"Aging / Death / Gerontology" Essays 351-406

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Organ Donation the Process of Donating Organs Term Paper

… ¶ … Organ Donation

The process of donating organs after death is misunderstood and underutilized by many. The benefits to society as a whole are numerous. The number of people awaiting transplants has greatly outpaced the number of people donating their organs. Currently, there are over 83,000 people on the national transplant list (Snell, Levvey, & Williams, 2004). Commonly-donated organs and their uses to recipients are described below.

A kidney transplant is generally more effective in treating kidney failure than many other forms of treatment, such as dialysis (Rosendale, 2003). The ability to discontinue dialysis treatment has an enormous impact on quality of life and increases life expectancy and general health. Most kidneys used for transplants come from people who have died in a hospital intensive care unit.

The liver is a commonly-donated organ. Alcohol abuse is the primary reason for liver transplant. The success rate of this procedure is ~80% (Rosendale, 2003).

The small bowel can be damaged so much by severe infection or in an accident that the person can no longer absorb enough food to stay alive. Transplantation of the small bowel is not yet widely available. Pancreatic transplantation is offered only to people with very severe diabetes and renal failure who have both a kidney and pancreas transplant at the same time. Occasionally, a diabetic may have such uncontrollable disease that transplant of a pancreas alone may be considered. Serious injury to the cornea can lead to scarring that prevents light from passing through to the retina and causes partial or complete blindness. Cornea transplants are generally highly successful and can be carried out under general or local anesthetic.

In most cases, the recipient of the organ…… [read more]


Assisted Suicide Legal History US Term Paper

… Physician-Assisted Suicide

For the most part, the current argument for physician-assisted suicide in the United States has much to do with whether or not, under special circumstances, is it morally and ethically permissible for a physician to provide the knowledge… [read more]


Brutus in Julius Caesar Term Paper

… However, Brutus goes beyond just being present when the assassination happens. He helps lure Caesar to his death. Caesar has been convinced by his wife, who has noted numerous omens and has dreamed of his murder all night, that he should stay home. However, Brutus comes to his house and argues that he may lose the crown if he does not come, saying,

"And know it now: the senate have concluded

To give this day a crown to mighty Caesar.

If you shall send them word you will not come,

Their minds may change." II.ii.98-101

Brutus not only agrees to the conspiracy but makes sure that Caesar will be at the spot chosen for his murder, guaranteeing that Caesar will be killed.

Finally, after Brutus has delivered the final stab wound and Caesar has died, Brutus has the opportunity to grieve for his dead friend. Even though he believes the assassination was necessary, surely a good friend would express grief. If he does not express grief for his friend's death, at least he will express grief that t was so necessary. Instead, Cassius offers the opinion that they have saved Caesar twenty years of worrying about when he would die. Brutus, who knew Caesar well enough to know what the audience knows -- that Caesar does not fear death -- instead joins in the rationalization, saying,

"Grant that, and then is death a benefit:

So are we Caesar's friends, that have abridged

His time of fearing death." III.I.113-115.

All through the play, Brutus shows the audience that he has turned on his friend. Instead of warning him, he participates in the plot, helps lure his friend to his death, and then callously rationalizes that it was better for Caesar to die. These choices make Brutus an opportunistic villain, not a hero.… [read more]


Assisted Suicide, or Called Euthanasia Term Paper

… " In 1995, 21% of the patients who were killed without consent were competent.

The legalization of Physician-Assisted Suicide is still being debated nowadays. Specifically, most of the debates and issues were represented by representatives from the medical practice, from the government, and from religious groups who believe that Euthanasia and Assisted Suicides should not be legalized. Opposing its legalization, Luke Gormally (1997) has the following reasons why Assisted Suicide should not be legalized.

The 'justification' of voluntary euthanasia involves rejection of a tenet fundamental to a just framework of laws in society

To legalize assistance in suicide is also inconsistent with the same fundamental tenet of a just legal system

If voluntary euthanasia is legalized then the most compelling reason for opposing the legalization of non-voluntary euthanasia has been abandoned

Legalization of voluntary euthanasia would also encourage the practice of non-voluntary euthanasia without benefit of legalization

Euthanasia undermines the dispositions we require in doctors and is therefore destructive of the practice of medicine

The legalization of euthanasia undermines the impetus to develop truly compassionate approaches to the care of the suffering and the dying

The pros and cons of Assisted Suicide seem to cover a wide area that up to now, no nation has totally agreed or disagreed with the practice. Despite of the different types of assisted suicide, the result of the practice is still to end one's life, whether it is voluntary or involuntary. And the question of morality and ethics will remain in the issues that the practice endlessly presents.

Bibliography

Earll, Carrie G. Physician-Assisted Suicide and Euthanasia.

2001. Focus on Social Issues Online. 2004.

http://www.family.org/cforum/fosi/bioethics/euthanasia/a0027997.cfm

B.A. Robinson. Euthanasia and Physician-Assisted Suicide: All Sides

1997. Ontario Religious Consultants Online. 2004.

http://www.religioustolerance.org/euth1.htm

Gormally, L. Euthanasia and Assisted Suicide.

1997. Linacre.Org. 2004.

http://www.linacre.org/newsle~1.htm… [read more]


Voluntary Euthanasia the Right to Die Term Paper

… Euthanasia: Pros and Cons

Euthanasia is the most debated topic in medical circles carrying very sensitive ethical and moral implications to it. While by no means can the right to put an end to life be considered a rightful decision… [read more]


Osteoporosis Is a Disease Term Paper

… Prevalence: Men and women, aged 50 and older, are most susceptible to the onset of osteoporosis. However, it is important to note that women are far more prone to the disease. For example, of the 10 million Americans estimated to have the disease, 8 million are women. Osteoporosis has also been reported as a significant risk in people of all ethnic backgrounds, though it is believed that Caucasians and Asians are more prone to developing the disease. Finally, although osteoporosis is often thought of as an older person's disease, it can strike at any age (NOF, 2004).

Role of Diet: Diet has a definite role to play in preventing osteoporosis. As has been observed earlier, low lifetime calcium intake increases the risk of osteoporosis. In addition, since calcium requirements increase with age, it is important to regulate the amount of calcium intake. For example, in most pre-menopausal women, and in men, at least 800 milligrams of calcium per day is required to maintain body calcium, while post-menopausal women require 1,200 to 1,500 milligrams daily. Another dietary factor is protein intake, since this affects the daily calcium requirement. An increased intake speeds calcium excretion, especially in the case of high-meat diets. Thus, careful regulation of diet can help reduce he risk of osteoporosis: "Ensure an adequate calcium intake, in the diet itself if possible (milk, yogurt) or at least by supplemental calcium. Calcium supplements may exert a partial suppressive effect on bone remodeling, whereas calcium in milk does not, so milk is preferred." Besides calcium, attention also needs to be paid to vitamin D intake, and it is recommended that excessive phosphates be avoided (Walford, 2000, p. 132-133).

The Role of Diet in Managing the Disease: A diet that is high in calcium, along with activities such as walking, running, tennis or even climbing stairs can all promote bone density. Thus, diet, body weight, and exercise can play an instrumental role in preventing and managing the disease. However, once osteoporosis has been diagnosed, treatment is dependent on age, sex, medical history and which bones have been broken. The treatments available include Hormone Replacement Therapy, Testosterone Therapy, calcium and vitamin D supplements (BBC, 2004).

Cure: Currently, there is no cure for osteoporosis (NOF, 2004). However, as mentioned earlier, there are treatments and medications that are available for treatment of the disease. The only role diet plays once the disease has been diagnosed is in increasing the level of calcium and vitamin D intake through foods such as milk and yogurt. But even here, usually the patients are advised to increase their intake through calcium supplements.

Conclusion: Osteoporosis is a disease that can be debilitating. Unfortunately, not enough attention is being paid to either prevent or detect the disease at an early stage. Thus, there is a great deal of effort that needs to be made in the area of educating the public about the role diet and exercise plays in preventing the disease. Similarly, the medical fraternity needs to mobilize greater efforts… [read more]


Pros and Cons of Assisted Suicide Term Paper

… ¶ … Assisted Suicide

The fright of continuing endless agony, of remaining captive by medical devices, of waning physical reliability and individual self-esteem and being a cause of emotional and monetary depletion on one's near and dear ones - these… [read more]


Physician-Assisted Suicide a Review Term Paper

… The argument could be made that people just die and there is no real difference but there is a strong difference between a good death and a bad one (Brody, 1992). People that are made to be afraid, to suffer,… [read more]


Human Central Nervous System Plays Term Paper

… The amygdala is strongly associated with emotional processing in the brain, and is a pea-sized new center of the brain (Dye).

A recent Stanford University study used functional MRI scans to investigate the connection between personality and the amygdala. The researchers selected 15 subjects, and tested the subjects to determine their degree of extroversion (outgoing and optimistic), or whether these individuals for slightly worried, insecure, and potentially shy. Participants were then showed a series of photographs, while being scanned by the functional MRI. In all subjects, an unpleasant or threatening expression on the face was associated with activity in the amygdala. However, the two groups differed significantly in their reaction to a happy face. Specifically, extroverted individuals showed a consistent activation of the amygdala in response to a happy face. In contrast, shy individuals showed little or no reaction to the happy face (Dye).

Diseases like Alzheimer's disease can also offer an interesting insight into how the Central Nervous System controls are personality. It Alzheimer's disease, large numbers of brain cells die over time. The death of these brain cells results in dementia, mental deterioration, and eventual death. Alzheimer's symptoms include problems with abstract thinking, impaired language and social skills, loss of short- and long-term memory, and significant personality changes (Windsor).

The personality changes seen in Alzheimer's disease can be linked directly to changes in the CNS. Personality changes seen in Alzheimer's disease can include uncharacteristic violence, paranoia, increased apathy, and social reclusion. In turn, these personality changes a result from the death of brain cells (Windsor).

In conclusion, studies of brain damage, individuals with Alzheimer's disease, and brain imaging have revealed a strong link between the CNS and personality. Specific regions of the brain, in particular, are linked to specific personality characteristics. However, as Dye notes, "we still have a long ways to go before we will understand why each of us became what we are."

References

Medline plus. Medical Encyclopedia: Central Nervous System. 15 November 2004.

http://www.nlm.nih.gov/medlineplus/ency/imagepages/8679.htm

Dye, Lee. Scientists Seek Personality's Roots in Brain. ABC News, June 27, 2004. 15

November 2004. http://abcnews.go.com/Technology/story?id=97961& page=1

ThinkQuest. The Nervous System: The Mind. 15 November 2004.

library.thinkquest.org/26773/a16.htm

Windsor, Eliza. THE I-FUNCTION AND ALZHEIMER'S DISEASE: WHERE IS THE

PERSON? 15 November 2004. http://serendip.brynmawr.edu/bb/neuro/neuro98/202s98-

paper1/Windsor.html… [read more]


Romeo and Juliet the Protagonist Term Paper

… Romeo and Juliet reaches a climax when Romeo believes that Juliet is dead. Taking the poison, he kills himself before knowing that Juliet's state was temporary and that she was still alive. When Juliet awakens and sees her lover dead, she too commits suicide and the play's plot is soon resolved.

