SOC313 Ashford University Parkinson’s Disease Case Study Prior to beginning this assignment, read Chapter 9 from the course textbook, The Stigma of Parkins

SOC313 Ashford University Parkinson’s Disease Case Study Prior to beginning this assignment, read Chapter 9 from the course textbook, The Stigma of Parkinson’s Disease (Links to an external site.) blog post, Neurodegenerative Diseases (Links to an external site.) web page, and the Instructor Guidance.

As the average life span increases, the likelihood of developing a chronic disease increases as well. This assignment focuses on Parkinson’s Disease (PD), which is a neurodegenerative disease. Neurodegenerative disease causes dysfunction and death of nerve cells in the brain and can affect motor, cognitive, and behavioral or psychological functioning. Usually, such disease has a profound impact on the family, as well as the affected individual. The case study below gives you the opportunity to learn more about issues faced by people who have PD as well as exploring the impact of PD on the micro-, meso-, and macro-level systems and the reverse – the micro-, meso-, and macro-level effects on the individual.

Parkinson’s Disease Case Study Details:

Background

Doug and his wife Maria have three adult children, all of whom are married with young children of their own. Doug works as a regional sales representative for a chemical company that produces plastics, chemicals, and agricultural products. He has been in the position for 15 years, having moved into this job after leaving a different company doing similar work. The job requires him to travel to give demonstrations of the products across a six-state region. This requires him to fly and drive in unfamiliar areas. Maria works as a junior high school principal. Doug and Maria are financially set for retirement at age 65. Overall, they are in good health. At the age of 60, Doug received a diagnosis of Parkinson’s Disease (PD).

Early phase

In the year before his diagnosis, Doug had three minor car accidents while he was traveling in unfamiliar territory. Maria was suspicious that the accidents were related to his PD and, after consulting with the neurologist and Doug, they decided he should no longer travel alone out of his immediate area. After a few months of traveling with a colleague, he reluctantly stepped down to a district sales representative position to stay closer to home. Within the next year, Doug started experiencing exacerbated (worsened) symptoms related to fine motor coordination, changes in speech, as well as anger, anxiety, and depression. The neurologist placed Doug on short-term disability at the age of 61. After six months on short-term disability, the law mandates that the individual must apply for Social Security Disability. Therefore, due to Doug’s health continuing to decline and his inability to return to work, Maria had to file for long-term disability for Doug. At first, Maria attempted to work with Doug to complete the disability paperwork. Doug was easily frustrated with formulating the responses to the questions on the forms; he did not know how to answer the questions nor where to find the information within their household records, so Maria hired a lawyer to complete the paperwork.

Three months after submitting the application, Doug was approved for Social Security Disability Income (SSDI). This was a significant drop in income. Doug’s employment income was twice that of Maria’s; he was bringing home $7500 per month. His SSDI income is $2788 per month. Since Doug left his full-time job, he was no longer eligible for health benefits from his employer. He is not eligible for Medicare under the disability guidelines until two years after payments begin. Maria completed the paperwork to add him to the health insurance through her job, which doubled her monthly contribution to health insurance. The decrease in household income required them to utilize their retirement funds earlier than planned. In addition, Maria knows, as the disease progresses, she may have to make decisions about her own full-time work as a principal, which will further strain their financial situation.

Middle phase

Doug and Maria enjoyed playing Scrabble with their friends Susan and Bob, who lived nearby. The two couples would get together every Saturday for some friendly competition along with dessert and lively discussion. A year after his diagnosis, Doug was exhibiting stooped posture and changes in his speech, which made it difficult to understand what he said. These were clear signs the disease was progressing. In some aspects of his life, he appeared to function well enough, such as easily performing most activities of daily living, but it became clear he struggled with activities in the game of Scrabble. For example, he was having a difficult time creating words from the tiles he chose, where to place them on the board, and he could no longer add up his points correctly. In addition, Doug was embarrassed because he continually knocked tiles out of place on the board, struggled to communicate clearly and interact with friends in a social situation. Doug felt a great deal of shame due to the changes and told Maria that he no longer wanted to participate in the weekly game night. This meant that Doug and Maria had less interaction in their own community and became more socially isolated, which is not uncommon for families with a chronically ill member.

