(240)-343-2585

Reply

separately

to


two


of your classmates posts (See attached classmates posts, post#1 and post#2).

INSTRUCTIONS:

Respond to two of your peers,

and discuss two separate resources they did not mention. One resource should be aimed at patient education and the second resource should be written for the health professional

.

“In your reply to each of your peers, discuss content that you learned while exploring the website and a resource they might find helpful as well.

The expectation is not that you “agree” or “disagree” with your peers but that you develop a reply post with information that is validated via citations to encourage learning and to bring your own perspective to the conversation.

– Utilize at least two scholarly references per peer post.

Please, send me the two documents separately, for example one is the reply to my peers Post #1, and the second one is the reply to my other peer Post #2.

– Minimum of 300 words per peer reply.

– TURNITIN ASSIGNMENT (FREE OF PLAGIARISM)

Background: I am currently enrolled in the Psych Mental Health Practitioner Program, I am a Registered Nurse, I work at a Psychiatric Hospital.

Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). INSTRUCTIONS: Respond to two of your peers, and discuss two separate resources they did not mention
POST # 1 LEANNE Dementia is an umbrella term for a group of disorders that affect cognition and behavior. Various types of dementia include Alzheimer’s disease, dementia with Lewy bodies (DLB), Parkinsonian dementia (PDD), and frontotemporal dementia (FTD). According to the World Health Organization (WHO) (2019) approximately 50 million people have some form of dementia worldwide, and it is a major cause for disability and dependency for older adults. The purpose of this discussion is to explore ways to reduce costs related to dementia while still maintaining a person’s quality of life (QOL).       Healthcare costs are known to be elevated in the United States (US), and the costs associated with dementia are significant. In 2015, it was estimated that the US spent $818 billion on dementia care (WHO, 2019), and that cost is expected to increase to $2 trillion by the year 2030 (Ijssel et al., 2019). The goal for Healthy People (2020) is to not only reduce the morbidity of dementia but also the costs associated with it while preserving or even improving QOL. Dementia is progressive and usually develops in stages, often overlooked in the beginning due to the gradual onset and mild symptoms including forgetfulness and losing track of time (WHO, 2019).       Early diagnosis could be a key factor in reducing costs associated with dementia. Different types of dementia can have varying effects on individuals as well as differing life expectancy. People suffering from Creutzfeldt-Jakob disease could have a life expectancy as short as three weeks, whereas someone with Alzheimer’s or FTD could live up to 20 years after diagnosis (Mulkey et al., 2019). Mulkey et al. (2019) explain that FTD is the second most common form of dementia with early onset, having symptoms that begin between age 50-60 and usually appear mor as personality and behavioral changes including depression, lack of interest, and being socially inappropriate. Given that one does not usually associate dementia with a person in this age group providers must be aware of changes such as these in a person that could indicate a serious issue. Although there was insufficient evidence found for recommendations on screening for cognitive impairment, the United States Preventive Services Task Force (USPSTF) (2020) agrees that detecting cognitive impairment early may allow for identification and treatment of reversible causes, allow for providers to anticipate problems patients may have following treatment plans, and educate the patient and their family on the implications of dementia so that advanced care planning may be done.       Given that dementia primarily affects older adults, many who suffer from the disorder also have other chronic illnesses. One of the objectives of Healthy People (2020) is to reduce the number of preventable hospitalizations to reduce cost. Many of these hospitalizations are attributed to unmanaged symptoms related to the dementia or symptoms from other chronic illnesses that are not being managed because of the dementia. Palliative care is a great resource that could be used to help manage dementia and its impact on other chronic conditions. Although traditionally palliative care focused on cancer patients, there has been an increased demand to extend palliative care services to all people with life-limiting illness including dementia (Murphy et al., 2016). Symptoms that occur with dementia including agitation, hallucinations, and aggression can be managed by palliative care, and support, education, and ongoing discussions regarding goals of care can be provided to family or caregivers. More providers need to be made aware of and consider palliative care services for their patients with dementia, regardless of the type. References HealthyPeople.gov. (2020). Dementias, including Alzheimer’s disease. Retrieved July 5, 2020 from https://www.healthypeople.gov/2020/topics-objectives/topic/dementias-including-alzheimers-disease Ijssel, J. C. D. V. D., Bakker, C., Smalbrugge, M., Zwijsen, S. A., Adang, E., Appelhof, B., … Koopmans, R. T. (2019). Cost‐consequence analysis of an intervention for the management of neuropsychiatric symptoms in young‐onset dementia: Results from the BEYOND‐II study. International Journal of Geriatric Psychiatry, 35(1), 131–137. https://doi.org/10.1002/gps.5229 Mulkey, M. A., Everhart, D. E., & Hardin, S. R. (2019). Fronto-temporal dementia: A case study and strategies and support for caregivers. British Journal of Community Nursing, 24(11), 544–549. https://doi.org/10.12968/bjcn.2019.24.11.544 Murphy, E., Froggatt, K., Connolly, S., O’shea, E., Sampson, E. L., Casey, D., & Devane, D. (2016). Palliative care interventions in advanced dementia. Cochrane Database of Systematic Reviews. https://doi.org/10.1002/14651858.cd011513.pub2 United States Preventive Services Task Force. (2020, February 25). Cognitive impairment in older adults: Screening. Retrieved July 6, 2020 from https://uspreventiveservicestaskforce.org/uspstf/recommendation/cognitive-impairment-in-older-adults-screening World Health Organization. (2019, September 19). Dementia. Retrieved July 5, 2020 from https://www.who.int/news-room/fact-sheets/detail/dementia