The resolution of the play occurs when Juliet stabs herself. Now the lovers are united in death. Their parents' fighting indirectly caused their suicides; the sight of their dead children inspires the Montagues and Capulets to resolve their differences and cease the feud.

Romeo and Juliet is set in Verona, a town in Italy. The setting accentuates the romantic theme of the play, for Italy is commonly thought of as a romantic locale. The setting is also important in bringing out the nature of the characters and of the two families: both the Capulets and Montagues are prominent, wealthy families in the town.

Finally, the theme of Romeo and Juliet centers on love. Love is shown to be a powerful, all-encompassing force of passion, but is also shown to be potentially destructive. The love between Romeo and Juliet is passionate and romantic, but it leads to their deaths. Nevertheless, their expression of love eventually caused their warring families to reunite.… [read more]


Eurydice by Jean Anouilh Contrasting Term Paper

… This begins as a light romance, and ends as a highly disturbing play that makes the reader really think about what just happened.

Eurydice is portrayed as an innocent. Her mother laments, "...she protects all the lame things in the world, God knows why - old cats, lost dogs, helpless drunkards'" (Anouilh 63). However, Eurydice is really worldly and not innocent at all, for she has lived a difficult life. She knows more about love than Orpheus does, but together, they form just the right combination of innocence and worldliness to make the reader believe they just might make it together. Of course, the reality is they are doomed from the start, but that is clearer to Eurydice than it is to Orpheus, who still holds out hope for true happiness. Eurydice knows happiness is really not available, and that is why she leaves, and consistently says, "It's so difficult'" (Anouilh 85). Life is difficult, and if Orpheus refuses to recognize this, Eurydice does. She can live with the memories of her one happy day, but Orpheus cannot. In fact, he cannot live without Eurydice at all.

Orpheus is not wrongheaded about Eurydice - they are simply two different people. Orpheus is really the innocent and the idealist, while Eurydice is the realist. He loves her so completely that it does not matter to him how she looks, but Eurydice knows, and tells him "Yes, but perhaps you thought I was someone else. And when you see me as I am...'" (Anouilh 91). Eurydice sees herself more clearly than Orpheus does, and so, she knows if they stay together, she will never live up to his worship and adoration. She is human, but Orpheus has put her on a pedestal. This does not make him wrong about her, because anyone can rise up to expectations of greatness. However, Orpheus is innocent, and does not see the realities of their relationship, or the reality that death is the only thing that can truly bring them together. M. Henri tells him, "You're unfair. Why should you hate death? She alone can create the proper setting for love'" (Anouilh 116). Thus, the final reality is set. Death is the only thing that can keep the lovers together, because life will always get in the way. The realities of life, from embarrassing mothers and incapable fathers will always get in the way of the illusion of idealism and love. Orpheus has to learn this the hard way, and he does when he sees his love dead in the street. The reality of life comes home to him then, and he understands the finality of death, and the end of his idealism. He and Eurydice will never be the same, but, they will be together, and that is the only thing that truly matters to him by the end of the play. Idealism and realism have come full circle, and everyone has learned a lesson in them when the playwright is finished.

References

Anouilh, Jean.… [read more]


Epic of Gilgamesh Term Paper

… He does not listen to Shamash, his personal god-friend, nor does he take the advice of Siduri. Gilgamesh, like most humans, has to learn the hard way. He learns from each mistake as the reader follows him through his journey… [read more]


Anti) Right to Die Science Term Paper

… This study was conducted on chronically ill patients who have attempted suicide. Many families who were overwhelmed with the difficulties of caring for their ill relatives often did not want them resuscitated. However, the state initiated a program wherein home… [read more]


Shakespeare's Hamlet and Herman Hesse Term Paper

… However, towards the end of the play he sees the evils of society as a reflection of larger human social evils, including but not limited to the fact that a good king's memory can be easily erased and forgotten. When contemplating Yorick's skull in the graveyard before the suicide Ophelia's funeral, he realizes that even Caesar's existence, not only his father's ended in death and dust. It is this fact that spurs him to state, much like a proto-Buddhist, "let be," to his friend Horatio when facing the duel that takes place before the bloody last scene of the play, not caring whether he dies or lives, and accepting that vengeance will come, not when he wills it, but when the world's actions meet in the correct constellation. Or, as Eliot says, "Quick now, here, now, always -- /A condition of complete simplicity/(Costing not less than everything)/And all shall be well and/All manner of things shall be well," echoing Hamlet's words of comfort to his mother after the infamous closet scene.

Hamlet kills Claudius at the end, but there is no catharsis or final revelation from the audience's point-of-view, only the protagonist's own demise and the promise of final revelation of Horatio to the usurping Fortinbras. However, the true resolution of the play is Hamlet's final sense of peace, though he leaves behind a bloody scene -- much like the Buddha achieves peace, though he does not change the material nature of the world of death, sickness, and human suffering. The change comes within both character's minds, rather in a physical sense. Both Hamlet and Siddhartha begin and end in the same place in body, but in spirit and mind they have traveled across oceans of human misunderstanding, through the "unknown remembered gate," as spoken of in Eliot, into a realm of true understanding.… [read more]


Holistic/Diagnostic You're Going Essay

… The story inspired her and she was better able to understand what I was trying to say. Anecdotes, I have found, often bridge the gap between intended thought and verbiage. However, I also wanted to tell Loreen that I felt that she might have been repressing her anger all this time: anyone who has been diagnosed with a terminal illness must on some level, at some time, feel incredible anger, resentment, and fear. I wanted to let Loreen known that it was alright to experience and express these emotions. However, when I tried to tell her this, the words came out garbled and they didn't really connect with what I was trying to communicate via the anecdote about spontaneous healing.

I'm just saying that being angry might be necessary for you."

She agreed but still didn't see how that connected with her dilemma between accepting death and fighting it. Later on, reflecting on what I should or shouldn't have said to Loreen, I realized that I should have told her that I thought that regardless of which path she chose, I felt that confronting her emotions would be more beneficial than repressing them.

Confronting a terminal illness or any other issue that touches upon the sensitive subject of death can be one of the most difficult topics to talk about. Words are totally inadequate to communicate the fear, empathy, and anger that accompany human mortality. Especially when speaking directly with someone who is acutely aware of their immanent mortality, talking about death can be frustrating and nearly futile. Here I am, a healthy, vital human being talking to a woman whose body is deteriorating. I can't possibly relate to what she is going through and yet I must in some way communicate love and understanding.… [read more]


Gilgamesh the King Term Paper

… He travels far and wide in search of immortality and comes across various important figures who remind him of the reality and certainty of death. Siduri the barmaid tells him categorically that immortality was an elusive thing that couldn't be attained by mortals because death was meant to be the final and definite conclusion of human life. She reminds him of the one crucial difference between man and god and that lied in the phenomenon of death. While human beings died, God is meant to live forever. Siduri further offers sound suggestions for enrichment of life and seeking a different kind of immortality. She tells Gilgamesh that he must fill his days with as much fun and frolic as he could while remaining kind towards others including his wife as such things had the power to enrich his life and give him spiritual immortality.

However Gilgamesh is not enlightened enough to understand the meaning of any kind of immortality other than the physical one and therefore even though he understands that he was being told the truth but is still not willing to give up his quest for immortality. He finally gets a chance to meet a man who had achieved immortality only to realize that pursuit of an endless life was a not worthwhile since it could lead to more misery and loneliness.

Gilgamesh however finally manages to get the immortality plant which a serpent steals on his way back. This incident opens the doors of enlightenment and Gilgamesh realizes that there must have been a lesson in this. He finally accepts that he must die too since human beings couldn't attain physical immortality. "One of the purposes of this [work] or the original that lies behind it, was surely to emphasize that even the king, in spite of his divine associations, must die; and to assert that this was no anomaly reflecting on the king's authority on earth, but the result of a solemn divine decree." (Kirk, 142)

Conclusion

Once he accepts the truth about life and death, Gilgamesh give sup his old ways and instead starts ruling with compassion and kindness. We must understand that one part of Gilgamesh's was not human and thus while his human side had to die, his god-like side was indeed immortal. But one person cannot be expected to die as well as live forever. Therefore we notice that while the physical side of Gilgamesh was meant to die, his spiritual side was destined to remain immortal. Gilgamesh attains this kind of immorality through his virtues and compassion. It is because of Gilgamesh's spiritual immortality that he is still one of the most widely talked and written about figures in the world.

REFERENCE

Kirk, G.S. Myth: Its Meaning and Functions in Ancient and Other Cultures. Cambridge U.P. And California U.P., 1970… [read more]


Euthanasia: "Should Physicians Be Allowed Term Paper

… Inconvenienced relatives could be encouraged to persuade patients to "voluntarily" ask for death; handicapped children and senile persons who are considered as burdens on the families and societies could be the next targets.

Another valid concern associated with assisted suicide… [read more]


Preservation of Assets Term Paper

… It is important for the elderly to understand the way property and cash affect their liability when it comes to medical bills and other costs such as nursing homes.

The government does provide a Medicaid program for those who have low incomes. Because a low income is a requirement of being in the program the elderly that have assets generally do not qualify. Instead those residents are forced to find ways to preserve their assets in the event they encounter such situations. Often times the elderly put their property or assets into the names of their children or other family members. Because there are time tables by which this has to be done or it will still be counted against the elderly income, it is important that the assets are transferred in a timely manner (Gurny, 1992).

In addition there are certain assets that are not attachable, including assets that are willed to family members in some cases. This allows the elderly to will certain types of assets to the family members and protect those assets from seizure or inclusion in the calculation for medical responsibility.

The government is constantly evaluating the criteria for paying the medical bills of the elderly as well as the criteria for financial assets of those who have to reside in a nursing home (Hogan, 1993).

The elderly have several options for preserving assets including gifting or selling their property to family members, willing some types of assets to those who will receive them, investing in things that do not show a profit and others. The elderly person who wants to preserve his or her assets in the face of medical bills and nursing homes would be prudent to ask an attorney for all of the ways they can do so.

REFERENCES

Family Unit Incomes of the Elderly and Children, 1994.(Statistical Data Included)

Date: 12/22/1996; Publication: Social Security Bulletin; Author: Radner, Daniel B.

A description of Medicaid eligibility. (Medicare and Medicaid Statistical Supplement)

Date: 01/01/1992; Publication: Health Care Financing Review; Author: Gurny, Paul Baugh, David K. Davis, Feather Ann

Health insurance and the elderly: data from MCBS. (Medicare Current Beneficiary Survey)

Date: 03/22/1993; Publication: Health Care Financing Review; Author: Chulis, George S. Eppig, Franklin J. Hogan, Mary…… [read more]


Suicide Among Youth and Elderly Term Paper

… Other identified risk factors include a family history of mental or substance abuse disorders, a history of physical and/or sexual abuse, low levels of communication with parents, the possession of certain cultural and religious beliefs about suicide (for instance, the belief that suicide is a noble resolution of a personal dilemma), and lack of access or an unwillingness to seek mental health treatment.

