Parkinson’s Disease Case Study  [WLOs: 1, 2, 3] [CLOs: 1, 2, 3, 4, 5, 6, 7] Pr

 
Parkinson’s Disease Case Study 
[WLOs: 1, 2, 3] [CLOs: 1, 2, 3, 4, 5, 6, 7]
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.

  Describe how a country can measure its income inequality. Evaluate the eff

 
Describe how a country can measure its income inequality.
Evaluate the effect of income inequality on the U.S. economy, such as unemployment, economic growth, and other economic factors.
Estimate the gap between those who hold bachelor’s and higher (master or doctoral) degrees and those who do not.
Explain reasons why the inequality gap between educated and less-educated workers has been widening.
Evaluate whether increasing opportunities for higher education can reduce income inequality.
Analyze what else causes U.S. income inequality to widen.
Recommend how to reduce educationally based income inequality or other factors if you were a federal policy maker.
Must be eight to 10 double-spaced pages in length (not including title and references pages) and formatted according to APA style as outlined in the Ashford Writing Center’s APA Style resource (Links to an external site.).
Must include a separate title page with the following:

Title
Student’s name
Course name and number
Instructor’s name
Date submitted

For further assistance with the formatting and the title page, refer to APA Formatting for Word 2013 (Links to an external site.).

  Many large U.S. firms invest abroad instead of exporting. Prior to beginning w

 
Many large U.S. firms invest abroad instead of exporting. Prior to beginning work on this assignment, read James Gerber’s (2017) Chapter 4 and Ed. Crooks’ article, America: Riveting Prospects (Links to an external site.), and respond to the following components.
Compare and contrast foreign trade and foreign investment.
Evaluate why many U.S. companies do not want to participate in exporting and rather build their plants and factories in foreign countries to produce there.
Assess the advantages and disadvantages of this type of foreign investment (i.e., building their plants and factories and producing their products in foreign countries).
Analyze how foreign investment and production can contribute the U.S. economy when its transactions are not counted into GDP.
Explain whether you are in favor of foreign trade (exporting) or foreign investment (production outside the United States), and why.
The Foreign Trade Versus Foreign Investment assignment
Must be three to four double-spaced pages in length (not including title and references pages) and formatted according to the Ashford Writing Center (Links to an external site.)’s APA Style (Links to an external site.)
Must include a separate title page with the following:

Title
Student’s name
Course name and number
Instructor’s name
Date submitted

For further assistance with the formatting and the title page, refer to APA Formatting for Word 2013 (Links to an external site.).
Must utilize academic voice. See the Academic Voice (Links to an external site.) resource for additional guidance.
Must include an introduction and conclusion paragraph. Your introduction paragraph needs to end with a clear thesis statement that indicates the purpose 
For assistance on writing Introductions & Conclusions (Links to an external site.) as well as Writing a Thesis Statement (Links to an external site.), refer to the Ashford Writing Center resources.
Must use at least three scholarly, peer-reviewed, and/or credible sources.

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
Must include a separate references page that is formatted according to APA style as outlined in the Ashford Writing Center. See the Formatting Your References List (Links to an external site.) resource in the Ashford Writing Center for specifications.
You are invited to carefully review the Grading Rubric (Links to an external site.) for the criteria that will be used to evaluate your week 2 assignment.

  write a quest narrative from your life using literary concepts from the readin

 
write a quest narrative from your life using literary concepts from the reading. You will demonstrate how you used those concepts to help you tell your story and share an inspirational vision or mission. The quest narrative you share should be true, but you can address it to a fictional audience. In Part II, you will evaluate the narrative you created and reflect on the writing process and the use of literary concepts in writing. You will explain how you made certain decisions to build the narrative, and you will reflect on the process of creating a work of literature. This assignment will be a good exercise in communicating leadership, which will be useful in the workplace and throughout your life.
You can write Part I as a letter, a story, a poem, or a play. There are many ways to approach this assignment for Part I. You can check the Unit 6 Assignment Part I Tip Sheet for examples to help you brainstorm ideas and narrow your focus.
It is helpful to think of the quest narrative through four decisions.
1.) What is my quest?
2.) Which genre will I use to write it?
3.) Which of the concepts from the reading could be useful in helping me to tell this story in an interesting way?
4.) Who is my audience? Who do I want to encourage to take on a challenge as I did?
Do be sure to carefully read the chapter’s discussion of the quest narrative. Then also consider the concepts from the reading on literature, as you will build those ideas into Part I and define them in Part II.
Part I: You will compose a quest narrative from your life. Your audience should be someone that you want to encourage to overcome obstacles, build resilience, or take the same quest. You will tell the audience your story and call them to action as well. You should be writing this as a leader who wishes to inspire the person reading your narrative.
You must employ at least two of the concepts from the assigned reading on literature, such as metaphor, image, or symbol.
As you create the narrative, include details, emotions, and ideas that happened in those moments. You may have taken action in this quest without thinking it through, but take this opportunity to analyze the decision as a part of self-awareness, finding your potential, and becoming inspired to improve your situation. Do include the highs and the lows of the quest along with insight into why you kept moving toward your goal.
The quest narrative in Part I must be at least 1 page, but it can be longer.
Part II: In at least 500 words, you will evaluate the quest narrative you wrote in Part I.
Explain how you used the two concepts of literature in creating your narrative. Use and cite the text to define each concept that was used and to explain how you interpreted and employed this concept in your narrative. Why did you select these concepts to apply, and do you feel they were effective?
Clarify for the reader how you demonstrated leadership in your call to action for the reader. How did you communicate your vision? How will this narrative help the audience to uncover their own potential as a human being? Why would a narrative be an effective way to call another person to self-reflection and change?
Reflect on the writing process. How was the process of writing the narrative? What was simple and what was a challenge? What helped you to get inspired? What made you tell this particular story?
Save Part I and Part II in the same document, so your instructor can easily move from one part to the other.

  Respond to the following in a minimum of 175 words:  The aggregate demand and

 
Respond to the following in a minimum of 175 words: 
The aggregate demand and the aggregate supply model allows us to examine how a variety of events can affect the economy.
In your own words, discuss which of the four sources identified with aggregate demand has caused a change in the aggregate demand for a product or service you or your employer use. Share the effect that source has had on how you or your employer contribute to the measurement of aggregate demand.