Reply separately to two of your classmates posts (See attached classmates posts, post#1 and post#2). INSTRUCTIONS: Respond to two of your peers, and discuss two separate resources they did not mention
POST # 2 DOUGLAS Pain Assessment and TreatmentThe United States is facing an ever-increasing elderly population and with that will come the challenges of treating their unique diseases and illnesses. One of the most frequent complaints of elderly patients in the primary and emergency room settings is that of chronic pain. Chronic pain has been defined as any pain that lasts for more than six months. In the elderly the physiology behind the pain is often different than in younger patients (Paul-Savoie, 2018).The opioid epidemic which faces the United States has been higher in patients over the age of sixty than for those under sixty. In fact, there is almost double the number of serious reported medical issues of a serious nature reported amongst the elderly related to opioids (Choi,2019). Managing pain in the elderly can be difficult as many elderly patients do not want to inconvenience anyone with their pain issues and some, especially those with dementia, often under report their pain. It is up to the care givers and providers to identify the physical signs and symptoms so that proper diagnoses and treatment can occur (Webster, 2019). It must be understood that there are many components to pain that must be address in the treatment plan including possible physical causes as well as underlying psychological and psychosocial factors that may be affecting the patient and their adherence to the care plan. (Quinlan-Colwell,2012).Changes that occur as we age bring about different root causes of pain, how the patient will process and or tolerate that pain and how they may process the medicine that we are prescribing. Essential neurotransmitters such as serotonin, acetylcholine, noradrenaline and gamma-aminobutyric acid (GABA) are less abundant in the elderly and since they are major components involved in the intake of pain medicine the efficacy may be different therefore dosing may need to be changed. There is also a decrease in peripheral nociceptive neurons int eh elderly patient. Pain thresholds are often exacerbated by depression and anxiety that are untreated in the elderly patients as well (Quinlan-Colwell,2012).One such tool that was used in the above studies is the Mobility Roland–Morris disability questionnaire (RDQ). This study includes twenty-four yes or no questions pertaining to activities of daily living. This toll is primarily designed to be used in the primary care setting and assesses social wellbeing, overall function and support. It is widely used and recommended for the assessment of chronic pain and has been translated into over thirty different languages for use around the world. Many studies have proven the reliability and validity of this assessment tool ( Yamato,2017).National institute of health reported that Nevada providers prescribed opioids at a higher rate than other states, approximately four more prescriptions per hundred persons just over eleven percent of deaths by overdose involved opioids and almost nine percent of those were prescribed. Those numbers have been on a decline over the past few years. For the elderly in Nevada the Seven Hills Mental health hospital, just outside of Las Vegas has great programs for recovery. Their programs are designed to assess underlying causes of the addiction and to assist with life changes needed to fight addiction. Resources:https://www.help.org/drug-and-alcohol-rehab-centers-in-nevada/http://dpbh.nv.gov/Resources/opioids/Prescription_Drug_Abuse_Prevention/https://www.nvopioidresponse.org/general-resources/References Choi, B. Y., DiNitto, D. M., Marti, C. N., & Choi, N. G. (2019). Emergency Department Visits and Overnight Hospital Stays among Persons Aged 50 and Older Who Use and Misuse Opioids. Journal of Psychoactive Drugs, 51(1), 37–47. https://doi.org/10.1080/02791072.2018.1557356Paul-Savoie, E., Bourgault, P., Potvin, S., Gosselin, E., & Lafrenaye, S. (2018). The Impact of Pain Invisibility on Patient-Centered Care and Empathetic Attitude in Chronic Pain Management. Pain Research & Management, 2018, 6375713. https://doi.org/10.1155/2018/6375713Quinlan-Colwell, A. (2012). Compact Clinical Guide to Geriatric Pain Management : An Evidence-Based Approach for Nurses. New York: Springer Publishing Company. Retrieved from https://search.ebscohost.com/login.aspx?direct=true&db=nlebk&AN=440783&site=eds-liveWebster, F., Rice, K., Katz, J., Bhattacharyya, O., Dale, C., & Upshur, R. (2019). An ethnography of chronic pain management in primary care: The social organization of physicians’ work in the midst of the opioid crisis. PLoS ONE, 14(5), 1–16. https://doi.org/10.1371/journal.pone.0215148Yamato, T. P., Maher, C. G., Saragiotto, B. T., Catley, M. J., & McAuley, J. H. (2017). The Roland-Morris Disability Questionnaire: one or more dimensions? European Spine Journal: Official Publication Of The European Spine Society, The European Spinal Deformity Society, And The European Section Of The Cervical Spine Research Society, 26(2), 301–308. https://doi.org/10.1007/s00586-016-4890-9https://www.drugabuse.gov/drug-topics/opioids/opioid-summaries-by-state/nevada-opioid-involved-deaths-related-harms