Late phase

Doug was in charge of managing his own medications, which he needs four times a day. One day, about four years after his diagnosis, Maria was away from home at noon when Doug called her to ask what he was supposed to do with the noon pills. “I’m supposed to throw them out, right?” That was an early sign of dementia. It was a signal for Maria that Doug could no longer control his own medications and that he probably shouldn’t be left alone for very long. The incident marked the start of a steep decline in Doug’s cognitive and emotional abilities, and the couple’s relationship changed from one of partners to one of patient and caregiver. Maria relied on their children and other family members to help with Doug’s care, and she began looking for support groups to help her figure out how to handle the deteriorating situation. Even though she had a rotation of helpers, most of the work of Doug’s care was Maria’s responsibility.

Doug’s condition progressed to the point of needing full-time care in a skilled nursing facility a little more than a year later, after he lost the ability to stand up, even with help. He always needed two people to help him, and that just wasn’t possible at home. In addition to the tremendous emotional stress on the family, moving Doug to a skilled nursing facility further increased the financial burden. Maria made the decision to sell the house and move to a small apartment by herself. She had to spend the proceeds from their home to pay for Doug’s nursing home care before Medicaid would help pay for his care, due to the Medicaid eligibility spend-down requirements. Doug passed away five months after moving to the skilled nursing facility. Maria was still paying for his care out of the proceeds from the sale of their home, so she never received Medicaid assistance for Doug’s care.

Address the following within the required Parkinson’s Disease Case Study template:

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 Affordable Care Act [ACA], stem-cell research, etc.)
Requirements to qualify for Social Security Disability Income (SSDI)
Requirements to take advantage of the Family and Medical Leave Act (FMLA)
Requirements to qualify for Medicaid/Medicare.
What are the requirements of these programs in terms of paying for skilled nursing for Doug? Do Doug and Maria qualify for assistance through these programs? Why or why not?
Americans with Disabilities Act (ADA).
A program, legislation, or initiative of your finding.
Use a minimum of three scholarly sources. List references in APA format within the response box on the template.

The Parkinson’s Disease Case Study assignment

Must be completed within the Parkinson’s Disease Case Study template.
Must be at least five double-spaced pages in length and formatted according to APA style as outlined in the Ashford Writing Center (Links to an external site.)’s APA Style (Links to an external site.)
Must utilize academic voice. See the Academic Voice (Links to an external site.) resource for additional guidance.
Must use at least three scholarly sources in addition to the course textbook.
The Scholarly, Peer Reviewed, and Other Credible Sources (Links to an external site.) table offers additional guidance on appropriate source types. If you have questions about whether a specific source is appropriate for this assignment, please contact your instructor. Your instructor has the final say about the appropriateness of a specific source for a particular assignment.
Must document any information used from sources in APA style as outlined in the Ashford Writing Center’s Citing Within Your Paper (Links to an external site.) See the Formatting Your References List (Links to an external site.)resource in the Ashford Writing Center for specifications.

