Study "Aging / Death / Gerontology" Essays 221-275

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Palliative Care Research Paper

… ¶ … Life

Legal Issues to Consider

End of life presents several issues to consider for the person dying and the people responsible for them. There a number of ethical and legal issues when approaching end of life such as… [read more]


Feminist Ethics Many Arguments Essay

… It is not difficult to see why doctors that fail to put in place the shunt to prevent the accumulation of fluid in the brain would be abandoning this very basic obligation. It is also easy to see why failing to repair the spinal opening would amount to hastening the death of baby John Doe -- an undertaking or action that cannot be reconciled with the duty to preserve life.

Third, there is also the argument that everybody has the right to life. The right to life, as MacKinnon (2012, p. 82) observes, has got to do with "the right not to be killed." By preventing the necessary interventions from being undertaken so as to save baby John Doe's life, Sarah and Mike would be violating an independent entity's basic right. It is, however, important to note that in some cases, it has been argued that it is possible for individuals to waiver this basic right, thereby cancelling other people's duty not to kill (Wennberg, 1989, p. 58). This is particularly the case when an individual commits murder, whereby it becomes permissible for the courts to prescribe the punishment of death. Baby John Doe has not waived his right to live. Denying him the chance to life just because of a medical condition would be immoral and inappropriate.

There is also the concept of autonomy. In basic terms, autonomy has got to do with "the right of a rational person to self-rule and to generate personal decisions independently" (Butts and Rich, 2005, p. 12). The application of this concept in this scenario would mean that neither the doctors involved nor baby John Doe's parents have the right to make such a critical decision about baby John Doe, especially a decision that has got to do with whether or not he should be allowed to continue living.

In the final analysis, therefore, baby John Doe should be allowed to live. All the necessary measures should be taken to preserve his life. If anything, it is baby John Doe who should be permitted to make that critical decision -- whether or not to live -- once he attains full awareness and is able to appreciate the consequence of his actions.

References

Butts, J.B. & Rich, K. (2005). Nursing Ethics: Across the Curriculum and Into Practice. Sudbury, MA: Jones and Bartlett Learning.

DeWit, S.C. & O'Neill, P.A. (2013). Fundamental Concepts and Skills for Nursing (4th ed.). St. Louis, Missouri: Elsevier Health Sciences.

MacKinnon, B. (2012). Ethics: Theory and Contemporary Issues (2nd ed.). Boston, MA: Cengage Learning.

World Medical Association. (1983). International Code of Medical Ethics. Retrieved from http://history.nih.gov/research/downloads/ICME.pdf

Wennberg, R.N. (1989). Terminal Choices: Euthanasia, Suicide, and the Right to Die. Grand Rapids, Mich: Wm.…… [read more]


Brophy Case Study

… Examples of people that could become included in such laws would include those with Down's Syndrome, the autistic, the paraplegic, the quadriplegic and so forth. Taken to the extreme, the paradigm could include the socially unproductive, the ideologically unwanted, the racially unwanted and so forth. If one is noticing a pattern here, that person would be correct because this is precisely what the Nazi euthanasia program and general eugenics proponents would suggest. Noted scholar on the subject of euthanasia Alex Schadenberg, who wrote the book Exposing Vulnerable People to Euthanasia & Assisted Suicide, notes that "the idea that there are lives unworthy to believed is dangerous." He continues by saying "the slippery slope is not imaginary. It exists -- and despite the efforts of euthanasia supporters, it cannot be wished away."

Before concluding this report, there shall be an assessment and review of both justice and beneficence as it relates to the Brophy, Schiavo and similar cases. When it comes to people with no advanced directives but yet a seemingly impossible decision like whether or not removing a feeding tube of someone in a vegetative state is moral or acceptable, the concepts of justice and beneficence come into play. Two terms that were bandied about, and still are, relative to Schiavo's case and ones like it is the ethics of justice vs. The ethics of care. Some argued that she was in surely in a private hell given that she was in that vegetative state for more than a decade. Beyond that, her chances of recovery were zero. While effectively starving someone is something that would give some people pause, a continued life of non-existence and nothingness is something very few people believed Schiavo would want if she were able to make that choice. The hard part of defining justice in this case is that there is no way to truly know for sure. Regardless, the removal of the feeding tube was seemingly the right call given the totality of what was known and what was not known (Hodges et al., 2006). As far as beneficence goes, the term is just another way of saying "benefiting." The ideas of justice and beneficence relating to the removal of Terri Schiavo's feeding tube are often seen as being two sides of the same coin. Schiavo surely did not benefit by having her life continued artificially. While she was not terminally ill, her life as she knew it was over. Letting her go was the best way to benefit it her as keeping her alive was of no real benefit to Terri (Johnson, 2006).

Conclusion

In the end, Brophy was eventually transferred to a different hospital that was not unwilling to remove the feeding tube. He was transferred, the feeding tube was remove and Brophy died in 1986. While the field of bioethics may deem that imposing morality, religion and ethics of any form on others is wrong, it is also very valid for medical professionals and others to act under the "do… [read more]


Ocial Work Practice With Individuals Term Paper

… (Kagawa-Singer, M., & Backhall, L. (2001))

Barbara A. Koening and Jan Gates-Williams also warn against the dangers of stereotyping. One the social worker got enough information about the personal life of a patient, she will carefully analyze and refrain from… [read more]


Pros and Cons of Euthanasia Research Paper

… 34). Likewise, critics of euthanasia argue that prohibitions on the intentional killing of others represent a basic precept of legal and human relationships that place a high value on human's basic equality (Somerville, 2003).

6.

Conclusion:

Do people have a fundamental right to die when they want? Advocates of euthanasia maintain that people do in fact possess this right under certain circumstances and that some people, such as those suffering terminal illnesses, will be better off dead than alive. Critics of legalizing euthanasia argue that the practice is morally wrong and the fact that the practice requires at least two people, one of them a physician, means that legalizing it would be harmful to the medical profession as well as society at large. In the final analysis, it is reasonable to conclude that most opponents of euthanasia are not living with terminal illnesses that cause enormous suffering or have not experienced the death of a close loved one in this fashion. It is easy enough to pontificate about the niceties of the human condition but it is a far more difficult matter to confront them head-on and take the steps needed to alleviate suffering. The United States should follow the lead of Oregon, The Netherlands and Belgium and legalize euthanasia under certain conditions, including the patient's voluntary and persistent request; the hopeless situation of the patient and consultation of a colleague.

References

Keown, J. (2002). Euthanasia, ethics, and public policy: An argument against legalization.

Cambridge, England: Cambridge University Press.

Marcoux, I. & Mishara, B.L. (2007, May/June). Confusion between euthanasia and other end-

of-life decisions. Canadian Journal of Public Health, 98(3), 235.

Nelson, F.L. (1984). Suicide: Issues of prevention, intervention and facilitation. Journal of Clinical Psychology, 40(6), 1328-1335.

Sinha, V. & Basu, S. (2012, April-June). Euthanasia: An Indian perspective. Indian Journal of Psychiatry, 54(2), 177.

Somerville, M. (2003, Spring). The case against: Euthanasia and physician-assisted suicide.

Free Inquiry, 23(2), 33-39.

ten…… [read more]


Euthanasia and Egoism Research Paper

… , 1980.

They will not consider others in their actions. The person believes that by promoting their own good they are in accordance with morality. They will believe that for as long as they are doing what they see is… [read more]


Detriments of Euthanasia Essay

… With the desensitization of the taking of life, it may be argued as linking in with an increased level of acceptability with reference to other forms of voluntary suicide, as seen with the way social networking has seen numerous groups emerge to support those who wish to commit suicide (Luxton et al., 2012).

Euthanasia may increase social divisions

An area of significant concern may be the way in which social divisions may impact on the practice of euthanasia. In Oregon, where euthanasia is legal, Kaldjian (2001) found that of those requesting euthanasia, 60% indicated that one of the influences was a desire not to be a burden. Invariably, those who are most likely to feel there are a burden will come from backgrounds where they will require a higher level of social support, often families of a lower social or economic status, which may also be aligned with ethnic minorities and lower education (Ward, 1980). The disparities which may lead to the desire to avoid being a burden are known to more prevalent with in ethnic minorities, and disadvantaged social groups, were ironically, there is likely to be a higher level of terminal illnesses at younger ages due to the health disparities (Geiger et al., 2007). Interestingly, it is noted that ethnic minorities tend to have a lower level of trust in authorities with regard to decisions made euthanasia and the overall practice (Ward, 1980).

Euthanasia may reduce the attention and commitment to developing effective palliative care.

If increasing numbers of people request euthanasia, rather than live… [read more]


Pressure Ulcers in the Elderly Research Paper

… (2002) found out that two hourly repositioning had the capacity to reduce ulcers. In addition, a cohort study by Rich et al. (2011) suggests that there is no relation between manual two hourly repositioning of elderly patients with the rate of ulcer reduction. Another randomized study (Vanderwee et al., 2007) found out that there was no difference in the incidence of pressure ulcer when compared to elderly patients fewer than two repositioning interval regimens. The reasoning behind this literature review is not only to discover whether the incidence of ulcers in the elderly residing in nursing homes can be lowered with automatic and periodic body turning, but also to determine just how important this type of review can be to the nursing field in general. One recent study determined that "pressure ulcer prevention is an important aspect in daily care for residents at risk in nursing homes" (Demarre, et al., 2012, p. 1426). If that statement is true, then this study will help to address the issue of pressure ulcers. Other studies indicate that regardless of the reason for incapacitation, turning is a basic step in improving the PU condition by removing stress and negative stimuli from the wound area (Pak, et al., 2009).

One important aspect of nursing home living is that most of the time the people living there are helpless to accomplish many tasks that are part of everyday living. The employees are trained (for the most part) and as one study found it is "important to assess whether nursing staff levels and skills are meeting nursing home resident care needs" (Zhang, Unruh, Wan, 2013, p. 290). For example, incontinence is a significant risk factor for skin breakdown. The moisture changes the chemical balance of the skin, and often without adequate ventilation and care, a route for bacterial infection. In either case, pressure on the wound area, increased bacteria and moisture, all contribute to the lesions becoming rather serious (Gefen, 2008).

Many of the employees are taught to turn the elderly in their beds to relieve pressure, presumably thereby lowering the incidence of pressure ulcers. According to Fossum et al., "pressure ulcers can be prevented if residents at risk are identified early and relevant preventive measures are implemented" (Fossum, et al.,, 2011, p. 2429).