Youth suicide protective factors can include an individual's genetic makeup, behavior and the environment. Other voluntary protective factors are learned skills in problem solving, impulse control, conflict resolution, and nonviolent handling of disputes. Family and community support is very important; as is access to effective and appropriate mental health care A scientific approach to preventing suicide involves describing and monitoring the problem, understanding risk factors and causes of suicidal behavior and protective factors, developing and implementing interventions and prevention strategies in the context of evaluation research, and disseminating information about effective strategies. The research is focused on promoting overall mental health among school-aged children by reducing early risk factors for depression, substance abuse and aggressive behaviors and building resiliency. Another approach is to detect youth most likely to be suicidal by confidentially screening for depression, substance abuse, and suicidal ideation. Efforts should be made to develop and implement strategies to reduce the stigma associated with accessing mental health, substance abuse, and suicide prevention treatments. Additionally, efforts to limit young people's access to lethal agents -- including firearms and medications -- may hold great suicide prevention value. Persons deemed at risk for suicide should then be referred for additional mental health services. (NIMH, 2003)

People involved with children and youth like parents and school personnel should be aware of the warning signs such as loss of energy or "making negative comments about oneself, behaviors.

Suicide disproportionately impacts the elderly. In 1998, the elderly represented 13% of the population, but suffered 19% of all suicide deaths. Firearms (71%), overdose [liquids, pills or gas] (11%) and suffocation (11%) were the three most common methods of suicide used by persons aged 65+ years. It is estimated that 20% of elderly (over 65 years) persons who commit suicide visited a physician within 24 hours of their act, 41% visited within a… [read more]


Euthanasia and Physician-Assisted Suicide Term Paper

… On the contrary, the artificial extension of life imposes a state-defined state of existence, one that denies personal liberty and the possibility of ending pain and suffering. The terminally ill contend with degrees of physical pain that most moralists cannot fathom. Moreover, voluntary euthanasia is often the only means by which a dying person can regain control of their life. Just as each person should able to choose their own lifestyle, so too should individuals be able to decide when they have had enough of hanging on by a thread.

Permitting terminally ill patients, many of which suffer from extraordinary mental and physical pain, to end their lives also significantly helps the family members of those who suffer. No one likes to watch their loved ones linger in a brain-dead state indefinitely. Voluntary euthanasia is often an expression of compassion for the family members as well as the individual in question also because of the exorbitant medical costs incurred with the artificial extension of life. Euthanasia is often a sacred pact between patient, family, and physician. Voluntary euthanasia is not a spur-of-the-moment decision based on momentary pain; it arises out of chronic illness and a willingness to accept mortality in a healthy manner.

Voluntary euthanasia, by definition, precludes unauthorized mercy killings predicated on delusional or malicious intent. In order for euthanasia to become fully legal, a strict definition should be devised. Voluntary euthanasia is also not depression-related suicide. Mental illnesses that evoke suicidal tendencies can be treated and do not warrant the premature termination of life. However, terminally ill patients who are hooked up to life support equipment or who have suffered irreparable brain damage, are candidates for legalized euthanasia, not angry teenagers or depressed housewives.

When considered in a legal context, euthanasia is first and foremost an issue of personal choice. The state should ensure the rights of its citizens to end their lives in instances of terminal illness. As with abortion, those who do not support the practice can do so without interfering with the rights of others. Furthermore, voluntary euthanasia, when addressed ethical grounds, is actually a morally upstanding choice. In most cases, voluntary euthanasia allows people to die pain-free, without lingering on a death bed any longer than is necessary and without expensive and cumbersome medical equipment designed to artificially extend life. Voluntary euthanasia is so controversial because it invokes our ingrained fear of death.

Works Cited

Euthanasia and Physician-Assisted Suicide: Introduction." Religious Tolerance.org. http://www.religioustolerance.org/euth1.htm.

Gula, Richard. "Euthanasia and Physician-Assisted Suicide: Killing or Caring?" Christian Century. 5 May 1999. Online at Find Articles.com. http://www.findarticles.com/cf_0/m1058/14_116/54588537/p1/article.jhtml?term=euthanasia.

Leutwyler, Kristen. "In Cases of Euthanasia, Men Most Often Kill Women." Scientific American. 24 Sept 2001. Online at http://www.sciam.com/article.cfm?articleID=000B5030-819D-1C61-B882809EC588ED9F&catID=1.… [read more]


Intergenerational Conflict Term Paper

… (Fox-Grage) The burden of paying for those could conceivably fall on the younger generation if the government bowed out of long-term care and left it to individuals.

Second, it would not address the real issue at hand which is this: all generations need to begin to take better care of themselves to avoid the illnesses that can be avoided (cancer from smoking, for example), and possibly diminish the severity of those that may be inevitable for many (Alzheimer's). Washington points out that most insurers do not reimburse patients for weight-loss programs but do pay for dealing with illnesses related to obesity, such as hypertension and diabetes. She also cites Rand Corporation, which claims obese patients spend 36% more on medical services and 77% more on prescription drugs than those of average weight. Smokers spend 21% more on care and 28% more on drugs.

Third, in the event that people do get sick, even after taking preventive health maintenance steps, such as not smoking, a better solution would be community-based services before people get to the point of needing a nursing home. Several states, including Wisconsin, already have such a program in place. And they find it saves on the average nursing home cost of $3,000 a month for bare-bones care, coming in at about $23,000 a year. (Fox-Grage)

It is clear that medical costs in old age begin in the things we do when we are younger, and putting a short-term stop to rising costs by denying care to current elders would do nothing to solve the problem in the long-term, and would heap even further generational stress on both generations. It is ridiculous to penalize elders for failing to heed health warnings that we are still failing to heed. It is apparent that the long-term solution to elder medical costs is to begin now by finding more community-based and less expensive alternatives to nursing homes to mitigate those costs without undue stress; to encourage insurance companies to pay for curing the base problems (smoking, overweight) rather than applying band-aids at enormous cost to the results, and; to begin, in all generations, to pay attention to the real science that can not only keep down elder medical costs, but make us all healthier and conceivably happier on the way to and through inevitable old age.

References

Caring for elderly parents is a health wake-up call. (2002, March 19). The Washington Times, p.…… [read more]


School Response to Student Suicide Term Paper

… King asserts that the very day of the suicide, the principal needs to inform all teachers there will be a face-to-face session the following morning, ensuring that staff have the facts correct.

Each first period teacher the following day, has… [read more]


Euthanasia Science and Technology Term Paper

… Though she mentions the financial and emotional toll on the Spring family, Goodman thus concludes that Spring must be given "the benefit of the doubt" (628).

Unlike Golway, Goodman does not believe in moral absolutes, particularly in questions like euthanasia. Though the position may seem vacillating, it also allows her to look at individual interests and to discern the moral nuances of euthanasia. Thus, she partly agrees with Golway in that euthanasia is forcing a change in the way society allocates resources for treatment. However, she stops short of Golway's value judgments.

Golway and Goodman's differing positions stem not only from different political stands, but different ethical precepts. At issue is what Ronald Dworkin terms people's belief in "the sanctity of life," a multidimensional value measured in several factors. First, life itself has an instrumental value, because everyone's life can contribute to the interests and well being of society as a whole. Second, life has a personal value, a good or personal worth to the living individual. Finally, beyond the instrumental and personal, life also has an intrinsic value. This intrinsic value exists independently of other people's valuation, regardless of the beliefs of its possessor or other observers (McMahan, 330).

For Golway and all opponents of euthanasia, any life has intrinsic value. This trumps any instrumental value (as assigned by society) or any personal value (as articulated by an individual seeking euthanasia). Goodman tries a different approach, one that combines intrinsic, instrumental and personal value. It is a more nuanced approach, but is most likely to face controversy and stiff opposition.

Since euthanasia is largely a question of morality and ethics, addressing this question through legislation will do little to quell the debate. The only certainty is that as science continues to advance, society will continue to grapple with the moral questions raised by the silent figures of Karen Ann Quinlan and Earle Spring.

Works Cited

Golway, Terry. "The Culture of Death."

Goodman, Ellen. "Who Lives? Who Dies? Who Decides?"

McMahan, Jeff. The Ethics of Killing: Problems at the Margins…… [read more]


Active Euthanasia Term Paper

… This 'slippery slope' theory owes more to atrocities committed by Hitler's Nazi regime, than to any objective or empirical evidence. The number of people requesting physician-assisted euthanasia would be as small as that which currently persuades others to act illegally in order to ease their suffering. Such an argument displays a frighteningly high level of paranoia, and worryingly low level of faith in the individual's desire for life and in the integrity of the medical profession. Human beings have an incredible will to live, and it is only when that life is no longer worth fighting for that anyone would resort to seeking assistance in ending it. If an individual's suffering is such that they would prefer to die, then no one else has the right to deny them that final choice.

The debate on active euthanasia often focuses on whether or not physicians should be permitted to assist terminally ill patients to end their life peacefully. Of greater relevance would be a campaign to ensure that active euthanasia should be restricted only to the assistance of physicians. Simply decriminalizing euthanasia would result in a similar situation to the present, with desperate individuals seeking assistance from already distraught family members. Only if active euthanasia were legally restricted to physician assistance would opposition arguments of system abuse and lack of safeguards be allayed. Permitting physician-assisted euthanasia allows the physicians to become actively involved in the decision making process, with the patient and their family, which would ensure important safeguards and allow the appropriate level of information and palliative care was available throughout the decision-making process.

The issue of legalized euthanasia, especially the involvement of physician assistance, is a potential battlefield of opinions and beliefs. There are many strongly held arguments opposed to permitting the medical profession to become involved in the process of active suicide. These arguments are important, in that they ensure that the topic is fully debated and, if given the legal go-ahead, will ensure that relevant safeguards are in place. However, opposition to physician-assisted euthanasia of terminally ill patients has no foundation in empirical evidence, but are based on subjective and emotional concerns. Above all other concerns must be the respect for an individual's right to self-determination and the freedom to make personal decisions about their life and death. By permitting physicians to assist in the process of upholding this basic human right, society can ensure that those who find themselves in such a position will be assured of the relevant safeguards and care

Reference

Brock, W., Dan, (1992). Voluntary Active Euthanasia. Hastings Center Report, March/April, 11-12, 14-17, 19-21.… [read more]


Shakespeare's Hamlet Contains Messages Term Paper

… Hamlet is aware that he possesses the "cause and will and strength and means / To do't," (IV, 4). But because Hamlet is basically a good man, he struggles with actually taking revenge.