Carefully review the Grading Rubric (Links to an external site.) for the criteria that will be used to evaluate your assignment. Donate
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The Stigma of Parkinson’s Disease
February 9, 2015
The hallmark signs of Parkinson’s disease — tremor, stiffness, slowness and/or walking problems
— are fairly obvious to the outside observer. Less apparent non-motor symptoms, such as
depression, anxiety and apathy, are also often present.
Both aspects of Parkinson’s — visible and invisible — can be misinterpreted, causing a stigma
sometimes associated with neurological disease. Slowness of movement or speech may be
perceived as intellectual disability, imbalance as intoxication, masked facial expression as an
unfriendly demeanor, and tremor as nervousness. Internalizing these judgments or trying to
hide the disease to avoid discrimination only make symptoms worse.
Nancy Mulhearn, a person living with Parkinson’s disease, recently shared her approach to
challenging social stigma with Neurology Now:
“I recommend surrounding yourself with a network of people dealing with the same problem… I
didn’t want to be pitied or stared at, and I didn’t want the world to change for me and my
condition,” she explains.
By openly sharing their personal experiences with Parkinson’s, people like Nancy are helping to
educate others. One person and one story at a time, we can work to gradually dissolve the social
stigma associated with neurological diseases like Parkinson’s.
Read the full Neurology Now article.
Rachel Dolhun, MD
Vice President
Medical Communications
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Neurodegenerative Diseases
Program Description
Neurodegenerative diseases a?ect millions of people worldwide. Alzheimer’s disease and
Parkinson’s disease are the most common types, with more than ?ve million Americans living with
Alzheimer’s disease, and at least 500,000 Americans living with Parkinson’s disease, although
some estimates are much higher.
Neurodegenerative diseases occur when nerve cells in the brain or peripheral nervous system lose
function over time and ultimately die. Although treatments may help relieve some of the physical
or mental symptoms associated with neurodegenerative diseases, there is currently no way to
slow disease progression and no known cures.
The risk of being a?ected by a neurodegenerative disease increases dramatically with age.
Population-wide health improvements have increased lifespan which, along with a larger
generation of aging Americans, means more people may be a?ected by neurodegenerative
diseases in coming decades. This creates a critical need to improve our understanding of what
causes neurodegenerative diseases and develop new approaches for treatment and prevention.
Scientists now recognize that the combination of a person’s genes and environment contributes to
their risk of developing a neurodegenerative disease. That is, a person might have a gene that
makes them more susceptible to a certain neurodegenerative disease, but whether, when, and
how severely the person is a?ected depends on what environmental factors he or she is exposed
to during life. Key research challenges are identifying and measuring exposures that may have
occurred many years before an individual is diagnosed and disentangling the e?ects of these
exposures.
What NIEHS is Doing
NIEHS currently funds research projects that look at how exposure to pesticides, pollution, and
other contaminants, alone and in combination with speci?c genes, a?ects neurodegeneration.
NIEHS also provides funding for career development programs to support talented researchers
and cultivate the next generation of leaders in the ?eld.
Grant recipients in this area study the following diseases:
Parkinson’s disease
Alzheimer’s disease
Huntington’s disease
Amyotrophic lateral sclerosis (ALS)
Motor neuron disease
Grant recipients in this area study the following types of environmental factors:
Pesticides, fungicides, and insecticides
Metals (e.g., arsenic, lead, manganese)
Chemicals used in industry or consumer products (e.g., polychlorinated biphenyls (PCBs) and
polybrominated diphenyl ethers (PBDEs))
Air pollution
Biological factors (e.g., endotoxins produced by bacteria)
Dietary and lifestyle factors (e.g., ca?eine, tobacco smoke, dietary antioxidants) in combination
with environmental factor(s) listed above
Program Leads
Jonathan A. Hollander, Ph.D.
Health Scientist Administrator
Tel 984-287-3269
P.O. Box 12233
jonathan.hollander@nih.gov Mail Drop K3-15
Durham, N.C. 27709
Delivery Instructions
Cindy Lawler, Ph.D.
Branch Chief, Genes, Environment, and Health
Tel 984-287-3280
P.O. Box 12233
lawler@niehs.nih.gov Mail Drop K3-15
Durham, N.C. 27709
Delivery Instructions
Related Links
Dementia shows gene-environment link, loss of smell is early sign
! !
SOC313 – WEEK 2 ASSIGNMENT
ENTER YOUR NAME IN THE BOX ABOVE
Parkinson’s Disease Case Study
INSTRUCTIONS: You should review Chapters 1, 2 & 9 before completing the template. Details are required for each section. If you
include enough detail for each section, the template portion of the final document will be at least five double-spaced pages in length,
which meets the paper length requirements. Include APA citations within the Response column where appropriate. You must use a
minimum of three scholarly resources within the assignment. List your references in APA format on the last row of this template. All
citations and references must be in APA style according to the Ashford Writing Center guidelines. Once you complete the template,
upload the document to the Week 2 Assignment section of the course.
REQUIRED ELEMENTS
RESPONSE
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 is the prognosis?
• 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
SOC313
1
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 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
SOC313
2
findings and 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.
o Legislation and lobbying efforts
(e.g., changes to the Affordable
Care Act, stem-cell research)
o Requirements for Social Security
Disability Income [SSDI],
o Requirements to take advantage
of the Family and Medical Leave
Act [FMLA],
o Requirements to qualify for
Medicaid/Medicare,
o Americans with Disabilities Act
[ADA]
o Program, legislation, or initiative
of your own finding.
List your References in APA format
from the scholarly sources you used to
support the information in the rows
above. You must include at least three
scholarly resources from the Ashford
University Library. Make sure to
include a citation within the rows
SOC313
3
where you use the reference material.
SOC313
4

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