Current research shows that, at least in nursing homes, employees have a cognitive nature concerning pressure ulcers (amongst other things) and the positive results from taking preventive measures. Much of the current literature espouses the fact that nurses are trained to do so, but there is not really a lot of specific information on… [read more]


Diamonds of the Night Research Paper

… Another motif that the film plays with is the idea that even when one is with something, one is still dealing with the lack of something. This is most commonly portrayed in art through the idea that even in life we are in death. For instance, the presentation of the woman who gives the boys the bread and milk: interlaced with that sequence are images of one boy hitting and killing her. Through that choice Nemec highly suggests that even in life we are in death, that all opposites are co-existing with one another at all times. Generosity and scarcity, gratitude and cruelty, existence and pain. In fact, Nemec demonstrates this to be true more than ever when one boy cannot eat the food that he is given simply because he has scurvy. This demonstrates yet another coexistence of opposites which is that with bounty there is lack: with food there is still hunger. This is comparable to the images of the people sledding in the snow: in the midst of the desolation and the barren frigidity, there are still people who are enjoying life and having a good time. In the midst of war, there is still merriment.

Another quality of life that Nemec plays with via the angles he chooses to shoot things in is the fleeting and ephemeral quality of life. Just as in life we are in death, Nemec constantly demonstrates that just as we are experiencing something, it is soon gone or soon taken from us. Nemec often composes shots from the perspective of the moving train or shoots in a manner where the camera is in seeming constant, unstoppable motion, much like the passage of time or the unavoidability of death.

This is part of the reason why the end of the film is quite so perfect because it demonstrates without a doubt just how intermingled life and death are. For example, it's not clear if the boys are in fact really captured or if it is all a dream, a day dream or a fear. The film ends with the idea of the captives and the captors. The boys are taken by the men with gun: we cut to images of the men eating chicken like savages, like wild animals and this helps to further that same theme earlier discussed: it is yet again an intermingling of opposites. The men eat the chicken like jackals and show us that even as humans were animals, even civilized we are wild. The boys are imprisoned and then walk to their death, their execution. Then Nemec deftly cuts back over to the two boys walking in a forest. Thus, even in imprisonment there is freedom and even with imminent death approach there is life with certainty. Thus, it is this particular ending which makes people accuse the film of being ambiguous and causes some to argue that one can't be sure whether or not the boys end up living.

However, the answer doesn't matter. Nemec it… [read more]


Health Promotion for End-Stage Dementia Research Paper

… Step 5: Goals and Objectives

The goal of the health promotion plan is to garner sufficient community support to successfully implement the EA model in a local nursing home, thereby increasing the quality of dementia care for patients with end-stage disease. The objectives are the following:

1. Identify all stakeholders and convince them of the need to improve the quality of care for end-stage dementia patients

2. Obtain the necessary funding from the local, state, and federal governments to implement the EA model

3. Shift the focus away from organizational needs to patient-centered care, including advanced care planning for life-sustaining care decisions

4. Engage patients and family members in the decision-making process

5. Implement dementia-specific care strategies with the assistance of dementia experts

6. Combat the three plagues of nursing home residents: loneliness, helplessness, and boredom (Monkhouse, 2003)

Step 6: Messages

Many of the local stakeholders may not realize the current state of dementia care; therefore, the main message will be that loved ones with end-stage dementia have traditionally suffered needlessly due to suboptimal care and neglect. Fortunately, interventions exist which can remedy this situation, but public support for implementation is needed. The main media outlets chosen to transmit this message are flyers handed out to patients and their families and advertisements in newspapers and on radio and television stations.

Step 7: Timeline and Budget

The timeline that Monkhouse (2003) used when implementing the EA model was three years before evaluating success. The Swiss nursing homes asked for and received a 30% increase in funding levels to support the transformation from the local government. A similar strategy will be implemented for this health promotion plan.

Step 8: Evaluation

The evaluation will be both qualitative and quantitative, since the quality of care depends to a significant extent on the experiences of patients and their loved ones. Questionnaires and validated instruments will be used to assess whether the experiences of residents and their family members have changed. Clinicians will also be asked to record the frequency of signs and symptoms associated with quality of care, including the prevalence of shortness of breath, constipation, fever, eating difficulties, falls, chemical restraint use, and life-sustaining interventions (Parsons, Hughes, Passmore, & Lapane, 2010). Additional measures will include the prevalence of advanced care plans, medication expenditures, sleeping pill use, staff turnover, staff sick days, bed occupancy, effective pain management, and time spent in hospice care

Discussion

The TQM and EA care models offer the promise of dying with dignity for dementia patients, who have been called by some the 'disadvantaged dying.' This often neglected and marginalized patient group deserves high quality care and to be free of the three plagues of traditional nursing home care: loneliness, helplessness, and boredom. This health promotion plan is designed to address the current shortcomings in dementia care through implementation of the TQM and EA models.

References

Brownie, S. & Nancarrow, S. (2013). Effects of person-centered care on residents and staff in aged-care facilities: A systematic review. Clinical Interventions in Aging, 8,… [read more]


Parents Would Be What Method Term Paper

… Part Two

To be perfectly honest, I understand that suicide is tragic in many circumstances (such as in the previous question) but not necessarily as tragic in other circumstances. Specifically, it is believed that the largest number of suicides in the U.S. is actually among the elderly who choose to end their lives consciously and rationally and at a time when the inevitable infirmities of advancing age make life unbearable, or at least less preferable to the alternative (Humphry, 2010). In fact, suicide among this population is thought to be widely underestimated, simply because under ordinary circumstances, law enforcement authorities do not investigate what appear to be deaths by natural causes among the elderly (Humphry, 2010).

In principle, I believe we need to draw distinctions between suicides that are the product of acute depression or acute reactions to temporary circumstances and challenges (or other treatable etiologies) and suicides that reflect more rational decisions. Physician-assisted suicide, for example, is perfectly understandable in many circumstances, such as to escape intractable pain or the slow deterioration of untreatable diseases like Alzheimer's. Certainly, we should direct all possible resources to treating the causes of acute depression and the other circumstances that typically result in suicide, and we should devote more effort to addressing the types of long-term psychological harm caused by traumatic experiences early in life that are statistically associated with higher likelihood of suicide later. However, I believe it is also time that we de-stigmatize the rational decision to end one's life in understandable circumstances, such as by rethinking penal laws prohibiting physician-assisted suicide.

References

Humphry, D. (2010). Final Exit: The Practicalities of Self-Deliverance and Assisted

Suicide for the Dying. New York: Random House.

Levine, C. (2008). Taking Sides:…… [read more]


Dementia Sufferers at the End Research Paper

… ¶ … Dementia Sufferers at the End Stage and Comorbidities

The prevalence of dementia in the United States has increased as a result of the increases in the numbers of the elderly segment of population. As growing numbers of baby… [read more]


Hypoxia (Flight Physiology) Term Paper

… For slower onset, which would be seen with altitude sickness, fatigue, headaches, and shortness of breath will be the first symptoms of a problem. Many people who are becoming hypoxic also feel nauseated and euphoric. When they become severely hypoxic or the hypoxia occurs very rapidly, seizures, coma, changes in consciousness levels, and death occur. By the time the issue is realized by others, there might not be an opportunity to help the person who has been experiencing the lack of oxygen without some type of permanent damage to the brain or other organs. Being aware of the symptoms of hypoxia that comes on slowly -- as it does when flying to a high altitude -- is very important because there is time to reverse the problems that start to occur. The earlier the lack of oxygen is noticed, the better the opportunity to descend to a lower altitude or receive supplemental oxygen to avoid hypoxia.

Altitudes and Onset

At sea level, a person's blood is oxygenated at or near 97%. When that same person goes to an altitude of 10,000 feet, the oxygen saturation in the blood drops to 90%. That is still enough for most normal life functions, although people in the medical field want to see a person's oxygen saturation point at or over 93%. At 14,500 feet (on the top of Pike's Peak, for example), the saturation is closer to 80%. That will cause the majority of people to have difficulty breathing, fatigue, nausea, and other symptoms that come along with altitude sickness. At 25,000 feet, oxygen saturation in the blood has dropped all the way to 55% and the person would lose consciousness. A pulse oximeter that clips on a finger is worn by many pilots today in order to see if they are becoming hypoxic.

The main altitude concerns are as follows:

5000 feet -- the retina of the eye will not get as much oxygen as it needs, and vision will be slightly compromised. This will be noticed most often in night vision. It is easier to misinterpret features on the ground, and maps and instruments in the cockpit can also be misread more easily. While most people can still fly safely at that altitude, it is important to be more careful than one would need to be at lower altitudes.

10,000 feet -- night vision is severely compromised, and this is the highest altitude at which pilots should trust their performance and instincts without supplemental oxygen. The minimum supply of oxygen is all that is being received at that point. Euphoria is common at that altitude, and after four hours or more there could be headaches and tingling that will also surface. Once a person flies over 10,000 feet in altitude, he or she will be severely disabled and will have dim vision and many other problems.

Conclusion

As can be seen, hypoxia is a very serious issue that can actually lead to death if not caught in time and taken seriously.… [read more]


Euthanasia in the Style Essay

… Terri's husband, perhaps the single person who knew her the best, petitioned the Court to remove her feeding tube and free her from what he called "inhuman torture." Terri's parents and a host of conservatives, including President George W. Bush,… [read more]


Caring for Elderly Patients Article Review

… Slide 4: How are the 3 Ds alike?

Delirium is a confused state caused by a psychological or physiological condition (Peacock et al. 2012:26). It is not a permanent mental state. Persons of all ages can experience delirium. However, the elderly are particularly apt to manifest it, given that the conditions which can cause it such as over-medication, a lack of sleep, and physical stressors are more likely to be suffered by aging patients (Peacock et al. 2012:26). Likewise, depression is also manifested in an estimated 40% of all elderly patients in resident care even though it is not an elder-specific disease (Peacock et al. 2012:26). All three -- dementia, delirium, and depression -- can manifest themselves as sharp changes of mood; shifts in eating and sleeping patterns; confusion; irrational behavior; and physical acting out.

Slide 5: How are they different

However, from the point-of-view of the clinician, the most important difference between all of these conditions is their cause. A patient experiencing delirium can potentially be returned to a coherent state if the underlying physical cause of the delirium can be addressed. A person with depression may not be irrational and unable to be reasoned with even though his or her mood is deflated and he or she may manifest a lack of affect: counseling and antidepressants are potentially beneficial treatments for a mood imbalance. In contrast, these forms of psychological counseling will not help someone with delirium and no pharmaceutical or therapy has been found to eradicate dementia.