Obsessed with death and revenge, Hamlet frequently ponders both the spiritual and physical nature of the end of life. "To be, or not to be, that is the question," is a meditation on the nature of human existence. These ponderings are universal and timeless. Hamlet also considers suicide, and struggles with the morality of that act. Hamlet's preoccupation with death is evident since the first act of the play, when he still wears mourning clothes. He also criticizes his mother for remarrying so soon after her husband's death: "O God, a beast that wants discourse of reason would have mourned longer," Hamlet says of Queen Gertrude (I, ii). He believes that his mother did not properly honor her husband's death. In Act 5, Hamlet fondles the lips of Yorick's skull, making the morbid reality of decaying human flesh real. "Here hung those lips that I have kissed I not how oft," (V, i). Although the afterlife is uncertain, death cannot be escaped. It is the final physical reality.

The themes of death and revenge are closely linked throughout Shakespeare's Hamlet. The play's protagonist preoccupies himself with the spiritual nature of death and the afterlife since his father's ghost appears to him in the first act. Hamlet is an introspective character that reflects on the nature of life, death, and revenge. Killing Claudius is Hamlet's only way to exact revenge for King Hamlet's murder. Throughout the play, Hamlet struggles with the timing of his revenge and finally achieves a type of salvation at the end of the play when he receives a soldier's funeral. The human desire for vengeance is not unique to Elizabethan times. Even today revenge is a primal drive of…… [read more]


Right to Die Term Paper

… "In Quinlan, the court wrote, "The only practical way to prevent destruction of the right is to permit the guardian and family of Quinlan to render their best judgment." They concluded that, "Quinlan's right of privacy may be asserted on… [read more]


Small, Crimson Birthmark on Georgiana Term Paper

… Hawthorne is making the point here that people tend to pay undue attention to flaws and ignore positive traits, often at great expense.

4: Aylmer had an obsession with science and the perfection of mankind beyond an earthly level. He had a passionate love of science and believed he could conquer any obstacle through the use of his mind and skills. Aylmer's failure in the laboratory to successfully and safely remove Georgiana's birthmark represents his failure as a husband and as a decent human being. This failure shows how an obsession with superficial perfection results in a degradation of humanity. Aylmer had the confidence that he could play God and rid Georgiana of her earthly imperfection in order to make her divine.

His failure to do so after taking drastic measures symbolizes the misdeed in attempting to conquer or change the essence of humanity,…… [read more]


Active and Passive Euthanasia Term Paper

… If active euthanasia is benevolent, or done with compassion and love, then passive euthanasia is malevolent, and wrong. If done for the wrong reasons of course, such as personal gain, any euthanasia is wrong, but that is not Rachels' argument here, it is whether active euthanasia should be recognized and applied.

Similarly, the utilitarian principle of the "greatest good" also applies here. "The Christian love ethic, searching seriously for a social policy, forms a coalition with the utilitarian principle of the 'greatest good of the greatest number.' Of course it reshapes it into the 'most love for the most neighbors'"

Fletcher 19). The greatest good applied here ultimately comes down to passive euthanasia as the greatest good for the greatest number of suffering, terminal patients. If a doctor must justify his or the family's decision to end the life of a patient, the principle of the "greatest good" not only applies to the suffering of the patient, but the suffering of the family as they watch their loved one die a prolonged and agonized death.

In conclusion, euthanasia is a controversial and emotional issue. Rachels treats it as a moral issue that must be addressed by the medical community, and his arguments are persuasive and rational. In a country where we routinely put beloved pets "to sleep" to end their suffering, it seems ridiculous and hypocritical that we cannot do the same for suffering loved ones. Many people are opposed to euthanasia on the religious grounds that it is murder. However, the merciful ending of a life that has already ended in every other sense seems not only compassionate and benevolent, it seems the only rational thing to do, and the last act of love and devotion a family member can provide their loved ones.

References

Rachels, James. "Active and passive Euthanasia." PLEASE ADD BOOK HERE.

A www.questia.com/PageManagerHTMLMediator.qst?action=openPageViewer&docId=85664345"Fletcher, Joseph. Moral Responsibility: Situation Ethics at Work. Philadelphia: Westminster Press, 1967.… [read more]


Crow Flies Term Paper

… She informs P.K. that although she has seen the angel of death, she is going to defeat it and keep it from its intended destination. P.K. is greatly relieved and reassured when his wife tells him that she intends to remain in charge of everything. He takes his golf clubs and leaves for another imaginary round of golf.

Even though Mrs. Chan is determined to battle Sandra Smith, no one realizes that the angel of death has already won the battle and is merely waiting like the "crow sitting on the window sill," for Mrs. Chan to come and follow it "home." Mrs. Chan cannot outsmart the ghost with Chinese ruses, she cannot use goldfish to keep the angel at bay, she cannot rely upon her front steps to keep the angel from entering the house, because the angel is already inside the house, and Mrs. Chan has already met her face-to-face.

In another instance of showing human similarities in spite of cultural difference, Mrs. Chan explains that she is not at all similar to foolish Americans who "Never think of death. Never prepare for anything. Always think, life goes on and on, forever." In claiming that she is dissimilar to people who think in this manner, she does not see that she is actually describing herself, another human oversight that is nearly universal.

The meaning of the white slips worn by both Hannah and Mrs. Chan under their dresses can be interpreted in at least two ways. Because both are wearing white slips under outer garments or disguises, one can see this as yet another example of the author's use of symbolism to infer that under the surfaces humans are rather alike. An additional interpretation is that when Hannah removes her disguise and sits down in Mrs. Chan's chair wearing a slip, she is displaying a sense of comfortable familiarity in the household. She will not have to use a disguise or subterfuge with P.K., because he has already stated he will have no resistance to her. She merely needs to wait for him. As Mrs. Chan departs through the garden to "go home," Hannah waits in Mrs. Chan's chair for P.K., knowing that he will come to the chair expecting to find his wife, and will instead come face-to-face with death. P.K. arrives shortly from his wanderings and approaches the chair from behind, exactly as Hannah expects him to do. Death is now at home in the Chan's house, and the Chans will soon both "be home" elsewhere.

With his use of symbolism and his humorous touches, Hwang not only put a human face on Death in this short play, but he also painted a picture of universality in human traits. He showed that despite the outward differences and the stereotypes, human beings are actually very similar at the core.… [read more]


Another Person's Perspective on Terri Schiavo Interview

… Euthanasia Worldview

The author of this response spoke to a young adult about the same age as the author. The author of this report agreed not to use the person's name in exchange for their brutal honesty and candor about what they thought about euthanasia. The interviewee noted that he is a Catholic. He cited the spiel that Catholics typically believe that suicide is a mortal sin and that means that the person would go straight to Hell. However, he noted that the fact that Terri was in a vegetative state would probably negate that. The respondent noted that he does not believe or agree in euthanasia or suicide but that he knows he cannot force others to believe or do the same way that he does. He also noted that he is not sure what he would do if he had terminal cancer or something like that and knew he was going to die.

The interviewee noted that he hated how the Terri Schiavo situation became such a media circus. He says the situation itself was complex and he understood that the husband of Terri and the parents of Terri had differing opinions. The interviewee noted that the biggest problem is that nobody could prove what Terri would have wanted. He said it was hard to say if the…… [read more]


PICO Revision Clinical Question A2 Coursework

… PICO Revision

Clinical Question

There is clear evidence that hospice services are being underutilized by advanced dementia patients in Lee County, Florida. Although patient/family- and organizational-barriers to hospice utilization can sometimes be substantial, clinician-associated barriers are theoretically preventable. The clinical question addressed by this quality improvement project is whether clinician exposure to evidence- and knowledge-based recommendations will improve clinician attitudes towards palliative and hospice services, thereby increasing hospice referral rates of patients suffering from advanced dementia.

The PICO format (patients, intervention, comparison, and outcome) is used to frame the clinical question (Clanton, 2014, p. 256-258); however, no comparison intervention or exposure will be used. The patient population will be physicians and DNPs caring for patient with a primary diagnosis of advanced dementia, who will evaluate the clinical efficacy of the ADEPP tool with respect to EOL care planning and prognosis determination. This includes patients with AD, vascular dementia, Lewy bodies dementia, and/or frontotemporal lobar degeneration (Alzheimer's Association, 2014, p. e49), who are residing in Lee County, Florida. The vast majority of these patients are expected…… [read more]


Plan for an Advanced Directive Workshop Research Paper

… Advanced Directive Health Promotion Plan

Advanced Directive Health Promotion Evaluation Plan

Advanced directives are an important health tool that could help preserve patient quality of life during the dying process and protect both patients and loved ones from unnecessary suffering. Hunter-Johnson (2014) describes the different elements that may constitute an advanced directive and why each could provide protection for the patient's care preferences. The intervention involves educational workshops combined with individual clinician-led assessment sessions, although it was unclear whether the intervention was based on prior research findings or what nursing theories were relevant. In addition, the content of the intervention was not mentioned, which would have been helpful for evaluating the potential effectiveness and relevance of the questions included in the survey instrument. The instrument content was adapted from surveys used by the AARP and another state agency, but it was unclear whether these survey instruments would be appropriate for not only the content of the intervention or the target population.

Other details that…… [read more]


Suicide Rates Research Paper

… , 2000.

This strategy is often effective since it promotes public awareness of suicide and encourages individuals to commit to social change.

There is also need to monitor emotional difficulties in this vulnerable group. Emotions such as stress and depression are precedents of suicide. Therefore there is need to encourage and counsel these individuals in order to prevent suicides. This strategy is often effective since it involves recognizing and reducing the factors that increase risk of suicide. It also fosters positive communication and dialogue and counters shame and prejudice which comes from stressful or depressing events Jr., 1999()

Another strategy that is often effective in preventing suicide is promoting policy, systems and environmental changes that facilitate suicide prevention Flavin & Radcliff, 2009.

These include increased scrutiny on prescriptions of opioids and increasing gun control policies to reduce access to firearms. These strategies promote public health and reduce access to lethal mechanisms of committing suicide.

Alternative strategies that can be used to prevent suicide

Increasing surveillance of suicidal behaviors is an important strategy in the prevention of suicides. This is because it ensures that the vulnerable people are identified early and that they receive mental health care and counseling to help prevent suicide. There is also need for the government to integrate prevention of suicide into reforms of the health care system. This will encourage the private sector to adopt similar measures thus helping to create a positive net effect on reduction of suicide rates. This can be done by increasing the proficiency of the health care workers to respond so suicidal people through crisis counseling.

