IndexIntroductionPathophysiologyRisk FactorsAgeGenetic FactorsEnvironmental FactorsTheory of AgingImpact on the Person and Ethical ConsiderationCare ModelConclusionReferencesIntroductionThis case will examine a resident of an aged care facility and his or her medical conditions and associated comorbidities. The pathophysiology of their conditions will be discussed and we will see how their condition relates to theories of aging. We will also discuss models of care and see how this condition affects the daily lives of residents. This case study concerns Mr A, a resident of the 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 falls, has a suprapubic catheter, constipation problem. According to Mr. A he first felt symptoms of his disease at the age of 60 and these symptoms worsened as he aged. He has difficulty walking and carrying out his daily activities as he requires constant help and supervision. Mr A's wife, who cared for him, died a few years ago and he decided to come to the aged care facility because he was unable to manage things on his own. He has a son who works and lives interstate. Mr A says it wasn't such a big shock to him when he was diagnosed with this condition as his father had Parkinson's. Mr. A's condition has dramatically changed his life as he must 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 Shouldn't Be Banned"? Get an original essay Pathophysiology Magrinelli et al., (2016) explain that Parkinson's has traditionally been considered a purely movement-related disorder that has a relationship with the degeneration of dopaminergic neurons, but, in recent years, the clinical definition has changed and defines the Parkinson's disease as a multisystem neurodegenerative disease characterized by motor and non-motor features. Motor signs and symptoms, including tremor, bradykinesia, and rigidity, are attributed to the loss of dopamine neurons, and gait and balance problems are linked to degeneration of the dopamine pathway. Non-motor features include depression and delusions, constipation, urinary and genital disorders, memory, olfactory dysfunction, and sleep disturbances and these are the result of multiple neurotransmitter deficiencies in the peripheral and central nervous systems. Each of these symptoms, alone or together, contributes to reducing the patient's quality of life and disabilities. The Australian Brain Foundation explains that Parkinson's occurs due to low levels of dopamine production, which is due to the death of the nerve cells that produce it (Brain Foundation, 2019). Dopamine is the chemical that helps transmit messages between the brain and the 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 (governs voluntary motor controls in the body), results in the loss of motor functions in people with Parkinson's. They further explain that two types of dopamine receptors, D1 and D2, influence motor activity in the extrapyramidal system, which includes the globus pallidus segment and the substantia nigra (SN). These components are further connected to the thalamus and cortex and the loss of dopamine results in a reduced ability of the thalamus to activate the frontal cortex leading to areduced motor activity characteristic of Parkinson's. However, the non-motor symptoms associated with Parkinson's are due to progressive and widespread aggregation of alpha-synuclein in specific nuclei of the peripheral nervous system and central nervous system, and these changes may become visible to the eye years before motor symptoms begin to appear. . .Risk FactorsAgeAging remains the most important risk factor for the development of Parkinson's disease since with advancing age a series of processes crucial for the correct 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 is rare in people under the age of 40, but the frequency tends to increase thereafter. Another study concluded that men are 1.5 times more likely to develop the condition than women. Rodriguez et al; (2015) explains that Parkinson's is a neurodegenerative disease in which aging is the main risk factor and the incidence of the disease increases exponentially in people over the age of 60. Genetic Factors Having a family history of Parkinson's 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 and these mutations can be passed down through family members and increase a person's chance of developing Parkinson's disease. Another similar study aimed at identifying key risk factors for Parkinson's disease found that having a family history of Parkinson's disease significantly increases the risk. Environmental Factors Some environmental factors can significantly increase the risk of Parkinson's disease, including exposure to pesticides, some heavy metals, head injuries, and Numerous drugs have been associated with Parkinson's disease, including calcium channel blockers, non-steroidal anti-inflammatories and statins. Chen & Ritz (2018) state that risk factors for Parkinson's disease increase due to genetic and environmental factors including pesticide exposure and traumatic brain injury. Aging Theory Theories of aging have been proposed in an attempt to explain why we age and what the aging process is, and the two main categories of modern theories are based on programmed theories and damage and error theory. Jin (2010) explains that the programmed cell death theory has further subcategories including programmed longevity, endocrine theory, and immunological theory, and the damage and error theory is divided into five categories. Venderova & Park, (2012) states that cells can decide and control their own fate using different functions and mechanisms and these functions are generally genetically programmed leading to programmed cell death (PCD). They further state that these cell deaths require the use of energy in the form of ATP and genetic changes and are generally of two types: apoptosis, autophagic and these processes have high significance in Parkinson's disease due to the similarity of genetic involvement. Apoptosis, the most common form Cell death is closely linked to Parkinson's disease and in this process the membrane of the cell 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 some mutated alpha-synucleins causes