References

Joosse, L, Palmer, D. & Lang, N. (2013). Caring for elderly patients with dementia: nursing

Interventions. Nursing Research and Reviews, 3: 107 -- 117

Peacock R., Hopton A., Featherstone I., & Edwards J.…… [read more]


Caregivers Article Critique

… The question and the objective of the study match the purpose of the study in that the perceptions and the experiences of the staff at the care homes will help in identifying the differences in dementia, delirium, and depression in patients admitted in such facilities. Dependent variables are the caregivers' perceptions and experiences while the independent variables are the identification of dementia, delirium, and depression. Because this was a qualitative research it is not appropriate to have a hypothesis.

Literature review is comprehensive as it uses only several sources. Only one source in the literature review was published more than a decade a go, the rest were published less than five years ago. Landmark publication in the literature review include the works of Siddiqi, Clegg and Young (2009) that talks about prevalence of dementia in care homes and Featherstone, Hopton and Siddiqi (2010) that reckons the challenges faced in differentiating between dementia, delirium, and depression. Mitchell and Kakkadasam (2011) aver that when people are depressed, withdrawal and sleepiness caused by delirium may be overlooked. This to me is new knowledge that should be explored further.

The study is of high quality bearing in mind that it uses very current literature in its literature review section. Despite the fact that the research question is not explicitly stated it can be identified by just reading the introductory section. The objective of the study is explicitly stated. It is the hypothesis that is not clearly stated because of the qualitative nature of the study.

References List

Featherstone, I., Hopton, A. & Siddiqi, N. (2010). An Intervention to Reduce Delirium in Care

Homes. Nursing Older People, 22(1), 16-21.

Mitchell, A. & Kakkadasam, V. (2011). Ability of Nurses to Identify Depression in Primary

Care, Secondary Care, and Nursing Homes -- A Meta-Analysis of Routine Clinical

Accuracy. International Journal of Nursing Studies, 48(3), 359-368.

Peacock, R., Hopton, A., Featherstone, I. & Jill, E. (2012). Care Home Staff can detect the Difference between Delirium, Dementia, and Depression. Nursing Older People, 24(1),

26-30.

Siddiqi, N., Clegg, A.,…… [read more]


Robots: The Future or Elder Article Review

… I am sure that scientists will be able to work these out sufficiently for robots to function very well as carers in the future. Indeed, once robots become readily available, the question might become would I like such a machine to look after me in my old age? Again, the answer would be yes. I would apprciate not only the company, but the platform for connecting with others without having to leave my home. The importance of human contact for emotional well-being cannot be stressed enough. Thes Robots can help to combat the problme of isolation among the elderly by offering a chat forum.

For the brevity of the article, I think I was well written. I would, however, have liked seeing more of Kelly's views, especially if this could offer a counterbalance for Antonio Espingardeiro, whom she quotes frequently throughout the work. Espingardeiro is an expert in robotics, and is therefore a good source for the aricle. Still, I feel that some information was missing from the article.

One such element was the fact that Kelly mentions "many" ethical issues, without naming any of them beyond the possibility that users could become emotionally attached to them. I would have liked to see what other challenges and bridges there are on the way to creating the perfect robotic care giver.

In general, I am impressed with the article. I believe that robotic technology will have to be the way of the future, especially when it comes to human beings as an increasingly aging population. I do not believe that anything is wrong with using robots or any other technology to improve the lives of any age group. As long as ethical challenges and other issues are thoroughly investigated, which the article clearly states as being done, I would approve of this technology in my home when…… [read more]


Suicide Is a Unique Topic Term Paper

… ¶ … Suicide is a unique topic, especially when dealing with forensic psychology. The purpose of this essay is to summarize a research study on the topic of suicide and how forensic psychology can apply to this study and under what circumstances a psychologist may use the information presented in the article to conduct evaluations on potentially suicidal patients.

McCarthy's (2010) article entitled " Internet Monitoring of Suicide Risk in the Population" is a very useful piece of research that can be used to a great extent for those working in forensic psychology. The author's premise of the article suggested that public health statistics are released too late, and when they are, the data is somewhat irrelevant. To help with this problem, McCarthy looked to internet search volume techniques, used in other disease control monitoring situations for an answer.

The research was quite simple but provided large amounts of useful information. The method used in this research was done through the search engine Google. "The terms "suicide," "teen suicide," "depression," "divorce" and "unemployment" were entered into Google Trends (Google Trends, 2009), an online log of internet search volumes. Results were limited to the United States. Search terms were chosen for their widespread use in the lay public and hypothesized relevance to suicide risk."

McCarthy soon found distinct cycles and patterns in the data he collected. During certain points of the year,…… [read more]


Kennedy Assassination the Entire Essay

… There is simply no point to conducting a series of autopsy photographs if there is no identifiable entry and exit point for the fatal wounds -- yet this was done in the case of Kennedy's autopsy. Similarly, the dearth of internal organs being visible in the pictures, and the lack of scale to determine the size of the wounds simply reeks of a cover-up. All of these points are definitely cause for alarm that the autopsy photos were egregiously mishandled.

Additionally, it is highly curious that of the bullet fragments examined 14 years after the president's murder, there were only two found that "differed slightly in their composition" (cite). What exactly does that mean, and how common is it for bullets fired in the same gun to be made up of different composition? Furthermore, if the bullets did have different compositions, how can "experts" (cite) be so certain that the came from the same gun?

As the textbook states, the evidence in determining whether or not there was more than one marksman is inconclusive at best. Therefore, when attempting to determine whether or not he had help in assassinating the president, it is difficult to say. However, it certainly seems that there was help given in maligning the investigation of the murder and the autopsy. If that sort of help was given in order to confuse the people about what events took place to lead to the murder of Kennedy then yes, it appears as though Oswald certainly had help indeed.

Similarly, it appears as though the most important perspective of the crime scense from this assassination would be that of the bullets that entered the president's back, since those are no longer traceable.

References

YOU'VE GOT THE TEXTBOOK, I DON'T

Clarke, T. (2013). "A death in the first family." Vanity Fair. Retrieved from http://www.vanityfair.com/politics/2013/07/icebergs-jfk-jackie-death-patrick… [read more]


Environmental Design Environmental and Interior Term Paper

… Hearing-impaired persons will appreciate a reduction of 'white noise' that further impairs their ability to listen (Kopec 2006: 174).

Geriatric populations

Even persons over the age of 80 can lead vibrant and active lives, and the environment must be orchestrated to allow them to accomplish daily tasks. Compensating, asking for help from others, restricting some activities and optimizing (planning the most effective way to perform the activity) are all ways for the elderly to cope with the challenges of aging (Kopec 2006: 175). Design improvements can better enable elderly persons to maintain an active lifestyle by compensating for age-related challenges, such as deterioration of balance (Kopec 2006: 176). Something as simple as an L-shaped kitchen that allows for greater maneuverability (given that elderly persons often cannot reach or use all of the burners) can make a great difference in the resident's life (Kopec 2006: 177)

Dementia of Alzheimer's Type

Alzheimer's, a form of cognitive decline has become an increasingly common problem amongst the population of America's elderly. To extend the time which the patient may remain with his or her family outside of nursing home care, designers can modify the environment to reduce the stressors of the illness, such as providing visual cues to prevent subjects from walking into doors or positioning the bathroom near the bedroom to reduce incontinence (Kopec 2006: 179). Remaining in a familiar place as long as possible can be highly beneficial for the patient.

Parkinson's disease

Parkinson's disease is a neurological disease caused by a deficit of dopamine that is most common in (but not exclusive to) the elderly which causes rigidity, tremors, and freezing in place. One important accommodation for sufferers is including 'grab rails' in frequent places, as the tremors typically appear when physical motion ceases and muscles are relaxed (Kopec 2006: 181).

Summary review

Changes in the physical environment can have a profound positive influence upon the ability of elderly and disabled populations to be functional. Designers must anticipate the specific needs of the populations which…… [read more]


Kevorkian Dr. Kevorkian the Act Essay

… Physician-assisted suicide is not as harmful to society as society believes that it is. Many of the patients seeking such an extreme end to their lives have very little to live for, and often suffer intense pain from incurable ailments. What Dr. Kevorkian was doing has been portrayed as a moral concern, when in fact it is purely a scientific decision to end a life that is incapable of functioning at an acceptable degree of health. There is no moral question, but rather a purely logical one, of whether human life is more precious than the reason of man, or if mankind is capable enough of making the correct decision of ending a life that ceases to be useful. There is nothing for Americans to worry about if people are making this decision to end their lives, these decisions should not be the concern of common people, but only of the individual and physician involved. Even families should only have limited knowledge of this practice, but those families that do choose to allow physician-assisted suicide should be allowed to carry out their wish despite the demands of the state.

Those who are against assisted suicide often cite God's will in their decision, drawing from the Bible various teachings against the act. This belief does not explain the action of the United States making suicide illegal, however, since the state has always been separate from the church. Those who are against Dr. Kevorkian usually play the part of society, while those who are with Dr. Kevorkian think of the patients first. It is these individual's desires to die peacefully and predictably, and it is Dr. Kevorkian's will to fulfill these demands. The government does not need to interfere with this transaction of life, as choice should be the ultimate goal for any human who values freedom and liberty over control.

In conclusion, Dr. Kevorkian took a risky practice and conducted it openly for decades, usually at the relief of his patients who chose to die rather than to suffer. He is a man who is driven strongly by his beliefs, and he deserves respect for approaching all of American society with the question of assisted suicide. His sentencing to jail may be necessary in the eyes of the state, but does not do much to explain why Dr. Kevorkian's practices are necessarily illegitimate. The final question that every body needs to ask is whether an individual should be able to make the choice of death, or whether it is society's role to prevent such…… [read more]


Ethics the Case Touches on Alzheimer-Type Degeneration Reaction Paper

… Ethics

The case touches on Alzheimer-type degeneration. Alice mother, Martha, suffers from this clinical condition. She is not capable of taking care of her self and relies on her daughter for virtually everything. Her daughter takes her to a special unit where Alzheimer patients are taken care of because the facility can provide long-term care for Martha. Before Martha is taken to this facility, Alice realizes that Martha is in a frail state.

Upon admission at the facility, Alice fails to complete doing the paperwork because of weariness. Unfortunately, only a few forms are in the process signed. She gave her mother's directive that if her heart stopped beating she never be subjected to Cardiopulmonary Resuscitation (CPR). It is however not clear whether the physician cosigned DNR order. After Alice had left the facility, her mother suffered a cardiac episode and was taken to an intensive care unit where she was put on a heart monitor, ventilator, and an intravenous line, something that really infuriated Alice.

This case highlights some important professional obligation of healthcare professional with regards to terminally ill patients or patients under long-term medical care. The case highlights issues pertaining to when CPR can or cannot be withheld. Conventionally and depending on the policies of a particular hospital, CPR is withheld when it is deemed to be of no medical benefit to a patient or when persons designated to make decisions for them indicate that they do not want CPR, should the need arise.