There are other specific strategies that are available in prevention of suicide. One is reducing access to mechanisms of suicide to the vulnerable group. This includes keeping away toxic substances, ropes and belts that can be used for hanging and firearms. Reducing domestic violence and abuse of drugs are also effective long-term strategies in preventing suicide since they prevent mental health problems Bearman, 1991()

Pharmacies or local drug stores can also play a part in preventing suicide by reducing the amount of drugs supplied in packages of non-prescription medicines that can be used in committing suicide such as aspirin. Health and community education programs regarding suicide and its risk factors can help to identify early warning signs easily and also increase the number of people requesting for help about suicidal tendencies Booth, Briscoe, & Powell, 2000()

References

Bearman, P.S. (1991). The Social Structure of Suicide. Sociological Forum, 6(3), 501-524. doi: 10.2307/684516

Booth, N., Briscoe, M., & Powell, R. (2000). Suicide in the Farming Community: Methods Used and Contact with Health Services. Occupational and Environmental Medicine, 57(9), 642-644. doi: 10.2307/27731384

Flavin, P., & Radcliff, B. (2009). Public Policies and Suicide Rates in the American States. Social Indicators Research, 90(2), 195-209. doi: 10.2307/27734783

Jr, T.E.J. (1999). The Clustering and Contagion of Suicide. Current Directions in Psychological Science, 8(3), 89-92. doi: 10.2307/20182569

Luo, F., Florence, C.S., Quispe-Agnoli, M., Ouyang, L., & Crosby, A.E. (2011). Impact of Business Cycles… [read more]


Ethical Leadership Advance Directives Essay

… E's decision at the time. I believe that a more ethical protocol would have been to contact the patient advocate involved and ask questions relating to the conditions that would have excluded the family from Mr. E's directive decisions.

In the case of Mr. Y, the most ethical decision he might have made in this case was to ask whether Mr. E expressed any wishes regarding his care in the event that he was unable to make such decisions. Mr. Y's appointment as medical power of attorney gives him the ethical responsibility to ensure that his brother's wishes are carried out. Hence, I do not believe it was ethical for him to authorize the use of a respirator for his brother.

There are several factors complicating the decision making process for Mr. E. First, his developmental challenges might have impacted his ability to make sound decisions regarding his care in the event of life-threatening conditions. Further, the fact that there was no clear family involvement in the decisions made might indicate that Mr. E did not truly understand the gravity of the advance directive. Finally, Mr. E's appointment of his brother as medical power of attorney without clearly informing him of the advance directive begs questions regarding his state of mind at the time.

The main HIPAA violation that occurred in the case of Mr. E is the fact that his brother, as medical power of attorney, did not receive full disclosure of his brother's advance directive (Pathfinder, 2010). Indeed, even without input from the patient advocate involved at the time, the brother could have provided insight into Mr. E's ability to make decisions of the kind. This could have provided important insight into the decisions to be made by the medical personnel working with Mr. E.

The nurses in this case all appear to have had a somewhat disrespectful and flippant attitude to Mr. E's situation. Referring to him as "retarded," for example, is a blatant indication of disrespect for his life, his needs, and his decisions. Further, pleading ignorance is not acceptable when it comes to nursing practice; all nurses should be lifelong learners to ensure that both their medical and ethical practices remain up-to-date. Failing to do so negatively impacts the image of the profession and can even lead to expensive law suits.

In this case, my first duty as nurse would be to ensure that the family is fully informed of Mr. E's advance directive. I would then question them about their involvement in the directive and whether this document could be considered valid, given Mr. E's developmental challenges. If their responses were to prove unsatisfactory, I would contact that patient advocate involved at the time. In all these steps, my main consideration as professional nurse should be honoring the rights of the patient.

References

ANA Board of Directors (2010, Jun. 14). Revised Position Statement. Retrieved from: http://www.nursingworld.org/MainMenuCategories/EthicsStandards/Ethics-Position-Statements/etpain14426.pdf

Mitty, E.L. (2012, Jul). Advance Directives: Geriatric Nursing Protocol. Hartford Institute for Geriatric Nursing. Retrieved from: http://consultgerirn.org/topics/advance_directives/want_to_know_more

Pathfinder.… [read more]


Active Support Person-Centred Care Essay

… According to one elderly resident of a facility which had chosen to implement person-centered care: "The hopelessness has been taken away from me. You have got reassurance wherever you go with staff and patients & #8230; and you seem to have a purpose" (McCormack, Dewing, & McCance, 2011).

Regardless of the individual's stage of life, there is a desire to feel a sense of competence and mastery over something and a reason and a purpose for going on day-to-day. When implementing the program in the nursing home, "the residents were provided with a greater range and number of choices. Specific activities, such as resident and family groups, have been initiated and established in the majority of settings to encourage more choices for residents" (McCormack, Dewing, & McCance, 2011). Being able to choose meals, activities, and mobility during the day is a profoundly empowering experience for nursing home residents who otherwise feel a sense of loss over the most basic physical and social activities.

When patients struggle, breaking down activities into meaningful stages or 'chunks' is more useful than simply performing the task for the patient. Even patients who cannot perform all of the tasks required to perform a particular action independently can at least perform some of them, giving the patient a sense of normalcy and accomplishment.

References

McCormack, B., Dewing. J., McCance, T. (2011). Developing person-centred care: Addressing contextual challenges through practice development. OJIN: The Online Journal of Issues

in Nursing, 16, 2: 3. Retrieved: http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No2-May-2011/Developing-Person-Centred-Care.html… [read more]


Pain Management Within a Nursing Essay

… Individuals can be encouraged by the care givers through helping them to draft self-help programs which they will follow in their path to elevating their pain and discomfort. They can also be encouraged to form self-help groups where they share their experiences and come up with ideas as a group to deal with the pain and discomfort (Scott, Baluch, Kaye, 2010).

Care givers in the nursing home can also assist individuals so as to ensure that they are positioned in a safe and comfortable manner. This can be done through finding out the comfortable and safe positions which an individuals can stay in .after the establishment of these positions then they can assist in making sure that the individuals are at this positions all the time so that they can not experience pain and discomfort.

There are various measures that have to be agreed upon between the patients and care givers so as to alleviate the pain and discomfort. It should be ensured that the agreed upon measures are followed routinely. Some of the measures can include taking medicine, regular exercises and sitting in particular position. Individuals should be encouraged to carry out the agreed measures. (Scott, Baluch, Kaye, 2010).

Care givers should ensure that they carry out the required monitoring activities that are related to managing an individual's pain and discomfort. This can be achieved through checking if an individual takes their medicine, is carrying out the required exercises, is involved in self-help methods and so on.

The records for an individual's progress when it comes to management of pain should be filled appropriately. This will ensure that it is easy to monitor the progress of individuals as they strive to relieve their pain and discomfort. It is also important to report findings as required as the reports will be used to judge whether a patient's condition is improving or not. The reports will also be used to guide in the next course of action incase there is no positive improvement on the individual.

References

Scott, J., Baluch, A., Kaye, A. (2010).Pain Management in the elderly population. Retrieved May 12, 2013 from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096211/

Severson, D.(2012).How to manage chronic pain in the elderly. Retrieved May 12, 2013 from http://www.ehow.com/how_4929178_manage-chronic-pain-elderly.html… [read more]


Alzheimer in African Americans Article Critique

… ALZHEIMER'S RESEARCH

In seminar

Popular vs. journal article reviews: Alzheimer's research

Alzheimer's disease is a devastating, progressive illness for both the sufferers of the illness as well as the patients' families. Because of the widespread prevalence of the disease, it is not uncommon to see scientific journal articles on the topic distilled into the popular media. This is evident in the New York Times piece entitled: "In blacks, Alzheimer's study finds same variant genes as in whites" by Gina Kolata. According to Kolata, African-Americans have a slightly higher rate of developing Alzheimer's than European-Americans. However, the study that was profiled determined that the genetic factors which increase one's risk of developing the condition are the same for both groups.

African-Americans "with Alzheimer's disease were slightly more likely to have one gene, ABCA7, that is thought to confer risk for the disease" while both groups were equally likely to have APoE4, which has been proven to increase Alzheimer's risk in older Caucasian populations. "ABCA7 was not very common, still leaving most Alzheimer's risk unexplained" (Kolata 2012). For an article in a popular newspaper, Kolata's article is surprisingly detailed. It is also very realistic and cautious in terms of evaluating the significance of the research findings. Other researchers in the field of genetics note that the associations of the genes in the study and Alzheimer's have long been noted, and it is unsurprising that these findings were generalizable across racial categories. Kolata is also very detailed and precise in her explication of possible reasons why ABCA7 may be so significant: "ABCA7 also moves proteins through the membranes that encase cells. One of the proteins it transports is a precursor of beta amyloid, the major component in the brain plaques found in Alzheimer's disease" as well as influences the development of cholesterol build-up (which may be a possible explanation why Alzheimer's patients often have heart disease)" (Kolata 2012).

The original journal article views the…… [read more]


Osteoporosis Pathophysiology: Osteoporosis Presentation Research Paper

… 5 SD or below the average value for premenopausal women warrants a diagnosis (Kanis 2002) "The same absolute value for BMD used in women can be used in men. The recommended site for diagnosis is the proximal femur with dual energy X-ray absorptiometry (DXA)" (Kanis 2002).

Management of the pathology

Medical

For younger patients in the early stages of the disease, management of the causes of the osteoporosis is essential, such as restoring the patient's normal menstrual cycles with appropriate diet; adjusting the patient's medications to reduce the risk of further bone loss; or establishing a normal endocrine balance of the patient's hormones. For patients at risk because of lifestyle factors such as inactivity, a program of weight-bearing activities may be prescribed.

Surgical

No surgical treatment is specifically prescribed for osteoporosis, although due to complications from the disorder such as a hip fracture, surgical procedures may be warranted.

Pharmaceutical

Action: The most common pharmaceutical treatment for osteoporosis is calcium supplementation. If this is not effective, bisphosphonate drugs like Fosamax may be prescribed (Osteoporosis, 2011, Mayo Clinic: Treatment and drugs).

Adverse effects: The most common side effects of bisphosphonates include nausea and other gastric conditions. Some women prefer the injectable form of the drugs for this reason. In some patients, the use of bisphosphonate has been linked to stress fractures in the upper femur and jaw osteonecrosis (Osteoporosis, 2011, Mayo Clinic: Treatment and drugs).

Most important nursing considerations: Treatment will vary depending on the severity of the osteoporosis, its cause, and the age and lifestyle of the patient.

Virginia Henderson: Four unmet needs and cares

Unmet needs

"Avoid dangers in the environment and avoid injuring others:" (Virginia Henderson's need theory, 2012, Nursing Theories). For an elderly patient, avoiding dangers in the environment may entail creating a housing configuration whereby the patient is unlikely to fall and injure herself (through the use of railings by stairs and in the shower, for example); for a younger patient it may require additional weight-bearing activities and exercise to increase bone mass or reduce the rate at which bone mass is lost.

"Move and maintain desirable postures:" (Virginia Henderson's need theory, 2012, Nursing Theories). For patients of all ages, yoga or other physical therapy to strengthen postural muscles and cope with the physiological problems caused by osteoporosis (such as a slouched posture or collapsed chest) can be helpful.

"Breathe normally. Eat and drink adequately:" (Virginia Henderson's need theory, 2012, Nursing Theories). A diet high in calcium and other minerals, with supplementation may be required.

