impossible for him to live alone at home. The various comorbidities linked to his illness also add to the difficulties. After moving into a care facility, Mr A has been able to manage his life better thanks to the medical support and constant care available to him.ReferencesAgency for Clinical Innovation-NSW Ministry of Health. (2014). Models of care | Agency for Clinical Innovation. North West Wales: Agency for Clinical Innovation (ACI) Accessed: 04/14/2019. Retrieved from https://www.aci.health.nsw.gov.au/resources/models-of-careBally, K. and Jung, C. (2015). Caring for the elderly: is home care always best?The British Journal Of General Practice: The Journal of the Royal College Of General Practitioners, 65(640), 565-566. doi:10.3399/bjgp15X687265Brain Foundation. (2019). Parkinson's disease - Brain Foundation. Accessed: 03/04/2019. Retrieved from https://brainfoundation.org.au/disorders/parkinsons-disease/Carr, D. and Luth, EA (2017). Advance care planning: contemporary issues and future directions. Innovation in Aging, 1(1). doi:10.1093/geroni/igx012 Chen, H. & Ritz, B. (2018). The search for environmental causes of Parkinson's disease: moving forward. Journal of Parkinson's Disease, 8(s1), S9-S17. doi:10.3233/JPD-181493DeMaagd, G. and Philip, A. (2015). Parkinson's disease and its management: Part 1: Disease entity, risk factors, pathophysiology, clinical presentation and diagnosis. P&T: A Peer-Reviewed Journal for Forms Management, 40(8), 504-532. Glick, D., Barth, S. and Macleod, K.F. (2010). Autophagy: cellular and molecular mechanisms. The Journal of Pathology, 221(1), 3-12. doi:10.1002/path.2697Jin, K. (2010). Modern biological theories of aging. Aging and Disease, 1(2), 72-74. Levy, OA, Malagelada, C., and Greene, LA (2009). Cell death pathways in Parkinson's disease: proximal triggers, distal effectors and final stages. Apoptosis: an international journal on programmed cell death, 14(4), 478-500. doi:10.1007/s10495-008-0309-3Lynch-Day, M.A., Mao, K., Wang, K., Zhao, M., & Klionsky, DJ (2012). The role of autophagy in Parkinson's disease. Cold Spring Outlook009365