Martha's clinical condition cannot be remedied because there are no medical interventions to it. It is therefore futile administering CPR because it is of no clinical benefit. The caregivers were therefore ethically wrong in administering CPR after she had suffered a cardiac episode because…… [read more]


Living Wills Research Proposal

… If there are problems with the initial intervention, there are opportunities to adjust it - but only if the reasons behind the problems can be discovered. A qualitative method that could be used with this intervention is observation. The desire would be to see how many people were "swayed" by what they were told regarding living wills. If a patient was provided information about living wills properly, would that patient decide to create a living will for himself or herself? Would the results of that style of intervention be any different than the results of the current (lack of) intervention that is taking place in hospitals and other medical facilities in the present day? That is a question that cannot be answered without study, but qualitative methods do not necessarily provide enough data to make an accurate assessment.

Another way to assess the intervention is to use quantitative methods. One of the most popular of these types of methods is the survey or questionnaire. However, it can become difficult to use this method on elderly individuals in the hospital and other medical facilities. The best way to measure the intervention quantitatively is through a statistical analysis of whether people are more likely to create a living will after they have been visited by the designated medical professional. If the difference is statistically significant and other variables can be controlled for, the intervention could be seen as having value for those who need information about living wills and are currently not getting that from their interactions with medical professionals. If the intervention is successful, there will be both short-term and long-term goals that will be met, as well. Short-term goals include the creation of more living wills and advance directives, which helps hospitals, doctors, and patients all be more prepared for the inevitability of aging individuals.

Long-term goals are more significant. They will allow the patient to have his or her affairs in order more clearly than would have been possible without the advance directive. It not only helps the patient, but it also helps the family of the patient. The doctors and nurses also benefit, because they are clear on what they need to do for each patient and what wishes that patient has for end of life care. Even though it is a subject many people avoid, end of life care should be addressed. Those who are elderly and/or those who have chronic or terminal conditions must be made more aware of the importance of advance directives. When they do not have living wills, they leave their last wishes and their end of life care decisions to others. An intervention could change all of that and provide them with information on living wills and follow ups where they could get their questions answered and create the documents needed to ensure proper end of life care.… [read more]


Terminally Ill People Research Paper

… Terminally Ill People

The debate on whether or not those considered terminally ill should be allowed to end their lives has been ongoing for a long time. Those in support of physician-assisted suicide continue to advance various viewpoints in support… [read more]


Experiences of African-American Women Who Have Lost a Male Son to Suicide PhD Model Answer

… ¶ … African-American Women Who Have Lost a Male Son to Suicide

A Re-Examination of cultural factors that mitigate risk and promote resilience in relation to African-American suicide: A review of the literature and recommendations for future research

Accoding to… [read more]


Antigone Is the Last Play Essay

… Antigone warns Ismene not to tell Creon what she has done -- defy his mandate -- and tells her "I shall be hating you soon, and the dead will too,/For your words are hateful. Leave me my foolish plan:/I am not afraid of the danger; if it means death, / It will not be the worst of deaths -- death without honor" (78-81). In this warning, Antigone makes it clear that she believes that there is nothing worse than a dishonorable death, which can either be attributed to Polyneices who is being denied a proper burial or can be construed as foreshadowing as Antigone believes that her death will serve a higher purpose and that she will not die in vain. Additionally, through this statement, she is separating herself from Creon, whom she evidentially believes is ignoble and only wants to secure his position of power and will do anything to ensure that people follow his mandates, whether by force or by fear.

By standing up for what she believed in, Antigone is fulfilling the Theban elders' expectations as outlined in the "Ode to Man." In the final part of the ode, the Theban elders make it abundantly clear that they do not tolerate any person who breaks the laws and sees his city crumble (295-330). By establishing his mandates, Creon demonstrates that he values his own needs above those of the gods. Creon's actions and behaviors are a direct contradiction to what Thebans hold to be noble and valuable in their society, however, Antigone, despite the fact that she appears to be fighting against Creon on her own, embodies the qualities that these Thebans hold dear.

While Antigone is prepared to give her life for what she believes in, and effectively establishes herself as a martyr within the community, Creon is not prepared to handle the consequences of his defiance of divine law. At the end of the play, upon discovering that Antigone has died, Haemon, Creon's son and Antigone's betrothed, commits suicide. His death is subsequently followed by that of Queen Eurydice, his mother and Creon's wife, who commits suicide due to everything that Creon had done and had allowed to be done.

Because Creon ruled with a "might makes right" attitude instead of providing his subjects with what they needed, he not only lost the respect and admiration of his subjects, but also lost his wife and son. On the other hand, Antigone believed that what was right was not determined by those who had power, or the means to attain it, and as such, she was able to capture the hearts of Thebans. However, Antigone is comforted not only by the fact that she stood up for what she believed in, but also because she knows that she will be at peace in Hades because she did what was right, follow divine law.

Works Cited

Sophocles. Antigone. Web. 8…… [read more]


Right to Die Physician-Assisted Suicide Case Study

… Director, Missouri Department of Health). The refusal of resuscitation thus can legitimately be considered an indicator that the patient would also refuse nutrition even though the court upheld Missouri's specific state requirement for written evidence.

If the state in which Mildred is located does not demand written evidence in the form of a living will that she does not want her life continued artificially, legally and ethically, acting in accordance with the wishes of her loved ones would seem to be the most compassionate action and it would be morally legitimate to withhold nutrition in this case. The family's legal right to make such a decision will vary on a state-by-state basis, but morally, given they are closest to the patient, Mildred's children are clearly in the best possible position to make such a choice. The fact that their decision is unanimous further supports the notion that Mildred made her wishes clear.

There is, of course, a slightly troubling 'other side' to the case. If Mildred felt so strongly, why did she not take the time and the trouble to write a living will, given that she had already suffered two heart attacks and had clearly faced death before? Granted, the subject may have 'come up' in conversation with her family, causing her to express her wishes, but the fact she did not actively put her thoughts down on paper makes her decision more in doubt than would be the case had a living will been authored -- or even simply a non-legal document detailing her feelings. However, given the available evidence and the medical prognosis, deferring to the patient's family in this instance is still the best alternative.

References

Cruzan v. Director, Missouri Dep't of Health, 497 U.S. 261 (1990). Retrieved:

http://biotech.law.lsu.edu/cases/consent/Cruzan_SC.htm

The right to die. (2012). Exploring Constitutional Conflicts. Retrieved:

http://law2.umkc.edu/faculty/projects/ftrials/conlaw/righttodie.htm… [read more]


Euthanasia it Is Generally Believed That Life Term Paper

… Euthanasia

It is generally believed that life is "good," and death is "bad;" but there are circumstances when this seemingly universal truth may become clouded and confusing. Lately, the issue of euthanasia has come to the forefront of modern society with many cases in the news. However, while a dictionary may define the term "euthanasia" as a quiet and easy death, or the means to acquire it, Philippa Foot asserts that euthanasia is a more complex and morally ambiguous act that often is misunderstood by the general public. According to Foot, there are a number of difficult issues surrounding the concept of euthanasia, including the idea of good and evil, the value of an individual life, and when, and even if, a person can consent to their own death. Since, as Foot points out, the current health care system already employs euthanasia in a different, albeit indirect manner, the question of euthanasia must be explored to not only define it as a term, but also to define when and if it is to be employed.

The dictionary defines "euthanasia" in a limited manner: a quiet and easy death, or the means to acquire it. But as Philippa Foot explains, there are a number of problems with this definition. According to Foot, a definition of euthanasia must include more than a quiet and easy death, in fact it must include the idea that the quiet and easy death is actually a "good" instead of an "evil." It must also be of benefit for the person being killed, and not simply be beneficial to those around the person. When speaking of "good," Foot is careful to stress that the "good" must be a real and tangible "good," not a perceived "good" on the part of those making the decision. And mostly, it can only be termed "euthanasia" when the death of an individual is a real escape from the greater "evil" of continued life. In other words, euthanasia must be a means of ending the "evil" of a life that is generally accepted by society as intolerable for the person living it.

This definition of euthanasia rejects the idea that a person can die when the pain in their life exceeds the joy. However, Foot asserts that life, even a good life, cannot exist without some pain; and even in cases where the pain exceeds the joy of life, in most cases, life should win out. As Foot stated in making her case, "merely being alive even without suffering is not a good…." (Foot, p.4) it seems that the connection between "good" and "life" is stronger than can be calculated, and as a result, the mere sums of pain and joy cannot be compared…… [read more]


Rabbit Hole the Symbolism Essay

… Pretending, then, or creating illusions through these "rabbit holes" of the imagination, is at least a way that Izzy deals with conflict and potential pain if not a more consistent character trait.

Howie, Danny's father, immerses himself in fantasy worlds in a more direct and apparent way than Izzy but a more indirect way than Jason. Instead of actually dealing with a future life where Danny is dead, Howie watches old home movies of Danny, immersing himself in the world of the past. Though not exactly the same type of imagining or pretending that the other characters engage in, Howie is still creating a false alternate world with these home movies. He has disappeared through a rabbit hole to a world that used to exist and doesn't any longer, and is in this way perhaps worse than an imagined future.

Becca's reaction to her son's death is the most enigmatic of any of the characters' reactions, and is also perhaps the most obviously profound because of the uncertainty it seems to create in her. While not creating an explicit alternate reality or any clear fictions to cover up or deal with her pain, Becca does not seem at all sure about what reality is like without her son, and with all of the other conflict in her life. In this way, she is perhaps trying to deal with Danny's death in a more direct manner than any of the other characters, but she ultimately fails to do so throughout much of the play/film, as she is to uncertain of how to go about grieving properly. Her "rabbit hole," as it were, is found in her inability to find the right rabbit hole -- to find the world of a future without Danny that can seem real to her, and that offers her a way forward. Until she receives some catharsis at the end of the play/film, Becca's is a journey of finding the rabbit hole rather than of finding her way out again.

All of the characters in Rabbit Hole are stuck in a symbolic rabbit hole created in part by Danny's death, as well as by the other more individual events, personalities, and traits of each of the characters. Through their own explorations of their made-up alternative universes, each character either deals with or avoids dealing with their grief, their confusion, and their pain when it comes to loss and to life. Perhaps the essential point of this text, then, is that we all have rabbit holes to which we must and even should succumb at times. It is human to be rabbit-like in this regard, and impossible to deny the impulse.… [read more]


Unlicensed Caregiver Experience in Dementia Research Paper

… Depressive symptoms were the second most common (77%) and anxiety and sadness were the primary ones observed. Disruptive behaviors were the least common (60%) and included arguing, irritability, and insomnia.