"Play or participate in various forms of recreation" (Virginia Henderson's need theory, 2012, Nursing Theories): Weight-bearing exercise appropriate to the patient's age is warranted. Weight bearing exercises include running, jumping, and weight lifting (versus non-impact activities like swimming or biking).

Unmet cares (Virginia Henderson's need theory, 2012, Nursing Theories)

Physiological: Proper nutritional and hormonal balance must be restored through dietary advice or medical treatment.

Safety: Safety must be enhanced with appropriate exercise, nutritional counseling, and changes to the patient's environment.

Belonging: Patient's… [read more]


Dementia and Alzheimer's Disease Dealing Research Paper

… From a different perspective, Gould (2010) there is a significant but small benefit in developing scripted training programs for staff in learning how best to manage dementia patients. In short, a general synthesis of this first area of research strongly promotes the understanding that quality nursing staff and a supportive psychosocial environment are critical to patient outcomes.

Regarding the best treatment of dementia, there is much less consensus. Defilipi (2000) found that typical antipsychotics have a modest effect on psychosis and behavioral symptoms, and preliminary studies suggest that atypical agents are effective. Yet, Steinmetzd (2010) argues that the patients considered difficult often are not in need of medical intervention and are not the ones experiencing major medical problems. Instead, they are the people who behave rudely and want a secondary gain. Patients with multiple non-specific complaints and those with psychosomatic problems are often the most challenging to manage long-term. Lastly, Williams (2009) argued that when discussing a treatment plan the probability of receptiveness to care varied significantly with communication acumen of the practitioner. An increased probability of receptiveness to care occurred with elderspeak compared with normal speak. Individuals with dementia slowly progress from forgetfulness to a stage of confusion which brings them to a new, different, initially strange and threatening mode of being. The patient's want and desire to keep up on their appearances and previous life is abandoned and their memory dissolves progressively more. They tend to live more in their own, dreamlike "world" which mingles the present and past together and the rules and structures of the "old world" looses its importance. During an increase of loss of memory, tends to derive limited vocabulary and verbal communication (Kuske, 2009).

In conclusion, the general literature around dealing with problematic patients and dementia is varied but clear trends emerge. The importance of a positive psychosocial environment is critical along with effective interventions cannot be understand from the studies examined in producing positive patient outcomes. Further research in the field in necessary…… [read more]


Positive Aspects of Getting Creative Writing

… Many old people are influenced by society in considering that they should accept their condition and that it is pointless for them to turn to concepts such as creativity, as they apparently lived their lived and there is nothing more for them to do about it. Many older people need to be provided with education and with encouragement in order for them to be able to understand that their life has actually reached a point where they are free to use their inspiration however they want to.

In addition to having the resources necessary for them to put across creative thinking, old people also have access to a multitude of memories that they can successfully use in producing impressive designs. They no longer feel the impulse and the naivety that they did when they were young, this providing them with the opportunity to organize their thoughts. Wisdom is more powerful when people are old, as it can influence them in differentiating between right and wrong and as it makes it possible for them to refrain from making significant mistakes. Wisdom is the product of life experiences, as old people are better prepared to anticipate situations that involve a lot of risk.

It is difficult to determine whether old age provides people with better conditions than young or middle age, but it is only safe to assume that it is not a period when people should abandon their hopes and dreams in favor of waiting to die. People are provided with significant advantages when they become older and this time is perfect for them to try everything that they wanted to try at a certain point in their lives.… [read more]


Active and Passive Euthanasia Term Paper

… ¶ … inferred from the content that the writer is a medical doctor or other health professional, however it is unclear from reading the article alone what the author's specific qualifications are to engender the reader's trust in his opinion. It is written in laymen's terms and not specifically geared toward an audience of medical professionals. The article sets itself as an opposing view of the accepted practice of passive euthanasia. The writer, James Rachels, starts by providing definitions of the terms to be discussed, including passive and active euthanasia. He tells the reader that the medical community generally accepts passive euthanasia to be permissible, and active euthanasia is considered inappropriate. He gives his thesis, which is that passive euthanasia should be considered more inhumane than active euthanasia.

Next he offers a passage of direct quotation from the American Medical Association to further illuminate their stance. This second paragraph primarily functions as background information and explication of his thesis. The third paragraph gives his first real-world example of a dying patient and his treatment. He continues the example, providing detail about the family of the patient and the decision of his doctor to withhold treatment. He argues that the withholding of treatment may mean that it will take the patient longer to die, rather than the application of a more active strategy. Then writer gives an account from a doctor's perspective of watching a child die from lack of treatment, a more dramatic and intentionally emotional example. He brings up that his opinion is that passive euthanasia is the worst of all stances to take, whereas he understands the advocacy of active euthanasia or of being opposed to all forms of euthanasia in general. He acknowledges the strong language used in making his argument.

The next paragraph is transitional, designed to lead into the writer's second argument. The writer then returns to his example of infants with Down's syndrome. He argues that oftentimes the reason that parents opt for passive euthanasia is not…… [read more]


Preventing Falls Fall Prevention Term Paper

… Preventing Falls

Fall prevention

Preventing falls amongst elderly patients at subacute facilities

Preventing falls amongst elderly patients at subacute facilities

While falling can be dangerous for any individual, regardless of their state of health, due to elderly patient's greater fragility falls are particularly dangerous for seniors. Having a serious fall is one of the greatest predictors of future degeneration and fragility for older patients. Although the common image of an elderly fall victim is someone who has 'fallen and can't get up,' and is lying alone at home, in subacute hospitals falls are reported to occur between 13% and 32% of admitted patients and in stroke rehabilitation units, falls have been reported in up to 47% of patients. Up to 70% of falls result in injuries and 1-10% of falls result in fractures as well as long-standing psychological effects for the elderly person (Haines et al. 2004). Falls are costly for the patient's and the patient's family in terms of psychological distress and also for the subacute facility in terms of additional healthcare costs, when treating the patient.

One recent study, as reported in the British Medical Journal found that a specific fall prevention program was extremely helpful in dramatically reducing fall rates. "Participants in the intervention group received a targeted falls prevention programme in addition to usual care. This programme consisted of a falls risk alert card with information brochure, an exercise programme, an education programme, and hip protectors" (Haines et al. 2004). The type of intervention depended upon the patient's specific complaint, level of cognitive impairment, and age. Regardless, all 310 patients who received intervention and care showed a significantly lower rate of falls than the 316 in the control group: 30% less.

Current research conducted by Dr. Andrea Trombetti of the University Hospitals and Faculty of Medicine of Geneva suggests that many types of educational programs can be helpful for the elderly in preventing falls -- the important thing is that an interventional fall-prevention program is indeed undertaken. A trial of 134 people, average age 75, with notable unsteadiness and identified as being at high risk for falls received weekly hour-long eurhythmics sessions. Eurhythmics focuses on teaching movement in time to music, having patients "walk and turn around, stay in step with changing tempos, learn to shift their weight and balance, handle objects while walking, and make exaggerated upper-body movements while walking" (Rabin 2010). Only 24 of the elderly patients in the experimental group experienced falls, versus 54 in the control group, suggesting that intervention of various kinds can have a demonstrable positive effect for the elderly. Despite the small number of participants in the study, the difference between the two groups is significant

Balance is a skill that can quickly deteriorate with age, if not reinforced. In another recent study comparing the balance of healthy elderly volunteers (average age 75), with undergraduates, despite the fact that the older individuals were in good health and exercised an hour a day: "They thought they were in good shape… [read more]


Bible Receiving Eternal Life Requires No Works Essay

… Bible

Receiving eternal life requires no works, but only faith. Understanding this message of scripture is the key to salvation. To receive eternal life, we must first die to our sins and transgressions: "As for you, you were dead in your transgressions and sins, in which you used to live when you followed the ways of this world," (Ephesians 2:1-2). Leaving sin behind, we also abandon the life that is full of temptation in favor of the life that is full of mercy and love.

The next step in receiving eternal life is by burrowing our hearts in the gospel. As Paul states, "I became a servant of this gospel by the gift of God's grace given me through the working of his power," (Ephesians 3:7). By grace alone we are saved. We remain measly, humble beings but our spirit is transformed. This is what is meant by eternal life. For me, this was achieved by a leap of faith. I heard the message of the gospel spoken by a friend. He spoke the words from his heart and directed me to scripture. All I had to do was to read a passage and I knew in my heart that eternal life was not just possible, but an imperative. There is no other way to live. Without Christ we are dead in our hearts; in Christ we live eternally. Christ dwells in our hearts, and we dwell with Him.

As sinners in the body, we are nothing. We are "are darkened in their understanding and separated from the life of God," (Ephesians 4:18). Receiving the message of the gospel, however, we become reborn in Christ and ready to receive the Grace of God. We are "made new in the attitude of your minds," and we "put on the new self, created to be like God in true righteousness and holiness," (Ephesians 4:23-24). We are reborn.

"But because of his great love for us, God, who is rich in mercy, made us alive with Christ even when we were dead in transgressions -- it is by grace you have been saved," (Ephesians 2:4-5). To…… [read more]


Abuse in Nursing Home Care Thesis

… Abuse and Neglect in Nursing Homes

Elderly abuse in nursing homes is a serious concern both the rapidly growing population that would need nursing care at some point in their lives and their families who depend on nursing staff since they cannot provide the care their elderly need. However quality of nursing care is deteriorating as has been evidenced by many researches and studies nationwide. There may be more than one reason for deteriorating quality of care in nursing homes that lead to elderly abuse. But some reasons are found more consistently in researches.

Citing the example of Colorado, Valerie Corzine (2005) found that the main underlying problem is insufficient staff that has led to compromised care which constitutes abuse of elderly in nursing homes. Corzine's research depends on Government Accountability Office (GAO) report among other sources and shows how despite nursing home care reforms of 1987, elderly abuse continues to be a serious problem in nursing homes nationwide. "Despite [some] impressive federal requirements, GAO reports conclude that nursing homes continue to have serious problems, such as malnutrition, abuse, pressure sores, and over-medication." (p. 31)

Catherine Hawes (2002) also found that elderly abuse is a common in country's 17,000 nursing homes and many more residential care facilities. Her research depends on complaints received by Atlanta Ombudsmen and Office of DHHS Inspector General. Instead of focusing on any researches and studies, Hawes bases her research on actual complaints, interviews and surveys where residents or workers at nursing homes spoke about incidents of abuse they had witnessed or experienced. Discussing the prevalence of abuse in nursing homes, Hawes reports: "Ninety-five percent of the residents who were interviewed as part of the Atlanta Long-Term Care Ombudsman study reported that they had experienced neglect or witnessed other residents being neglected...Similarly, in one study, 37% of the CNAs reported they had seen neglect of a resident's care needs…" (p. 5). According to her research, the main problem is lack of adequate training. Unlike Corzine who had blamed shortage of nursing staff for abuse issues, Hawes finds that lack of proper training is the main cause of neglect and abuse in nursing homes. "61% of the aide registry directors argued that poor training was a significant factor causing abuse;…58% of the ombudsmen identified inadequate training of CNAs as a major obstacle to quality of care in nursing homes." (p. 9)

The third source we found useful for our report is a report prepared for Rep. Henry A. Waxman by the Minority Staff, Special Investigation Division. This report will be mentioned as Waxman report in this paper. The Waxman report (2001) depends on findings of state investigations conducted under the orders of U.S. Department of Health and Human Services. These state investigations found that apart from physical and emotional abuse, residents had also been subjected to sexual abuse in many nursing homes nationwide. It was also reported that in most cases, abuse problems were discovered only after a formal complaint had been filed. The increase in cases… [read more]


Osteoporosis Literally Means Porous Bones Research Proposal

… Osteoporosis literally means porous bones, and is a progressive disease that can cause serious injury. With osteoporosis, bones gradually lose their density to the point where they become brittle and break easily. The hips, spine, and wrist are common fracture zones (National Osteoporosis Foundation). Fractures in turn can cause deformity or severe, chronic pain (National Osteoporosis Foundation). The fractures caused by osteoporosis can be caused by even the slightest stress that would not affect a healthy bone.