cell death by apoptosis. Venderova & Park (2012) states that the overexpression of some genes including SNCA, PINK1, some DJ1, LRRK2,are one of the main triggers of apoptosis and increase the sensitivity to apoptotic cell death, and these genes are also common in the pathogenesis of Parkinson's disease. as defined by Glick, Barth, and Macleod, (2010), it is an important process for balancing energy sources in response to nutritional stress and also plays a role in the removal of aggregated proteins and damaged cellular organelles. Parkinson's pathogenesis shares some common themes including oxidative stress, mitochondrial dysfunction, and protein aggregation, and all of these themes are closely linked to autophagy. Michel, Hirsch, and Hunot (2016) explain autophagy as an adaptive response when the body is starved of nutrients and state that several Parkinson's-related genes, namely DJ-1, alpha-synuclein, and LC3, are linked to the dysregulation of autophagy which can lead to neurodegeneration and Parkinson's disease. .Impact on the person and ethical considerationParkinson's disease has dramatically changed Mr. A's life, as evidenced by his deterioration in physical functioning. Rizek, Kumar, and Jog (2016) explain that some of the classic symptoms of Parkinson's disease include tremor, soft voice, expressionless face with reduced eyelids, bladder or bowel problems, and muscle stiffness. These symptoms can be observed in Mr. A and greatly affect his life. Due to the tremors, he needs constant supervision in all his daily activities and also in his mobility. He is at high risk of falling. His eyes don't blink and need regular eye drops as they are always red and water keeps running out of them. Mr A feels isolated as his social interaction has drastically 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 his doctor suggested the catheter. Mr. A, in the presence of his doctor, son and nurses, wrote his Advance Care Plan (ACP) a few years ago. Carr & Luth (2017) define the Advance Care Plan (ACP) as a tool that allows patients to communicate their treatment preferences and is a way to respect and achieve patient and family priorities. He neither wants to undergo any surgery in the event of an injury or fall, nor does he want to be resuscitated. He has appointed his son as the primary decision maker when he is unable to communicate his needs in the future. Your ACP clearly mentions your care priorities in the event of an accident and provides your elderly care, doctor and healthcare assistants with a clear view of your care needs and thus respects your autonomy. NSW Department of Health-Clinical Innovation Agency Care Model (2014) explain that a care model should be person-centred, resource efficient, support safe and quality care for patients at the right time and which has two types, financial model of assistance and clinical assistance. The financial model of assistance can be direct-to-consumer or residential. Bally and Jung (2015) state that people living in residential communities have better access to doctors and other healthcare teams and are at a lower risk of hospitalization and therefore greater access to healthcare. Mr A lives in an aged care facility and this has been of great help to him since his wife passed away. Mr. A has healthcare professionals who regularly assist him with his needs, including ADLs and ambulation. Thenurses are at his disposal day and night to constantly administer medications and other relevant care and doctors can make visits if necessary. Mr. A is always encouraged to participate in activities with other residents in the facility to increase his social interaction. Therefore the residential care model is the best option for Mr A in terms of health and safety. Please note: this is just an example. Get a custom paper from our expert writers now. Get a Custom Essay Conclusion The current health condition of Mr. A has been discussed in this paper. We discussed how Parkinson's is linked to the programmed theory of aging and which genes are commonly involved in it. Parkinson's has had a great impact on his life and because of this he faces many problems in his daily life. As he aged, it was becoming difficult for him to manage himself, and after the death of his wife it was almost impossible to live at home alone. The various comorbidities associated with his disease also add to the difficulties. After moving to a care facility, Mr. A was able to manage his life better thanks to the constant medical and healthcare support available to him. References Clinical Innovation Agency-NSW Ministry of Health. (2014). Models of care | Clinical Innovation Agency. North West Wales: Agency for Clinical Innovation (ACI) Retrieved on: 14/04/2019. Retrieved from https://www.aci.health.nsw.gov.au/resources/models-of-careBally, K., & 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. Retrieved on: 04/03/2019. Retrieved from https://brainfoundation.org.au/disorders/parkinsons-disease/Carr, D., & Luth, E.A. (2017). Advance care planning: Contemporary issues and future directions. Innovation in Aging, 1(1). doi:10.1093/geroni/igx012Chen, H., and 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 formulary management, 40(8), 504-532. Glick, D., Barth, S., & 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 Illness, 1(2), 72-74.Levy, O.A., Malagelada, C., & Greene, L.A. (2009). Cell death pathways in Parkinson's disease: proximal triggers, distal effectors and final steps. 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, D. J. (2012). The role of autophagy in Parkinson's disease. Cold Spring Harbor Perspectives in Medicine, 2(4), a009357-a009357. doi:10.1101/cshperspect.a009357Magrinelli, F., Picelli, A., Tocco, P., Federico, A., Roncari, L., Smania, N., . . . Tamburino, S. (2016). Pathophysiology of motor dysfunction in Parkinson's disease as a rationale for pharmacological treatment and rehabilitation. Parkinson's disease, 2016, 9832839-9832839. doi:10.1155/2016/9832839Marinus, J., Zhu, K., Marras, C., Aarsland, D., & van Hilten, J. J. (2018). Risk factors for non-motor symptoms in Parkinson's disease. The Lancet. Neurology, 17(6), 559-568. doi:10.1016/S1474-4422(18)30127-3Michel, Patrick009365