The dementia-related behaviors that triggered the strongest reactions in ULCs were threats of self-harm, mentioning death, and expressing feelings of low self-worth. Moderate reactions were elicited by threats to harm others and engaging in behaviors that were potentially dangerous. The least upsetting behaviors were memory problems and not finishing things.

A significant positive correlation was found between the number of dementia-related behaviors and how upset an ULC would become (r = 0.73, p < 0.01), with depression-related behaviors triggering the strongest negative reactions (r = 0.64, p < 0.01).

Discussion

The primary finding of this study is that dementia-related behaviors in an assisted living setting have a significant impact on the experiences of ULCs. In essence, the more frequent the behaviors are encountered the more negative the caregiver will perceive their experience, with behaviors related to depression triggering the biggest reactions.

The authors of this study selected a specific question to answer and provided the theoretical context for why this question is important enough to spend research dollars on (Ragin, Nagel, and White, 2004, p. 3-4). The experimental approach was outlined clearly, methods for data collection not controversial, and data analysis straightforward. As designed, this study could be easily replicated by others.

The limitations of the study were discussed openly and honestly by the authors. The main limitation was the ULC sample contained a significant number of certified nursing assistants (53%), which are considered licensed caregivers (McKenzie, Teri, Pike, LaFazia, and van Leynseele, 2012, p. 98). Despite this limitation, this sample still reported low levels of dementia care training overall. It would have been nice though, if the data could have been stratified by unlicensed and licensed caregivers to see if there was an effect. In addition, it would have also been interesting to see if the amount of dementia training influenced the perceived caregiver experience.

The authors discuss the relevance of the findings to prior research, which suggests that dementia-related behavioral problems have a significant negative impact on the morale of caregivers, from registered nurses to nursing assistants. The findings presented by McKenzie and colleagues (2012) reveal that the negative effects of dementia care is universal for all professional caregivers and provides empirical support for promoting increased dementia care training for all caregivers.

References

Chodosh, Joshua, Pearson, Marjorie L., Connor, Karen I., Vassar, Stefanie D., Kaisey, Marwa, Lee, Martin L. et al. (2012). A dementia care management intervention: Which components improve quality? American Journal of Managed Care, 18, 85-94.

McKenzie, Glenise, Teri, Linda, Pike, Kenneth, LaFazia, David, and van Leynseele, June. (2012). Reactions…… [read more]


African-American Suicide Article Review

… Walker, RL., Wingate, LR, Obasi, EM, Joiner, T (2008).An empirical investigation of acculturative stress and ethnic identity as moderators for depression and suicidal ideation in college students. Cultural Diversity and Ethnic Minority Psychology Copyright 2008 by the American Psychological Association 2008, Vol. 14, No. 1, 75 -- 82

This paper explores the relationship that exists between ethnic identity and acculturative stress with depressive symptomology as well as suicide ideation. The scales used are SAFE Acculturative Stress Scale, Beck Depression Inventory, Multi-Group Ethnic Identity Measure and Beck Suicide. The work indicated that acculturative stress as well as ethnic identity moderated cases of depression-suicide ideation relationship for the African-Americans but not European-American students.

Literature has indicated that suicide is the leading cause of death among African-Americans aged between 10 and 44 (CDC,2005). It goes further to indicate that every four and half hours, an African-American loses his or her life due to suicide (Crosby & Molock, 2006). Averagely, African-Americans are noted to complete suicide about a decade earlier that persons from other racial or ethnic groups as indicated in the work of Garlow, Purselle, & Heninger (2005).

The paper also indicates that the rate of suicide among the African-American male and youth has seen a significant increase while the completion rates among African-American women has remained relatively low and stable (Griffin-Fennell & Williams, 2006). Due to the high suicide rates among the Whites as compared to the African-Americans as well as the stigmatization of the act of suicide among the African-Americans, case of suicide among the Whites are noted by Anglin, Gabriel, & Kaslow (2005) to dominate the public health as well as research agenda.

Limited number of research has been focused on the risk factors of suicide among the African-Americans. These literature cites the following as the risk factors for suicide completion among the African-Americans; being of male gender and being under 35 years old, substance abuse, firearms at home as well as violence (Barnes, 2006; Willis, Coombs, Drentea, & Cockerham, 2003). The risk factors for suicide attempt are however noted to include; prior attempts, acceptability of suicide, aggression, psychological stress, substance abuse, aggression, hopelessness, familial and marital dysfunction, racial inequality, life stress, income and a myriad of other factors.

In regard to suicide and its effect on families, the paper noted that for each and every suicide case, six to ten survivor or victims are left in bereavement as noted by Jordan and McMenamy, (2004).Suicide survivors are noted to rarely experience any form of…… [read more]


Theme and Symbolism Essay

… ¶ … Symbolism

In Kate Chopin's "Story of an Hour" an unexpected turn at the end of story, ends up defining the true theme of this writing. An individual's inability to evade death becomes the overarching theme that surrounds every element of this story. Despite family attempt to avoid death for Mrs. Mallard and for her to accept the death of her own husband, the story teaches us that people can take precautions in order to delay dying, but the twists and turns of life make death completely impossible to avoid.

The author achieves this theme by constantly mentioning the fear that everyone has of death and the steps that they take to prevent an early death for Mrs. Mallard. They do everything possible to prevent Mrs. Mallard from dying. Her heart condition is almost a sure death sentence, so everyone has to tiptoe around her to make sure that nothing too drastic occurs, so as to not upset Mrs. Mallard in anyway. Personifying death as an entity constantly surrounding the house make the readers feel as if death is a gloomy shadowy mist that is always present. Death takes on human characteristics by portraying an action, instead of a state of being, "When the doctors came they said she had died of heart disease -- of joy that kills." What was supposed to be a happy moment in her life, ended up killing her. Using personification as a literary device adds on to the impact that the theme is supposed to have on its readers.

Irony is an element used to constantly allow the readers to know the lesson of this story: people are unable to avoid mortality. Mrs. Mallard is confined to the four walls of her own home. She is constantly being looked after as if she were going to die any minute. Upon the death of her husband, her family is torn about how and when to break the news to her, for fear of her untimely death due to her weak heart. However, when the news is broken to Mrs. Mallard, she is in disbelief, yet still alive. Once she has overcome any immediate grief, she pulls herself together, realizing that she must now live for herself (a concept that is ironic in itself). The twist comes in the end, where a symbolic and ironic concept merge as one, Mr. Mallard is still alive. Once Mrs. Mallard sees him, she is in such shock, that she ends up dying. What is ironic about this is not just the fact that Mr. Mallard was indeed still alive, but that in the end, the people who…… [read more]


Assisted Suicide Research Paper

… No one should die who is not yet ready.

The primary argument against assisted suicide hinges on a different moral argument than the one used in favor of death with dignity. An opposing view suggests that death is a negative thing, and that life is qualitatively better. This view is ignorant of the gamut of human experience, for all persons do eventually die. The life a person lives should be as good and enjoyable as possible. Andre and Velasquez note that views against assisted suicide call upon "a fundamental reverence for life and the risk of hurling down a slippery slope toward a diminished respect for life." It is easy to rebut this claim, however. Assisted suicide supports even greater reverence for life than does a taboo against it. This is because assisted suicide values the quality of life over the quantity of years spent alive. The slippery slope argument can be rebutted, also. It is essential to ensure a system of checks and balances within healthcare that prevents untimely deaths or physician persuasion of patients and their family members. Moreover, assisted suicide may be only carried out in circumstances in which the patient is already participating in palliative care (Humphry).

Because assisted suicide reflects freedom of choice, patient empowerment, and the right to live as one chooses, it makes perfect sense to legalize practices that promote death with dignity. No person should be forced to be on life support simply because their heart is still beating. If a person is in a persistent vegetative state or "locked in," that person could suffer for years or even decades. To support such conditions is cruel and immoral. Assisted suicide alleviates suffering caused paradoxically by the strength of the medical system.

Works Cited

Andre, Claire and Velasquez, Manuel. "Assisted Suicide: A Right or a Wrong?"Santa Clara University Markkula Center for Ethics. Retrieved online: http://www.scu.edu/ethics/publications/iie/v1n1/suicide.html

Humphry, Derek. "Liberty and Death." Assisted Suicide. Retrieved online: http://www.assistedsuicide.org/liberty_and_death_manifesto_right_to_die.html

Topping, Alexandra and Jones, Sam. "Locked-in syndrome sufferer wins high court hearing for his right to die." The Guardian. 12 Mar 2012. Retrieved online: http://www.guardian.co.uk/society/2012/mar/12/locked-in-syndrome-sufferer-court-hearing… [read more]


Ageism in the United States Essay

… Programs like social security provide funds to elderly people of the country and there are some who question why these people should be entitled to such funds just because they have reached a certain age. This becomes a greater issue with the predominance of figures like the aforementioned Betty White who is illustrating that a person passed the age of ninety can be a fully functioning member of the citizenry. If she can work, why can't all elderly people and why should the American taxpayers be held responsible for those that cannot, seems to be the type of question that comes up in such scenarios.

Thirdly, researcher Susan Letvak poses in the article "Myths and Realities of Ageism and Nursing" that one of the reasons that people mistreat their elders is because of a fear of their own mortality. She says that "Ageism is a form of oppression that not only limits people who are objects of that oppression, but also influences all people, regardless of age, who have ageist attitudes" (1). When forced to encounter aged people on a daily basis, a person cannot help but realize that they will one day also be old and potentially enfeebled. If that group that causes fear is pushed to the margins, then there is less likelihood for constant interaction and the fear can be allowed to move to the margins as well (1). This is similar to the scapegoat theory of ageism in that there is an inherent anger or jealousy of the group that is being marginalized. People who have ageist attitudes will inevitably pass those beliefs on not only to their own progeny but will encourage other people in their community to have their same value system. Thus ageism, becomes a vicious cycle of misplaced fear and anger which some people may not even be aware that they posses.

Ageism is still one of the most common forms of prejudices that occur in the United States. These are but three potential reasons for explaining the psychological reasoning behind the marginalization of the elderly by the majority population of the country. Stereotypes of the elderly are heavily encouraged by the media. Either elderly people are portrayed as weak and close to death or they are shown as vibrant and vivacious to the point of impropriety. There is also the implied irritation by the majority population that the elderly somehow benefits unfairly because of their age. Finally, there is the potential reason that people look at members of the elderly and see their own eventual death and wish to castigate them so as to separate themselves from their mortality. Whatever the reasoning behind this oppression, it must be understood that ageism still occurs and at a rate that is disappointing and unsettling to anyone who believes that America is truly a land of equality.