Older women are at the highest risk for developing osteoporosis, and are about four times as likely as men for developing the disease (National Osteoporosis Foundation). Certain ethnic groups are at higher risk for the disease, with Caucasian and Asian women being at a higher risk than women of African decent (Shiel). Poor nutrition can contribute to osteoporosis.

Persons with osteoporosis often remain unaware that they have developed the condition until it is too late and they break a bone. However, bone density tests can alert…… [read more]


Osteoporosis Is a Debilitating Disease Thesis

… Osteoporosis is a debilitating disease in which bones become fragile and more likely to break (fractures). Today, approximately 44 million Americans have osteoporosis and low bone mass. "Osteoporosis now causes an estimated two million fractures each year and often results in immobility, pain, placement in a nursing home, isolation and other health problems -- conditions and circumstances that could largely be prevented through proper bone density testing and diagnosis," said Robert Recker, M.D., president of the National Osteoporosis Foundation (Access to Osteoporosis…, 2009, para. 8).

If not prevented or if left untreated, osteoporosis can progress painlessly until a bone breaks. Your body normally makes new bone as old bone is reabsorbed (broken down). Osteoporosis occurs when your body reabsorbs more bone than it makes, causing a loss of bone mass (amount of bone). Some loss of bone mass is normal as people age, especially for women after menopause. Bone loss can also be caused by other factors. Some of these factors include genetics (inherited from family), medicines such as steroids, or not eating enough calcium-rich foods (Calcium and osteoporosis, 2008 ).

Although there is no cure for osteoporosis, there are steps you can take to prevent, slow, or stop its progress. In some cases you may even be able to improve bone density and reverse the disorder to some degree (Osteoporosis what is it?, 2008).

Preventive Health Study

A preventive health program identified three million patients of the Kaiser Permanente Group of California at risk for osteoporosis. The program involved screening, and provided treatment for the disease, significantly reducing the overall incidence of hip fracture by 37% over five years, according to a study presented at the American Academy of Orthopedic Surgeons

in 2009 (Boughton, 2009 ).

Five Steps to Bone Health and Osteoporosis Prevention

Eat Right: Get your daily recommended amounts of Calcium and Vitamin D Adults under age 50 need 1,000 mg of calcium daily, and adults age 50 and over need 1,200 mg of calcium daily. Vitamin D is needed for the body to absorb calcium. Adults under age 50 need 400-800 IU of vitamin D daily, and adults age 50 and over need 800-1,000 IU of vitamin D daily (Osteoporosis what is it?, 2008).

The nutrients strontium and vitamin K2 are effective additions to calcium and vitamin D supplementation for the prevention and treatment of osteoporosis. Any nontoxic strontium salt (not radioactive strontium-90) can strengthen bone, according to Jonathan V. Wright, MD (Strontium, vitamin K2 ..., 2009).

Exercise: Engage in regular weight-bearing and muscle strengthening exercise. The best exercise for your bones is weight-bearing exercise such as walking, dancing, jogging, stair-climbing, racquet sports and hiking.

Maintain a Healthy Lifestyle: Avoid smoking and drink alcohol in moderation. Drinking alcohol in excess (more than two drinks per day) may cause bone loss.

Get Tested: Have a bone density test and take medication when appropriate. A Bone

Mineral Density test (BMD) is the only way to diagnose osteoporosis and determine your risk for future fracture. Since osteoporosis can develop… [read more]


Alzheimer's Early Onset Alzheimer's Disease Medically Speaking Essay

… ALZHEIMER'S

EARLY ONSET ALZHEIMER'S DISEASE

Medically speaking, Alzheimer's disease, named after German neurologist Alois Alzheimer in 1864, is also known as senile dementia and is characterized by mental confusion, memory loss, disorientation, restlessness, speech disturbances, the inability to walk or sit properly and sometimes hallucinations. The person afflicted with this disease may often refuse to eat and may be unable to feed oneself and lose control of bowel movements. Under most circumstances, Alzheimer's disease begins in the later years of life after the age of 65 with slight defects in memory and behavior and occurs with equal frequency in men and women. In the human brain, Alzheimer's is based upon certain types of plaque that accumulate in the cerebral cortex and on the surfaces of ganglion cells. Within recent years, treatment for Alzheimer's disease has included specific medications and changes in a person's diet, but the main cause of the disease is still under examination but has been linked to certain chemicals and substances in the environment.

Alzheimer's disease is almost always found in people over the age of 65, but there is another form of the disease known as early onset Alzheimer's which occurs, although very rarely, in persons in their 30's, 40's and early to mid-50's. Exactly why these persons become affected by Alzheimer's is not known, but recent research has suggested that these persons are genetically predisposed to early onset, much like inheriting a specific defective gene that leads to diseases like Parkinson's and Huntington's disorders.

Generally, there are seven specific stages that a person afflicted with Alzheimer's experiences within a prescribed length of time, ranging from seven to nine years. These stages are also experienced by those with early onset Alzheimer's and depending upon when the disease begins its progression, the person with early onset may not survive much past the age of sixty. According to the Alzheimer's Association, these seven stages "provide useful frames of reference for understanding how the disease may unfold and for making future plans" when the affected person becomes unable to care for him/herself during the final stages of the disease (2009, "The Warning Signs of Alzheimer's," Internet).

These seven stages are as follows. First, the affected person will generally have no impairment during stage one related to memory and the ability to function normally, both physically and mentally. Upon entering stage two, the affected person will experience very mild cognitive decline which may include lapses in memory, such as forgetting a person's name or being unable to locate common objects used on a daily basis. However, during this stage, friends and family members may not be aware of any cognitive decline and might consider small lapses of memory as nothing out of the ordinary (2009, "The Warning Signs of Alzheimer's," Internet).

In stage three, the affected person will experience mild cognitive decline which unlike stage two will be noticed by friends and family members. Some of the more common traits linked to stage two include a decreased ability to recall… [read more]


Euthanasia: Legal Considerations Euthanasia, Doctor-Assisted Suicide Term Paper

… Euthanasia: Legal Considerations

Euthanasia, doctor-assisted suicide, and mercy killing of any type is prohibited by law in the United States. In June of 2007, 79-year-old retired pathologist and patient rights activist Jack Kevorkian was released from federal prison, after serving eight years for his second-degree murder conviction (Martindale, 2007).

Prior assisting in the 1998 suicide of Tomas Youk, then in the final stages of Amyotrophic lateral sclerosis ("Lou Gehrig's Disease"), Kevorkian had always been very careful to avoid crossing the line between merely advising his patients and documenting their suicides and actually assisting them or implementing their requests by his own hand.

In 1998, Kevorkian deliberately and purposely crossed that line to force his own prosecution and thereby bring national attention to the need for legal reforms pertaining to doctor-assisted suicide.

The Ethics of Physician-Assisted Suicide and the Role of Law:

In Kevorkian's view, euthanasia is sometimes warranted by the ethical desire to end the suffering of patients with fatal illnesses who wish to end their lives instead of enduring unnecessary pain before inevitably succumbing to their ailments. Many contemporary medical ethicists agree with Kevorkian, reasoning that the Hippocratic

Oath to which physician licensed in the United States swear before beginning their medical practice, was conceived long before modern medical science, at a time when life expectancy, and specifically, continued survival after the onset of debilitating disease were virtually inconceivable (Humphry, 2002). Kevorkian and other who share his position believe that the physician's primary role is to prevent suffering, and that this aspect of medical ethics is even more important than the prolongation of life, merely for life's sake (Abrams & Bruckner, 1983).

Proponents of legalizing physician-assisted suicide acknowledge the essential role of legislation to establish guidelines, definitions, criteria, and appropriate regulation. In that sense, physician-assisted suicide…… [read more]


Euthanasia as Marker Points Out, the Privilege Term Paper

… Euthanasia

As Marker points out, the privilege of euthanasia can be abused. Unscrupulous family members, doctors and health care centers might view euthanasia as a cost-saving alternative to continued care. However, every single legal right we have as Americans can be abused and it is up to the courts to rectify those rare cases. Restricting the rights of citizens for fear of abuse creates an unnecessarily, illogically intolerant society. For the most part, legalizing physician-assisted suicide would end the enormous pain suffered by a sizable number of terminally ill patients. Moreover, such patients might not want to remain hooked up to life support systems indefinitely, their suffering on display and their family members forced to foot the bill as well as the emotional trauma.

Euthanasia is never a spur-of -- the moment decision. Were it legal, a set of strict regulations and laws would be in place to ensure that neither doctor nor patient abused the privilege. Certain conditions must be met before a doctor could even consider assisting a patient's suicide.…… [read more]


Philosophy Practice Dying How Do You Feel Term Paper

… Philosophy

Practice Dying

How do you feel about Plato's advice to "practice dying?" think Plato's advice is well taken for a number of reasons. He is trying to tell us that we should be able to die gracefully and with dignity, but also that we need to live our lives fully and with happiness in order to do that. If we practice dying throughout our lives, we can take a look at where we are and how happy we are, and where we need to change. It is helpful to think of where our priorities and affections are from time to time, and to practice dying is to look at these and see what we would do differently if we knew we would die tomorrow, next week, or next month.

Few people really want to die, but stopping and looking at what dying would mean to us right now gives us a good indication of how well our life is working and how happy we are. Plato is not being morbid or negative about life, but he is encouraging people to always assess their life and what they are doing with their life. Who…… [read more]


Tube Feeding Term Paper

… ¶ … feeding tubes at the end of life. The writer examines literature with regards to patients who have dementia, cancer and other end of life issues and reviews what has been concluded about using feeding tubes at this stage. There were three sources used to complete this paper.

