BNURS20 Nursing

Case Scenaria Three Peter Thompson is a fiercely independent 78 year old male who is the sole carer for his wife, Shirley. Peter has significant industrial deafness and refuses to wear his hearing aids. Shirley has Type II diabetes mellitus and is vision impaired. She has never been in paid employment and has never had the need to drive. She is very reliant on Peter who takes great pride in ensuring that all her needs are met. Peter was recently involved in a motor vehicle incident and his license has been suspended.

 

In relation to this scenario consider and discuss the perspectives of Peter and Shirley and possible courses of action from these perspectives. Discuss and evaluate a range of theories of ageing that may shape the beliefs and attitudes of the different people involved. 

Analyze the way in which age intersects with other social categories in this scenario, such as gender, class, ethnicity and sexuality. Include a discussion of the physical and biological changes that may have an impact on Peter ‘s situation. 

1.1 Perspectives of People Involved

• Jack – With his retirement which definitely means that his source of income has been cut, Jack could be anguished by the subsequent associated losses for example, loss of cash flow, motivation, and interpersonal connections already built in his work place. By him being a type II diabetes patient as well as being diagnosed with renal failure, he is bound to be depressed by his health status. He is also likely to suffer loneliness for being detached from hos social life and alternatively dedicating much of his time to his health (Pachana, 2016). He, for example, may not be able to continue his close relationship with the local Aboriginal Community.
• Alice – Due to her husband’s deteriorating health status, she is also likely to be depressed. It is also most likely that she is going to be detached from her work on the board of the local Aboriginal Medical Service because she has to dedicate her time to take care of her ill husband. Subsequently, she is going to be grieved by the loss of her status in the society (Loue, 2008). Loneliness might hit her after being disengaged from the life she had been accustomed to.
• Jack’s children and grandchildren – They are all likely to get stressed by their Father’s/grandfather’s worsening health condition.

1.2 Possible Courses of Action

• Jack – With his retirement as a mechanic and his income cut, he could seek alternative sources of income by utilizing his mechanical skills. He, for example, may start a small garage and employ workers. His work will be coordination and oversight. For his health, he could adhere to diet guidelines as well as prescribed medication. He could also employ a home-based carer. To curb loneliness and the feeling of detachment, he may occasionally attend Aboriginal community and youth functions.
• Alice – Attending to her ill husband with at most dedication will ease her depression. She could also help in starting and running any money-generating project that will carter for their financial needs. She may also cease her full time employment and take on part time work (Aldwin & Gilmer, 2013).
• Children and grandchildren – their children could financially support their parents in meeting their needs. Since children are sources of joy in a homestead, the grandchildren could be spending much time with their grandparents and more-so during the school holidays.

2. Theories of Ageing

a). Disengagement theory

• It views ageing as a process that results in disengagement from social life as people age and become elderly. It states that, with the passage of time, elderly individuals disengage or withdraw from relationships and other social roles that were previously at the epicenter of their lives during adulthood (Williams, Tibbitts, & Donohue, 2008).
• Disengagement is spurred by lack of desire by an individual to damage their reputation by losing abilities and skills while still engaged in social roles fully (Crossman, 2018). It is most likely that neither Jack nor Alice is willing to quit their positions in the Aboriginal society.
• A disjunction will occur between the society and an individual if both are not ready for disengagement to occur. If both are however ready, complete disengagement occurs (Crossman, 2018).
• To avoid demoralization or identity crisis, new roles are adopted by individuals who are disengaged. Alice, for example, could seek part time employment.
• Disengagement is also allowed by the society so that vacant job positions are created for the upcoming ages, to meet the social needs of nuclear families and because people die (Williams, Tibbitts, & Donohue, 2008). The vacant position that will be left by Alice in the board if she quits to care for her husband will be filled by a younger and enthusiastic person.
• Upon disengagement, there are shifts in the remaining relationships, change of rewards as well as hierarchical shifts. The local Aboriginal youth group will for example have to source another person to pass on cultural history.