Works Cited:

Cook, F.L. "Ageism: Rhetoric and Reality." The Gerontologist. 32(3): 292-293. 1992. Print.

Letvak, Susan. "Myths and Realities of Ageism and Nursing." AORN Journal. 2002. Print.… [read more]


Evidence-Based Practice Using PICO Essay

… Clinical Oncology. Vol 13(3), 209-218.

Kinzbrunner, Barry (1994). Ethical dilemmas in hospice and palliative care. Supportive Care in Cancer. Vol. 3(1), 28-36.

McKinlay, Eileen; McBain, Lynn (2007). Evaluation of the Palliative Care Partnership: a New Zealand solution to the provision of integrated palliative care. The New Zealand Medical Journal. Vol. 120(1263).

After this success, I would pose that the question is better stated as, "Does early entry into a hospice program result in better pain management?" The reason for the change from "early admitted" to "early entry" is that entry brought up much more accurate results. It would appear that entry is the term used within the medical community when referring to admittance into a medical program or department.

The next search I ran was on Medline. I first tried using the same search results as I did with the previous search, but the articles were less helpful. This time I added in the term "and" between the two search terms to see if this narrowed the results. This did not narrow the results at all, there were still 191 documents that came up. Next I tried adding the term "terminal care" in quotations and removed the term "Hospice." While the search widened to 240 documents the titles were more of what I wanted to see. The following was the most helpful titles on the first search page:

Improving Quality of end-of-life care. A possible and necessary change. Epidemiol Prev. August 2011.

I decided to try one more search on this database and put back the term hospice and added the terms "and admission. This brought up 16 new documents including the following:

"Assessing and treating pain in hospices: current state of evidence-based practices." J. Pain Symptom Manage. May 2010. From the lack of useful information obtained from this search site, my best conclusion is to keep the question the same, and continue on to the next search site.

The final search I ran was using the Cochrane Summaries. This site did not seem as helpful. I initially tried using the primary search terms and only one result came up:

Dileo, Bradt (2011). "Music Therepy for End of Life Care."

So, I decided to try some different search terms. First I entered the single search term of hospices. This single term only brought up four articles. The music article came up again and two other slightly applicable articles:

Kolliakou, Hall; et al. (2011). Improving palliative care for older people in care homes.

Shepperd, Wee; et al. (2012). Home-based end of life care.

This search engine did not seem very helpful at all. Perhaps it is meant more for basic definitions as opposed to research-based questions.

The most helpful article that I found during my searching was the Miller article "Does receipt of hospice care in nursing homes improve the management of pain at end of life." I…… [read more]


Difficult Patients Mitigating Risks Research Paper

… Research Methodology

It is essential to precede any planned review with a search to establish the existence of extant reviews. Such a search will typically identify both quantitative and qualitative systematic reviews. In formulating a review question an existing qualitative… [read more]


Dying Process Pain Is an Inherent Component Essay

… ¶ … Dying Process

Pain is an inherent component of human life, which can be either useful or unfortunate. In the case of a terminal illness, it is generally assumed that pain will form part of the dying process, which may range from months to a year or sometimes more. How to manage such pain has been the topic of considerable debate, and continues to be so. Short of euthanasia to help a suffering person end his or her life completely, alternatives have been sedation or pain management by means of prescription medication. Some terminal patients have also begun to enter the family setting rather than the clinical setting for their end of life care needs. The purpose of this study is then to create a quantitative research design to determine the connection between physical and emotional pain, its management, and the role of the family in alleviating such suffering.

As mentioned, the research design will be quantitative. This means that statistical parallels will be drawn among various categories of pain and the choices that such suffering leads to. Claessens et al. (2011), for example, found that palliative care that involves sedation could be offered as an alternative to patients who do not wish to enter the highly controversial debate regarding euthanasia, but whose symptoms are nonetheless non-responsive to pain management offered in ICUs and hospices. Family care offers a further dimension to end-of-life care options (Given et al., 2008). It also means, however, that more dimensions of suffering may be added for family members who are ill prepared to care for such a person. Kahn and Steeves (1996) make it clear that suffering concerns more than just physical pain, which is a dimension worthy of exploration for terminal patients.

In this study, the sample will consist of terminally ill patients nearing the end of their lives. Two groups will be compared; those who have been committed to clinical institutions and those who have, for the majority of their illness, received family care. The families of these groups will also be included in the study. The extent and effect of the illness on the patients themselves and their family members will be monitored and investigated, as well as how this correlates with…… [read more]


Dementia Alzheimer's Disease Term Paper

… They are believed to produce a neurotoxic effect and are akin to functionless brain scar tissue.

3. Neurofibrillary Tangles. The neurofilaments of a neuron are the skeletal structures of the cell and serve as the transport system for components within the neuron. When these become malformed the cells cannot function properly nor send messages to other neurons. Tangles also lead to cell death.

Third, there is no cure for AD. AD is progressive and is 100% fatal (although many elderly patients may die from other complications). There are many conditions that mimic dementia and are reversible. The average expected lifespan for a person diagnosed with early AD is about seven to eight years, but the course can last anywhere from one to twenty years (Molsa, Marttila, & Rinne, 1995; Ropper & Samuels, 2009).

Fourth, there is no way to predict for certain if a person will develop AD. Recently, there have been a number of studies using PET scanning or other brain scanning techniques that demonstrate promise in identifying individuals at risk to develop AD, but all these at risk individuals will not develop dementia (Ropper & Samuels, 2009).

Fifth, AD appears to have several subtypes which do not have the same progression in every individual (Ropper & Samuels, 2009).

Treatment for AD

There is no cure for AD but there have been medications developed that are hypothesized to slow the course of early AD and one class of medications hypothesized to accomplish this in the later stages. Medications are (Miller & Boeve, 2009; Sadock & Sadock, 2007):

1. Cholinesterase Inhibitors. These are based on the "Cholinergic Hypothesis of AD" from early studies demonstrating a reduction of the neurotransmitter acetylcholine in the brains AD patients. Acetylcholine is also believed to be important in memory. When neurotransmitters are released and have performed their function they can be reabsorbed chemically broken down. Cholinesterase is a by-product of the breakdown process of acetylcholine. Cholinesterase inhibitors reduce the rate at which acetylcholine is broken down. The most commonly used cholinesterase inhibitors approved for AD include Aricept, Razadyne, and Exelon. Most of these medications are hypothesized to be effective in the earlier stages of AD; Aricept has some support for its effectiveness in later stages.

2. NMDA Receptor Antagonists. These work on glutamate, an excitatory neurotransmitter. When glutamate neurons become overly stimulated for extended periods they may die through a process known as excitotoxicity. The NMDA neuron receptor is a glutamate receptor. These drugs bind to these receptors and inhibit firing of the glutamate neuron. Memantine is the drug in this class also known as Namenda, Akatinol, Axura, Memox and Abixa. These drugs are often used for the later stages of AD, often combined with Aricept.

3. Behavioral Problems in AD. These problems range from apathy, depression, aggression, and hallucinations and delusions. Such issues are commonly treated with psychotropic medications.

References

American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental

Disorders- 4th edition- Text Revision. Washington, D.C.: American Psychiatric Association

Launer, L.J., Andersen, K.,… [read more]


Elder Abuse Today, in a Society Reaction Paper

… Elder Abuse

Today, in a society that is rapidly aging because of the health science we now have available to us, an increasing number of people is also becoming vulnerable to elder abuse. The speaker, Laura Masqueda, there are many contributing factors to this sad phenomenon in society. One of the most important factors, in my view, is a simple unawareness in general society that anybody can be a victim of this crime, and anybody can be a perpetrator. The fact is that older people tend to be less important, to the general mind, than children or younger women who are victims of abuse. This, along with the fact that older people often suffer from disabling conditions that make reporting difficult or impossible, creates a type of bubble of blissful ignorance about the issue for society in general. If we were to call ourselves civilized, I believe that society should gather its collective powers to stop this gross violation of basic human rights.

The words that struck me most in the presentation are probably that "anyone can be a victim" and "anyone can be a perpetrator" of violence against the elderly. It is also a sad fact to me that there are so many possible types of abuse from the openly and physically violent, to the financial, to the more insidious types of abuse like neglect.

Masqueda mentions a number of contributing factors. One of the most important of these is the nature of getting older, which creates in older adults a feeling of powerlessness; many are reluctant to admit to being abused as a result of a sense of shame, for example. They may even be willing to take such mistreatment as a preference to being placed in a nursing home. Older adults may be unable to report abuse as a result of a debilitating mental condition or the removal of freedom and contact by those who are guilty of this crime.

On the part of society in general, the main challenge is ignorance. The common perception…… [read more]


Cardiac Disorders in the Elderly Article Critique

… ¶ … Alvez et al., what surprised me most was that cardiovascular conditions could also lead to dementia symptoms. What surprised me even more is that these conditions could be related to Alzheimer's disease as well. In the general, conventional wisdom, the two conditions could not be further apart, with the one being a heart condition and the other affecting mental health. The article therefore provides valuable research, not only in the field of dementia and is potential causes, but also in how some of these causes could be prevented. In a world and society where the population is increasingly aging, the reality is that an increasing number of people are succumbing to dementia, creating a burden for individuals, family, society, and the medical care system. If some causes could be eliminated, thousands of people could live a longer, more productive, and higher quality of life.

The article offers a very thorough literature review and identifies the factors most likely to be implicated in Alzheimer's disease, cardiovascular related dementia, or a combination of the two. Potential risk factors include hypertension, diabetes, smoking, heart failure, hypercholesterolemia, plasma biomarkers, Arial fibrillation, coronary artery disease and cardiac surgery, and stroke. The literature review ends with a consideration of cardiac diseases as potential risk factors in developing dementia symptoms, as well as a section that focuses on mild cognitive impairment and its connection to vascular risk factors.

The literature review is graphically presented in a table that includes the studies done to focus on the specific risk factor and the outcomes of the studies involved. This presentation provides a valuable view of the outcomes of each study and how each risk factor compares with the others in terms of severity and likelihood to be implicated in developing dementia symptoms. In general, the literature discussion is thorough and critically sound. The specific shortcomings…… [read more]


Consequences of an Older Research Paper

… The assistance provided to the elderly can also be reduced to a certain extent to ease of the burden of younger employees who will have to work all the time in order to pay off their debts and those of the elderly.

An ageing population also has an impact on social security reforms around the world. Agreed that providing incentives for older people to work longer would increase their productivity and reduce their burden, but they would be pushing the young people out. Here another problem of an ageing population I would like to highlight is that, since they are living longer, they will be receiving benefits for a longer period of time! And we do not want to keep neither party unemployed, so which one is more beneficial?