The past few years have seen many controversial stories played out in the news regarding end of life feeding tubes and their use. Society lines up on both sides of the issue and hotly debate whether or not using a feeding tube at the end of one's life is something that should be done even if the patient is not capable of consenting. Meanwhile patients all over the nation languish between the two sides of the debate with their families trying to make the most humane and compassionate decision regarding the placement of a feeding tube into their loved one. Many studies have been conducted regarding the use of a feeding tube on a patient who is at the end of life with differing results. With a small risk in the actual placement of the tube the question centers around whether prolonging life with a feeding tube is really in the best interest of the patient.

LITERATURE REVIEW

One of the more controversial issues surrounding the use of a feeding tube is with patients who have Alzhemier's Disease. Patients with dementia often refuse food and without the ability to communicate it is difficult to determine whether they feel hunger or whether they want the life sustaining measures of a feeding tube used in their care.

According to Doctor Thomas Finucane the use of feeding tubes in patients with the disorder varies from state to state. One study examined the use of feeding tubes for this patient population and found that in Maine only 7.5% of the patients had feeding tubes inserted whereas in Missouri that figure increased to 40%. Further study indicates that the two factors most often present in the decision not to use a feeding tube are (1) the specific request by the patient or the patient's family not to use one, (2) being of white heritage (Finucane, 2001).

In addition the study notes the economic differences in the two states as a possible reason for the differences.

Another study examined the survival rate of patients who had feeding tubes placed against patients who did not. The study included more than 81,000 patients and concluded that the use of a feeding tube provided an average of survival for six additional months as opposed to those who did not have one placed whose survival rate was just over a month.

Using a tube and not using a tube each have their benefits and their problems. The study reported a higher incidence of pneumonia with patients who had feeding tubes inserted, while those who did not have tubes reported a higher incidence of malnutrition.

In increase in pneumonia for patients with feeding tubes and dementia relate to aspiration pneumonia as well… [read more]


Family Assessment Term Paper

… ¶ … family assessment on the Calhoun family, from the movie the Notebook, written by Nicholas Sparks. The writer includes all of the basic elements that an assessment is supposed to include.

The family members are named Noah and Allie Calhoun. They are both in their 90's and they live in a town called New Bern. Noah completed high school and then went into the military during World War II, while Allie completed high school and went to college while studying poetry and other things that would be useful to being a wife during those times.

While Allie never worked, she came from a wealthy family that owned tobacco companies. Noah had always worked and came from what was considered a lower class background in the early days of their courtship.

Both Noah and Allie are from a Christian background though they are not extremely active in any particular faith or church activities during their early courtship.

Both Noah and Allie are white.

Currently both Noah and Allie reside in the same residential nursing home. In the past no mental illness was reported however, currently Allie suffers from Alzheimer's disease.

Physically both the Calhouns are above average looking even given their advanced ages. They reported that in their youth they were considered above average looking as well.

The family reports that the members have always had open and honest communication. The parents get along well and they raised their children to become productive adult members of society.

The Calhouns interact well within the residential nursing home setting, though they report that Noah snuck into Allie's room when they were forcibly separated due to Allie's deteriorating disease.

Until Allie became ill with Alzheimer's she and Noah were reportedly able to perform their own basic hygiene functions. When they got where they could no longer live on their own they moved into the nursing home. Until that point they reported they were able to fulfill family tasks according to societal norms of their era.

The family reports that the couple have what they need to sustain life. They are fed at the nursing home and prior to their entering their senior years Noah provided for the family through his employment.

These provisions allowed them to live at a normal healthy level.

While the couple reports they no longer engage in sexual relations due to Allie's condition, they report that they had a normal active sex life up until the onset of her illness.

There are no children under the age of 18 at this time. They did have children and raised them to adulthood where they now are productive in society.

At this point in their lives Noah and Allie are completely dependent on the nursing home staff for their well being and protection, however, Noah reports that for many years the family members depended on him when he was younger, and as he began to age he and his wife began to depend on their adult children. Noah reports now that… [read more]


Independent and Dependant Variables Term Paper

… On the other hand, if a longitudinal study were developed, the results could be slightly different. For a longitudinal study, the population would be the same, but the survey would be administered over a longer period of time; in this example, ten years. Over the course of the ten years, the data would be collected from the same population, and thus, could indicate a change in the data over time, as well as link together possible connections between length of time smoking and lung disease. Again, while cause and effect cannot be established, hypotheses about length of time smoking and gradual lung disease could be developed. In the cross sectional study, no relationship over time could be measured, but in the longitudinal study, these measurements could generate a number of new hypotheses.

Clearly, both the cross sectional and longitudinal design have their own advantages and disadvantages. For certain subjects, such as the study of attitudes and behaviors on experimental subjects, a cross sectional design would be the best alternative, since it is low cost, and can generate hypotheses to be used in a quantitative study. For other areas, such as how variables change over time, the longitudinal method is preferred. In both cases, however, a well-structured, well-planned study can easily generate the desired results.

References

Community Foundation, Silicon Valley. (2003). Giving Back: A Practitioner's Toolkit. Palo Alto, CA: Community Foundation of Silicon Valley.

Gliner, J. (2000). Research Methods in Applied Settings: An Integrated Approach to Design and Analysis. Mahwah, NJ: Lawrence Erlbaum Associates.

Hoover, K. And Donovan, T. (2004). The Elements of Social Scientific Thinking, 8/e. Florence, KY: Wadsworth.

Hopkins, W.G. (2000). Quantitative research design. Sportscience, 4(1): 90-92.

Larkin, T. (1985, June). Evidence vs. nonsense: A guide to the scientific method. FDA Consumer, 19: 23-25.

Saint-Germain, M.A., PhD. (2004). Research Methods. Retrieved October 25, 2005 from California State University. Web site: http://www.csulb.edu/~msaintg/ppa696/696preex.htm.…… [read more]


Articles on Hoarding Behavior in Dementia Patients Term Paper

… ¶ … articles on hoarding behavior in dementia patients and in the elderly. Compulsive hoarding is an interesting and compelling phenomenon in a wide variety of the population. The two studies investigate hoarding in the elderly, and in patients with dementia, attempting to find the causes of the behavior and some of the affects the behavior has on those who hoard, including psychiatric symptoms associated with the behavior.

Hoarding is characterized by a need to acquire and maintain a wide variety of possessions that eventually clutter and fill living areas until they can no longer be used for the purpose they were designed for. This behavior has come under scrutiny from the media in recent years, and several studies have been conducted to discover why people hoard, and what the consequences of the behavior can be. Hoarding does occur in the general population, but it is also quite prevalent in the elderly, and in dementia patients, as these two studies indicate.

The first study indicates hoarding behavior is relatively common in dementia patients. All the patients had been diagnosed with varying forms of dementia, and had been hospitalized for their illness. The 133 patients in the study were divided between those who hoarded and those who did not hoard. Twenty-two point six percent of the patients hoarded items, and the items varied from daily necessities to food, newspapers, and even cigarette butts. These items were stored in a variety of places around their homes, in boxes, in closets, or even carried with the patients (Hwang et al., 1998, pg. 286). Psychiatric symptoms of the hoarders included repetitive behaviors, hyperphagia, and pilfering (Hwang et al., 1998, pg. 287). The elderly hoarders collected many of the same items. The elderly study reports, "elderly clients commonly hoarded paper, containers, clothing, food, books, and objects from other people's trash" (Steketee, Frost & Kim, 2001, p. 179). Usually, the clutter was so prevalent that it prevented using certain rooms in the home, and clutter usually occurred in more than one room of the home. In addition, these elderly collectors often showed signs of problems with their own personal care, in addition to the cleanliness of their homes. The dementia patients usually had some form of nursing or aide care, but they also had problems with personal care. The study found that in the elderly, "home sanitary condition, odor, and physical appearance were all significantly related to clutter and impairment from clutter. More clutter was especially associated with poorer sanitation in the home" (Steketee, Frost & Kim, 2001, p. 180). Thus, because the elderly most often live alone or with a long-time partner, the clutter problem is worse, because it may have been going on longer, and there is no daily intervention to manage or attend to the clutter. Many of the elderly living in cluttered homes face sanitary and health issues that would not affect the same elderly living in a non-cluttered environment.

Both groups tend to hoard food and other items that can create… [read more]


Firelight in "The Night Term Paper

… That is firelight. It can burn you if you get too close, but it is oh so comforting if you can stay at just the right distance.

I think a good example of people who live in the firelight are old people. Often, when people get very old, they tend to live in their memories, and retreat into times past. They are in their own dream world of thoughts and memories that no one else really understands. Their future is uncertain at best, so they retreat into their past, where the outcome is certain, but dreams can change the facts. My grandfather was like that in the last years of his life. Often he would sit for hours, just staring ahead out of his nearly blind eyes, and he would obviously be lost in thought. He would not talk, but it was easy to see he was thinking about things, and remembering his life past. He could not really tell you what he was thinking about, but it was clear he was in that hypnotic state that comes from warmth, safety, and comfort. I did not understand his silences at the time, and now, it seems as if he had lived a long and good life, and he was eager to remember the good times. When you live in the firelight, you do not have to acknowledge reality, just as the young boy did not want to acknowledge his mother's voice. My grandfather was old, a widower, nearly blind, and dependent on others for his survival. In the firelight, he was young and vital again, and he did not have to face reality.

In conclusion, the firelight is a hypnotic and dreamlike state that can certainly become ambiguous. However, it is mostly a state of mind. They fire hypnotizes us with its warm and promise of comfort, and we are powerless in its grasp.

References

Wolff, Tobias. The Night in Question. New York: Alfred A. Knopf,…… [read more]


Physician-Assisted Suicide Term Paper

… He shows why people who are seriously injured, and have "no hope" of recovery should not give up; they have a lot more to give to the world and the people that love them. If people have the "right" to die, what is the difference if they take their own life, or take another life? How is one life more important than another is? What gives anyone the "right" to die? They were put here on Earth to serve some purpose, and it was not a purpose to be cut short because they do not feel like being here any longer. Life is not easy, but it is better than the alternative, no matter what.

There is another thing that many people do not think about when they think about physician-assisted suicide, and that is someone who cannot make the decision on their own, and their relatives make it for them. "How can we make sure that no one will be pressed to end his or her life by self-interested relatives, friends, enemies, or caretakers?" (Van Den Haag 140). If they are pressured into committing suicide, no one would ever know, and it would not only be morally wrong, it would be horrible. People that even think about that are monsters. There is also the question of terminally ill children. The right to die laws are "limited to adults" (Carter 143), and so what happens if a child wants to commit suicide? Do they have the right to die, too?

Now, many states are looking at laws to allow people to commit physician-assisted suicide in their states. I think states that do this are wrong. People will come there just to die, and then what will happen to them? Will the state have to pay for their funeral and/or burial costs? If they are so ill, how will they get there?

There are too many unanswered questions about physician-assisted suicide, and too many moral issues for it to be a simple decision. Helping someone commit suicide is a felony, and I think it…… [read more]

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