b). Neuroendocrine Theory

• It dates back to 1954 and its original coining is attributable to professor Vladimir Dilman and Ward Dean (Loue, 2008).
• It focuses on wear and tear while basing on the neuroendocrine system. It states that reduced sensitivity of the hormone receptors in portions of the brain and more precisely, the hypothalamus is the cause of ageing.
• Lower hormone levels have been directly attributed to increased possibilities of contracting chronic diseases such as cancer, heart disease and Alzheimer’s during old age. This is evident by Jack being diagnosed with Renal failure.
• The control center of the human brains is the hypothalamus, a gland the size of a walnut which is adversely affected by the levels of hormones. It is also the hypothalamus that is in charge of reactions produced by hormones and other biochemical messengers (Aldwin & Gilmer, 2013).
• As an individual grows old, the hypothalamus begins to malfunction and subsequently decreases its responsivity to changing hormones. Additionally, it is damaged by higher amounts of the stress hormone scientifically known as the Cortisol (Miller, 2009).
• This hormone is most likely to be produced in high quantities in Jack’s and Alice’s bodies as they are likely to get stressed by the prevailing problems.
• If the hypothalamus is damaged by the Cortisol, it becomes a vicious cycle of damage over time leading to an ever-increasing production of cortisol and thus more damage to the brain (Miller, 2009).
• To prevent speedy ageing, effective stress management is an important intervention for Jack and Alice as it will also reduce their chances of contracting chronic illnesses.

3. The Intersection of Age with other Social Categories

• Class – With Peter and his wife ageing, they are most likely to grouped in the low social-economic class. This is due to their cut sources of income as well as minimal social interactions that are likely to follow with time (Hankivsky, 2011). If Alice will quit fulltime work, her remuneration will decrease respectively.
• Gender – Research has it that the speed of ageing is higher in male than in female (Hankivsky, 2011). This is clearly evident as Jack has begun having age-related complications such as renal failure while his wife is still active.
• Sexuality – The ageing process directly interferes with an individual’s sexuality. For Jack, age will affect his biological sexual processes, emotional as well as spiritual feelings (Hankivsky, 2011). Alice who is in post-menopausal stage will have her sexual orientation affected.

4. physical and biological changes that could impact Peter’s situation

• Deposition of fats in the arterial walls could result in overworking of the heart (Pachana, 2016). Subsequently, atherosclerosis and high blood pressure could be threatening issues for Jack and Alice.
• Bones shrink in density and size with the passage of time (Aldwin & Gilmer, 2013). Jack is therefore at a higher risk of fractures.
• His tendons, joints, and muscles are also bound to lose flexibility and strength as he grows older.
• As human beings age, slowing down of the swallowing and digestive reflexes are inevitable (J-M-H, 2015). Jack and Alice are therefore likely to experience hardships during swallowing due to less forceful contraction of the esophagus.
• Due to the natural loss of cells even in the brain, Jack and Alice are bound to experience memory loss as time goes by. This is also most likely to affect his coordination capacity.

References

Aldwin, C. M., & Gilmer, D. F. (2013). Health, Illness, and Optimal Aging, Second Edition: Biological and Psychosocial Perspectives (2 ed.). Springer Publishing Company.

Crossman, A. (2018, April 03). Disengagement Theory: An Overview and Critique. ThoughtCo. Retrieved August 15, 2018, from https://www.thoughtco.com/disengagement-theory-3026258

Hankivsky, O. (2011). Health Inequities in Canada: Intersectional Frameworks and Practices (illustrated ed.). UBC Press.

J-M-H. (2015, Sep 22). 9 Physical Changes That Come With Aging. JOHNSON MEMORIAL HEALTH. Retrieved August 15, 2018, from https://blog.johnsonmemorial.org/9-physical-changes-that-come-with-aging

Loue, S. (2008). Encyclopedia of Aging and Public Health (illustrated ed.). Springer Science & Business Media.

Miller, C. A. (2009). Nursing for Wellness in Older Adults (illustrated ed.). Lippincott Williams & Wilkins.

Pachana, N. A. (2016). Ageing: A Very Short Introduction (illustrated ed.). Oxford University Press.

Williams, R. H., Tibbitts, C., & Donohue, W. (2008). Process of Aging: Social and Psychological Perspectives. Transaction Publishers.