In a study of Social Security Programs and Retirement around the World (Gruber et al., 2009) it was concluded that older people in the workforce do not necessarily reduce opportunities for the younger population. So there was no evidence found that increasing employment of the ageing population would increase unemployment of the youth.

So even though this ageing population may seem like a bane to our existence, there are upturns and possible preconceived notions about this change, which is another demographic change and which can be tackled with the right management.

References

Jonathan Gruber, Kevin Milligan, David A. Wise (2009). Social Security Programs and Retirement Around the World: The Relationship to Youth Employment, Introduction and Summary. In the National Buraeu Of Economic Research.

Margaret Patrickson, Linley Hartmann, (1995). "Australia's ageing population: implications for human resource management," International Journal of Manpower, Vol. 16 Iss: 5, pp.34 -- 46

Neeraj Kaushal (2009). Elderly immigrants' labor supply response to supplemental security income. Journal of Policy Analysis and Management Volume 29, Issue 1, pages 137 -- 162.

Patricia Apps, Ray Rees, Margi Wood. (2007). Population Ageing, Taxation, Pensions and Health Costs. Australian Journal of Labour Economics. Volume:…… [read more]


Models of Loss Reaction Paper

… ¶ … film I recently saw, one character asked another why we die. He replied that the reason was "to make life important." This is the first thought the first lines of Chapter 9 brought me. Grief, according to the chapter, and I find myself agreeing, is an expression of how precious those who died used to be, and how precious their memory will continue to be. In this light, I do not really agree with Freud's suggestion that "letting go" is an essential part of healing. Instead, I feel that we should, in one sense, never let go.

In my admittedly limited view, Freud's definition of "letting go" appears to be to move past the sense of loss and grief completely in such a way that the memories of the person becomes less important and hence less painful. He seems to suggest that, as human beings, we can only lead healthy and happy lives if we somehow "forget" the intense sense of loss we felt with the passing of a loved one. As such, we should "let the person go" and ourselves move on with life. I believe that this is not a productive way to handle loss.

As mentioned above, life is precious and important because we will all lose it sooner or later. Those who die are a painful and important reminder of this. In this way, the grieving process is much more than simply letting go of painful memories. It is more even than getting over and moving past the sense of loss. While it is not healthy to hold on to painful feelings and mourning for the rest of one's life after the passing of a loved one, I think one can use it as a reminder of the need to appreciate one's own life. In other words, one does not get over the loss as much as use it as a way to become aware of the preciousness of life. We appreciate life and each other much more because we have lost the loved one. Loss becomes an instrument to appreciation, in other words.

In more specific terms, grief and loss also has another important function in terms of the specific person that we have lost to death. The connections we make during…… [read more]


Lived Experiences of African-American Women Article Review

… Nineteen participants from throughout the continental United States participated in this study. Many of the participants were recruited from national conferences that focused on suicidal behaviors, prevention, and intervention in persons of color. Others responded to an advertisement that was placed in a national newsletter for suicide survivors. The interviews were conducted during a 5-year period.

For data analysis, the standardized and exploratory format of interviews was used as the main basis for collecting all the necessary data required to attain the aims of the study. The researcher explained that the interview format was perhaps the most useful way as he was looking to get detailed and profound information.

Keeping in view that qualitative data is not gathered with a standardized method similar to that of quantitative, it was divided into categories so as to be analyzed. In this research the wide-ranging strategy that was utilized for data analysis is reliant on hypothetical propositions, which basically means that this study pursued the original propositions on which the (1) aims and objectives and (2) design of the study were founded upon. With the aim of successfully analyzing the gathered data, the survey results were first classified into identical themes. Thereafter, in the discussion chapter (chapter 4) the researcher attempted to explain the research questions and purposes which transformed the concentration of the research.

Thereafter, the data collected was arranged into different theoretical frameworks and assessed with regards to their consistency and similarity. During some stages of the data analysis, the researcher came across a number of concepts and theories, which had not been revealed by other researchers in their studies. These theories and concepts were thereafter described in great detail and the researcher also proposed a number of ways on how they could be associated with the other theories.

Link theoretical or conceptual frameworks used to support the articles.

The researcher points out that there is a paucity of research on suicide survivors and even fewer studies exist on African-American suicide survivors. He conceptualizes suicide survivors as individuals who have lost a family member to suicide. Furthermore, he illustrates that although suicide is a relatively rare event, particularly among African-Americans, the recent dramatic increase in suicide among African-American youth makes it critical to understand this phenomena.

Subsequently he signifies the phenomenon of suicide survivors by highlighting various facts. For instance, he highlights that according to the Centers for Disease Control and Prevention (CDC), between 1980 and 1995, rates for African-American youth aged 15 to 19 increased 128% compared to 19% for Whites. Furthermore, he argues that although there has been a recent decline in the suicide rates among African-American youth, suicide continues to be the third-leading cause of death for 15- to 24-year-old African-Americans (National Center for Injury Prevention and Control, 2004).

He conceptualizes that bereavement with regards to suicide and points out that it has many emotional complexities that may evoke such symptoms as anxiety, difficulty concentrating, sleep disturbance, and depression. Lastly, he conceptualizes the awareness o suicide figures amongst… [read more]


Alzheimer's Disease Course Project Part II: Reading Research Paper

… Alzheimer's Disease

Course project part II: Reading and reviewing current epidemiological studies

I selected a variety of studies from international peer-reviewed publications, focusing first on the manifestation of Alzheimer's disease; the second two on causal factors associated with AD in specific genetic populations.

The first article studied behavioral risk factors, the second genetic risk factors, the third genetic and environmental risk factors.

The determinants of the first study were to examine the phenomenon of the expression of the disease itself, the determinants of the other two were to determine the interplay between various risk factors, including genetic predispositions, heart disease, and educational levels (in the case of the third study).

Study

Satler, Corina; Carlos Uribe, Carlos Conde, Sergio Leme Da-Silva, & Carlos Tomaz. (2010).

Emotion processing for arousal and neutral content in Alzheimer's disease.

International Journal of Alzheimer Disease. Retrieved October 10, 2011 at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2915644/

Causality Criteria

Description: An assessment of the ability of Alzheimer's disease (AD) patients to perceive and process emotional information

Exposure, Intervention: Subjects watched a neutral and emotional story, asked to interpret both

Outcome: As well as memory, emotional interpretation was also impacted by AD

Study design: Experimental; correlative

Study Population: 24 subjects (12 with Alzheimer's Disease, 12 in a control group without AD)

Main Result: Emotional processing is part of the decline associated with AD

Internal Validity

Observation bias: Questionnaires, rather than interviews used to measure validity

Recall bias: Use of Emotional Memory Test, a previously well-tested screening instrument was designed to reduce bias

Confounding: Demographic characteristics were assessed by a t-test; emotional rating scores and total answers for each version of the test were evaluated by a mixed-model ANOVA 2 x 2; Stepwise linear regression analyses were performed for each group to determine the best predictors of dependent variables

Chance: Possible, given the small sample size

Generalizability

Eligible population: Patients with AD

Source population: Yes, can be applied to the source AD population

Other population: Other sources of cognitive decline could reduce emotional recall, but that cannot be determined from this study

Study 2:

Chacon, Aldrin E. Molero; Gloria Pino-Ramirez; Jose A. Luchsinger; Joseph H. Lee; & Gladys

E. Maestre. (2010). Risk of dementia associated with elevated plasma homocysteine in a Latin American population. International Journal of Alzheimer Disease. Retrieved October 10, 2011 at http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2925085/

Causality Criteria

Description: An assessment of the relationship between total homocysteine (tHcy) and dementia risk

Exposure, Intervention: Plasma tHcy, vitamin B12, and folate were measured using blood samples obtained between 7: 00 and 8:00 AM, after overnight fasting to determine plasma levels. Diagnosis of AD was performed according to standard DSM criteria; diagnosis of stroke was self-reported.

Study design: Correlative

Study Population: 2100 Venezuelans (?55 years old) of the Maracaibo Aging Study, designed to study patients with a high genetic risk for developing AD

Main Result: Elevated levels associated with dementia, even when other risk…… [read more]


Eldercare in Assisted Living Facilities Humanity Today Research Paper

… Eldercare in Assisted Living Facilities

Humanity today has made great progress in terms of not only computer and communication technology, but also in terms of biomedical technology. For this reason, many people today live much longer than was the case… [read more]


Alzheimer's Disease: Summary of Results Case Study

… , 2003).

Why?

Because cross-sectional analysis provides for observation of the population at large, or a representation of the population, which is critical for studying AD patients; a case study analysis would not provide a large enough sample for providing information for a disease as rampant and variable as AD.

3.Do you agree or disagree with answer Case Study 5 -- Why?

The reliability and validity of proxy respondent information is typically valid in youthful populations (Macarthur, Dougherty & Pless (1997). If the controls were intact, it is likely that this information may be helpful in adding to the information provided from cross-sectional studies. It could contribute significantly to information already gathered on AD. It may not compete with data gathered from observational studies, as this has historically been the primary source of information about AD, however a case control study obtained from controls that were cognitively intact could be comparable to an observational study even on a large population of individuals with AD and dementia, who are less reliable given their mental status difficulties. It is for the most part, a system of checks and balances.

4.Do you agree or disagree with answer Case Study 6 -- Why?

The could be studies that were funded by the tobacco industry; it is not unheard of for say, pharmaceutical companies that wished to put to market a drug to push studies that put their pharmaceutical product in a favorable light. In the same manner, the tobacco industry would seek out studies that would attempt to put tobacco in a favorable light. When tobacco was first discovered, if used moderately without the addictive properties considered, undoubtedly there were many studies published regarding the favorable effects of the product.

However, there are likely far more studies published regarding the negative consequences and effects of tobacco. Studies highlighting the favorable effects of tobacco may also highlight those individuals that are in the earliest stages of AD, rather than those who have already deteriorated rapidly or are in advanced stages of the disease; this would explain why smoking might appear to help the disease, or not have a negative impact or even a positive impact on AD. Many people that are addicted to nicotine feel that it has positive effects on their life. This could be played up or on in marketing campaigns.

References:

Jones, GMM., Reith, M., Philpot, MP, et al. 1987. Smoking and dementia of Alzheimer's type. (Letter).

Neurol Neurosurg Psychiatry, 50; 1383.

Macarthur, C., Dougherty, G., and Pless, B. 1997. Reliability and validity of proxy respondent information about childhood injury: An assessment of a Canadian surveillance system. Am. J. Epidemiol. 145(9): 834-841.

