Acromegaly Case Study: Healthcare Needs

Changing Care needs through the life stages

You are required to write an assignment based on a person who is in the late stages of adulthood. The person can be a family member, friend or client.

The assignment requires you to write about in general the physical, intellectual, emotional and social development in later adulthood first and then compare it to the actual individual’s current well being and lifestyle using the PIES tool. You must explore your own personal prejudices, fears and anxieties about working with people in your care. What has influenced it? What has changed it?

Included in the assignment should be any variations whether positive or negative that are affecting the individual as well as recommendations on how you can positively and confidently respond to the needs of the person during this stage of life.

Specific conditions: You must seek permission from the adult before writing essay.

You must change the identity of the person as well as respecting confidentiality of the person.

The essay must cover the following headings

• P.I.E.S of development during late adulthood(10 Marks)
• P.I.E.S of development of individual as well as your own personal prejudices, fears and anxieties.(5 Marks)
• Variations/factors affecting individual at this stage of life(5 Marks)
• Recommendations to respond confidently to the needs of the person(10 Marks)

Introduction

For my assignment I have chosen a family member in the late stages of adulthood with a condition called acromegaly. For this assignment I will use the internet, books and information directly from my family member and her immediate family in order to complete this assignment. All names will be changed in order to protect the person’s privacy and confidentiality. Permission has been sought from my family member to do this assignment on her condition and her stage of development.

Main Body

Clients Name – Lucy

Age – 67

Condition – Acromegaly

‘Acromegaly is a hormonal disorder that develops when your pituitary gland produces too much growth hormone’ (Mayoclinic.org, 2015)

P.I.E.S of development during late adulthood

Physical needs –

During late adulthood our physical appearance is diminishing slowly this is due to cellular senescence (cells in our bodies start to decline) (Mark Stibich, 2015). Wrinkles start to appear as skin is losing elasticity. Our bones start to lose calcium and can become brittle (osteoporosis) and harder to heal. Certain illnesses are more likely to appear as one ages such as arthritis, heart disease, diabetes and respiratory problems. A good diet and regular exercise and most importantly a positive attitude in late adulthood can help greatly in prolonging these physical changes. However, even with a good lifestyle and a positive attitude, unforeseen circumstances may happen which triggers further degradation of a person’s health at this stage of development. Retirement and all it has to bring is in full swing. (Maslow, Hierarchy of Needs) According to Erik Erikson from the age of 65 we start to feel that our lives have become less productive. This indeed can be very true if we do not have a good retirement plan. With the more and more emphasis that is been put into place for retirement plans and groups that are been set up for the retired person this is helping greatly with these issues.

Intellectual needs –

As we age our cognitive ability declines. In late adulthood this can become apparent as our intellectual abilities start to decrease, some difficulties with memory and information processing (Paget). This is why it is crucial that adults in this stage keep their brain stimulated and active with certain activities. Even by keeping up reading newspapers, crosswords, bingo, and quiz’s.(Activity Theory) A lot of retirement groups that are being set up and there are courses that adults in this stage of development can do which will keep their minds busy and their brain stimulated which can have a domino effect on their mental health. Unfortunately illnesses may occur that have a negative effect to our cognitive ability such as dementia (Alzheimer’s, Lewy body, front temporal and vascular), Stroke or acquired brain injuries.

Emotional needs –

Erik Erikson stages of development describes late adulthood stage 65 + as a stage of Ego Integrity vs Despair. He believed that at this stage we look back on our lives so far and if we do not feel we accomplished everything we needed to at this stage of development we can develop a sense of despair which in turn will lead to feelings of depression. With this in mind this can be a very emotional time for some. At this stage of life it is imperative that we have family and friends that we can talk to and share our fears and feelings with. At this stage of development a person that has a life threatening illness may go through several emotions which is described by Elizabeth Kubler-Ross in her grief cycle.

(Changingminds.org,2015)

Social needs –

At this stage of development it is crucial to have interaction with family and friends. As without these interactions a person in late adulthood can feel very isolated. A lot of people before this stage of development, are used to a busy social life, whether it is working or raising their families (Jung’s Theory on Ageing). It is very important that they are invited to family gatherings, social events and are visited regularly. This will help greatly with their physical, intellectual, and emotional needs which can have positive effects on the person’s health if they are kept socially active. It is also important that a person is encouraged to get involved with the various retirement clubs that are set up in their area.(Active retirement Ireland).

P.I.E.S of development of individual as well as your own personal prejudices, fears and anxieties

Physical needs –

As Lucy is 67 and is in the late stages of adulthood her physical appearance is starting to diminish. Along with these changes unfortunately Lucy has to contend with other physical changes due to her condition acromegaly. A once average size woman Lucy has significantly shown signs of change physically. Her feet have gone from a size 6 to a size 9 shoe, her hands have grown bigger in size also and her weight has risen. She has had to deal with retirement and her condition all at once. A mother of 4 whom held down a full time job as a care assistant in a local nursing home in her area and kept her housework to perfection as she says her self she is a cleaning addict. At the age of 64 she discovered she had the condition acromegaly and in the last 3 years she has undergone surgery and radiotherapy to try and reduce the benign tumour on her pituitary gland. Unfortunately this was unsuccessful and Lucy has now to inject herself daily with Somavert 10mg, a medication to reduce the secretions of growth hormone by the pituitary gland. Lucy lives with her daughter, her daughter’s husband and their 2 children. I feel this is helping greatly with her physical needs as she still helps out with housework when she is well and she brings her grandchildren for walks to the park and playground.

Intellectual needs

Intellectually Lucy keeps her mind active by reading novels, and attending bingo when she is well enough. As part of her condition acromegaly she is part of a team in Beaumont Hospital whom are researching this condition that is affecting 400 people in Ireland. I feel this is helping her greatly intellectually as she is learning more and more about the condition and it is keeping her mind and brain active while doing so.