Robert, P.H., Schuck, S., Dubois, B., Lepine, J.P., Gallarda, T., Olie, JP, Goni, S., Troy, S. 2003. Validation of the Short Cognitive Battery B2C. Value in screening for Alzheimer's disease and depressive disorders in psychiatric patients. Encephale, 29(2 Pt1). 266-72.

Wang, H.X., Fratiglioni, L., Frisoni, G.B., Viitanen, M. And Winblad, B. 1999. Smoking and the occurrence of Alzheimer's disease:…… [read more]


Poor Elderly Are a Vulnerable Term Paper

… Success of the program primarily hinges on management and organization.

Even though the Project CARE Mobile Medical Clinic is slanted to an elderly population, it could easily be expanded to anyone who lives far and could also be appropriate to immigrants who do not understand English. For instance research shows that immigrants of the U.S.A. have worse access to care than non-immigrants of that same country due to their isolation and to their difficulty with the native language (Chesney, 2004). Hispanics, per example, are more likely to receive sub-standard care and to experience poorer outcomes from treatment, with fewer follow-up visits and earlier discontinuation due to their language differences, particularly incomprehension of language nuances relating to health factors, and a consequent fear of dealing with any situation that involves the language on a level that is incomprehensible to them thus causing them to avoid help when they most need it. Differences in cultural idioms used to express comfort or discomfort also play a part as well as somatic presentation (Sandy & Elliott, 1996).

In this case, the vans could serve a dual purpose: by being staffed by people who speak the native tongue e.g. Mexican, who may be Mexican -- American (for instance) themselves thus lessening the intimidation of the encounter, and who come accompanied with booklets written in the immigrant's language. Knowing and appreciating the culture can help volunteers better reach out to an overlooked population.

Such a traveling mobile program, integrating services to the elderly and the immigrant population would be doubly important since both sectors tend to be overlooked, both have difficulties with communication, both are often in need of assistance, and either may be unable to ask for it.

References

The Ark

http://arkchicago.org/content/services

Chesney, A.P., Chavira, J.A., Hall, R.P., & Gary, H.E. (1982). Barriers to medical care of Mexican-Americans: the role of social class, acculturation, and social isolation. Med. Care 20, 88

Orlando Sentinel. (Dec., 04. 1993). Clinic On Wheels To Take Health Care To Elderly Poor

http://articles.orlandosentinel.com/1993-12-04/news/9312040190_1_clinic-project-care-seniors

Sandy, R, & Elliott, R.F. (1996). Unions and Risk: Their Impact on the Level of Compensation for Fatal Risk, Economica, 63, 291 -- 309.… [read more]


Physician Assisted Suicide and Active Euthanasia Essay

… Ethics

Physician-Assisted Suicide and Active Euthanasia

In January of 1983, twenty-five-year-old Nancy Beth Cruzan lost control of her car. The final diagnosis projected she suffered anoxia pr deprivation of oxygen for twelve to fourteen minutes. It is known that generally after six minutes of oxygen deprivation, the brain generally suffers permanent damage. At the time of the U.S. Supreme Court hearing in 1990, Cruzan was able to breathe on her own but was being feed by way of a feeding tube. Doctors had surgically implanted the feeding tube about a month after the accident, subsequent to the consent of her then-husband. Medical experts diagnosed Cruzan to be in a permanent vegetable state, capable of living another thirty years (Courts and the End of Life - The Case of Nancy Cruzan, 2011).

This was the first time the right-to-die issue had been brought before the U.S. Supreme Court, which chose not to rule on whether Cruzan's parents could have her feeding tube removed, but instead, it considered whether the U.S. Constitution prohibited the state of Missouri from calling for clear and convincing evidence that an incompetent person wishes withdrawal of life supporting treatment. In a five-to-four decision the Supreme Court found that the U.S. Constitution did not forbid the state of Missouri from wanting convincing evidence that an incompetent person wants life supporting treatment taken away. The court majority ruled that the State's meticulous requirement of clear and convincing evidence that Cruzan had declined termination of life supporting treatment was warranted (Courts and the End of Life - The Case of Nancy Cruzan, 2011).

The Court felt that they had to be very careful in making this decision due to the fact that an erroneous decision may lead to a consequence that could not be reversed. If it could not be determined for certain that Cruzan would want to be taken off of the life support then the court felt that this was not something that could be allowed to happen. If the court had ruled that clear and convincing evidence was not needed to…… [read more]


Pulmonary Autopsy Findings Essay

… The differences in the alveoli and their spaces which were identified in the latter group and were used in comparison with the former group should be isolated and studied to confirm that they actually have been caused by negative pressure in the air, as the researchers postulate in the discussion, and are not indicative of some other condition. Such an examination could help to solidify the researcher's conclusion in light of the inconclusive statistics of the number of microscopic fields with longitudinal dimensions greater than 300 mm between these two groups.

Conclusion

In summary, despite the fact that there were a number of prudent measures undertaken in Comparison of pulmonary autopsy findings of the rats drowned at surface and 50 ft depth, it has enough significant lapses in its presentation, methodologies and findings that warrant it far from an ideal study. One of the benefits of this occurrence, however, is that these slights leave plenty of opportunity for further studies on the issue of lung damage in drowning victims as a means for gathering forensic evidence for the cause of death. In particular this study lends itself to further analysis and examination of the histological role of alveoli and its differences and similarities between victims which drowned on the surface and then sank to depths of heightened water pressure and those which actually drowned at those high levels of water pressure.

Also, it should be noted that Comparison of pulmonary autopsy findings of the rats drowned at surface and 50 ft depth has made a significant attempt to further the research in this field of drowning and the physiological responses of the body which may be used for purposes of forensics. Unfortunately, a successful attempt requires more than simply trying, and the identical nature of the histological findings with that of Pathology of the Lung in Near Drowning damper this paper's degree of success of pioneering findings in this field.

References

B. Brinkmann, G. Fechner, K. Puschel, Lung histology in experimental

drowning, Z Rechtsmed 89 (4) (1983) 267 -- 277. Retrieved from http://www.ncbi.nlm.nih.gov/pubmed/6837169

Toklu AS, Alkan N, Gurel A, Cimsit M, Haktanir D, Korpinar S, Purisa S. Comparison of pulmonary autopsy findings of the rats drowned at surface and 50 ft depth. Forensic Sci Int. 2006 Dec 20;164(2-3):122-5.

Betz, P. Nerlich, A. Penning, R. Eisenmenger, W. Alveolar macrophages and the diagnosis of drowning. Forensic Sci Int. 1993. March 4; 62 (217-224) Retrieved from . http://epub.ub.uni-muenchen.de/7690/1/eisenmenger_wolfgang_7690.pdf

Karch, S.B. Pathology of the lung in near-drowning. The American Journal of Emergency Medicine. 1986. Jan.; Volume 4 Issue 1 (4-9). Retrieved from http://www.sciencedirect.com/science/article/pii/0735675786902408

Knieriem, A., Garcia Hartmann, M. Comparitive histopathology of lungsfrom by-caught Atlantic white-sided dolphins. Aquatic Mammals 2001, 27.273-81. Retrieved from http://www.aquaticmammalsjournal.org/share/AquaticMammalsIssueArchives/2001/AquaticMammals_27-02/27-02_Knieriem.PDF

Calder, I.M. A method for investigating…… [read more]


Bioethics Moral Decision Essay

… ¶ … Patient over Seventy Years of Age be given a Liver Transplant?

The woman in question, Mrs. Burgone, needs a liver transplant and has the money to pay for one (they are extremely expensive, costing up to $200,000). However her doctor tells her that "social policy" prevents doctors from conducting liver transplant operations on people 70 years of age or over. Mrs. Burgone argues that she can pay for it herself, to no avail. Then the doctor offers a rather strange justification for his position. He claims that if one older person is given permission to have a transplant -- even if she can afford it -- then "society would have to pay for those who can't afford it, and society can't afford to do that," he argued. That is a strange logic, because in the first place if there is a guideline against anyone 70 or older receiving a liver transplant then that rule should remain in place, no matter whether it is on the taxpayers' dime or the person can pay for it herself. The doctor would have been smarter to just say there are data that show older people are at greater risk than younger people, if that was in fact true.

The Argument -- She Shouldn't be Given a Transplant

For the doctor, he actually had a series of good arguments to use in reply to Mrs. Burgone's wishes to have a liver transplant. For example, professor Paul Flaman of St. Joseph's College at the University of Alberta states that "… a widely used and approved criterion of selection is to give priority to those who have a great need and who are expected to benefit greatly" (www.ualberta.ca). What is Mrs. Burgone's real need? Is she desperately hanging on to life and needs one urgently? Readers don't know that. She does she it is unfair to "condemn someone to pain and a greater risk of death when a way of changing this is available." Also, Flaman writes that ethically, it doesn't make sense to give "a limited number of available" number of organs to those & #8230;. Who are expected to only live marginally longer but suffer much with the transplants, when others would benefit greatly" (Flaman, p. 7). Also, the doctor could have pointed out there is a long list of potential recipients that have been waiting for years, so why would Mrs. Burgone be quickly given a liver when 83 people who truly need a liver -- and have waited years -- to survive are on a list ahead of her? These are all reasons why Mrs. Burgone should…… [read more]


Multiculturalism in Healthcare Aim at Long-Term Care Research Paper

… Multiculturalism in Healthcare Aim at Long-Term Care

The process of aging is inescapable, as every human being is its victim. Aging does not discriminate; transcending gender, economic class, ethnicity, religion and culture. During this process, individuals are subject to the… [read more]


Autonomy and Medical Practice Essay

… Autonomy and Medical Practice

What is the principle of autonomy and what role does in play in physician-assisted suicide, treatment refusal, and truth telling. Is the decision to receive help dying (prior to the body giving out) an absolute moral… [read more]


Ethics Assisted Suicide White Paper

… ¶ … tried to expand on areas that looked very week. You can copy and paste into your paper. If you have any questions or concerns let me know

I'd put this in either the first section the basic dispute… [read more]


Business Case for Single Responder Ambulance Paramedic Business Proposal

… Business case for single responder ambulance paramedic to use CPR without stops for ventilating the patient.

Cardiopulmonary resuscitation (CPR) is a procedure that can be administered from a single person in an attempt to keep a person alive that has… [read more]


Euthanasia Debate Research Paper

… Euthanasia Debate

The topic of Euthanasia has sparked numerous debates in the recent years, as many continue to consider that the procedure is wrong and that it should not be supported by the authorities. Euthanasia has become a notable solution… [read more]

NOTE:  We can write a brand new paper on your exact topic!  More info.