Emotional needs

Lucy’s emotions at this stage of her development and with the condition acromegaly can be all over the place. But with her family network around her and her close friends that she can talk to about her fears and anxieties this is a great help to her emotionally. I feel from talking to Lucy that she is very well informed by the research team at Beaumont and this is helping her greatly in dealing with her condition. From talking to her about her life so far I have gathered that she feels she has accomplished everything she needed to so far for this stage of development and I feel she can develop through this stage with a virtue of wisdom (Erik Erikson)

Social needs –

At this stage of development Lucy’s social needs are still of high importance. She still attends bingo with a close friend, family gatherings and family outings. Sometimes she feels that people she hasn’t seen in a while think she has put on weight by over eating but in fact it is because of her condition. She is a very outgoing person so this doesn’t bother her much as she just explains to them her condition. During her outings to Beaumont for research days she has got close to other people whom are at the same stage of development as her and also going through the same condition.

My own personal fears, prejudices and anxieties at this stage of development

Upon starting my work experience in a nursing home I had a fear that people in the late stage of adulthood development that were in a nursing home were left sitting in an arm chair all day with no interaction from other residents or staff. I realised the first day that this was not the case and that my nursing home had a activities coordinator that did SONAS activities with all residents. As part of the new HIQA standards person centred care approach this was a crucial part of standard working procedure.

Variations/factors affecting individual at this stage of life

At this stage of development Lucy is quite lucky as her daughter and son in law and grandchildren live with her and her sons live within a mile radius of her house. I feel this is a positive factor at this stage of life and with her condition as she has the comfort of a close knit family always there to help her at this stage and she has the added bonus of helping them too. With her condition acromegaly and the stage of development she is at I would worry that her medication daily (somavert) and indeed the condition itself would have adverse effects on her health (cardiomyopathy, diabetes mellitus and osteoarthritis) during this stage of her life. Lucy has informed me that the team at Beaumont are keeping a very close eye on her through many different tests including liver tests, blood tests and scans in order to keep a close eye on any adverse reactions to her medication and condition.

Recommendations to respond confidently to the needs of the person

In order for me as a HCA to respond confidently to Lucy’s needs I would need to have the correct information about her condition in order to help talk her through her treatments as I feel it is imperative to be able to confidently answer any questions she may have. I can research local support groups for Acromegaly sufferers and encourage her to join them and bring her family to help them further understand what changes are going on in her body. Using my interpersonal skills I can be a good listener and shoulder to cry on when she is feeling depressed and can take her on shopping trips to specialised shops that cater for women of larger stature. Lucy loves to write letters to family in Galway and England but finds it difficult, when her hands are paining her, therefore I can write dictations from her to keep her hobby. Even though she is not at risk of dementia from her illness, I feel it would be good to help her feel a sense of integrity about her life if we make a life book with her as she can visually see all that she has accomplished. (Erik Eriksson)

Conclusion

Upon researching for this assignment I have learned that the late stages of adulthood development can be an emotional rollercoaster for any individual. It is my duty going forward as a HCA to be able to understand the basic needs of a person going through this stage. In doing so I need to put myself in their shoes in my thinking and how I would like to be treated at this stage of development.

References

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Cliffsnotes.com, (2015). Theories of Aging. [online] Available at: http://www.cliffsnotes.com/sciences/psychology/development-psychology/psychosocial-development-age-65/theories-of-aging [Accessed 3 Apr. 2015].

Headstrongbrain.com, (2015). What is Cognitive Decline?. [online] Available at: http://www.headstrongbrain.com/FAQ/~Q3-48/What_is_Cognitive_Decline [Accessed 3 Apr. 2015].

Independent.ie, (2011). Pituitary gland: The tiny gland that can cause very big problems – Independent.ie. [online] Available at: http://www.independent.ie/lifestyle/health/pituitary-gland-the-tiny-gland-that-can-cause-very-big-problems-26776040.html [Accessed 3 Apr. 2015].

Mark Stibich, P. (2015). Senescence, Healthy Aging and Longevity. [online] About.com Health. Available at: http://longevity.about.com/od/whyweage/a/senescence.htm [Accessed 3 Apr. 2015].

Mayoclinic.org, (2015). Acromegaly Complications – Mayo Clinic. [online] Available at: http://www.mayoclinic.org/diseases-conditions/acromegaly/basics/complications/con-20019216 [Accessed 3 Apr. 2015].

Mayoclinic.org, (2015). Acromegaly Definition – Diseases and Conditions – Mayo Clinic. [online] Available at: http://www.mayoclinic.org/diseases-conditions/acromegaly/basics/definition/con-20019216 [Accessed 30 Mar. 2015].

McLeod, S. (2007). Maslow’s Hierarchy of Needs. [online] Simply Psychology. Available at: http://www.simplypsychology.org/maslow.html [Accessed 30 Mar. 2015].

McLeod, S. (2015). Erik Erikson | Psychosocial Stages | Simply Psychology. [online] Simplypsychology.org. Available at: http://www.simplypsychology.org/Erik-Erikson.html [Accessed 30 Mar. 2015].

Medicines.ie, (2015). Somavert 10mg, 15mg and 20mg Powder and Solvent for Solution for Injection – Summary of Product Characteristics (SPC). [online] Available at: http://www.medicines.ie/medicine/9530/SPC/Somavert+10mg,+15mg+and+20mg+Powder+and+Solvent+for+Solution+for+Injection/ [Accessed 30 Mar. 2015].

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OTHER USEFUL INFORMATION

Healthcare Support1Edel Brew