Chronic Condition: Lupus Review the websites shown under the required resources and linked below related to legislation and laws that affect people with disabilities Americans with Disabilities Act | U.S. Department of Labor (dol.gov) Family and Medical Leave Act | U.S. Department of Labor (dol.gov) Disability Benefits | SSA Who is eligible for Medicaid? | HHS.gov Who is eligible for Medicare? | HHS.gov Discuss two challenges and impediments that might occur when patients try to utilize these laws and services (e.g., cost, application process, appeals, doctors participating in a timely manner, patient’s knowledge of health care and the laws, etc.). 300 words APA formatting · 6 pages · Double Spaced · APA Formatting · Use a minimum of three scholarly sources · Briefly define Parkinson’s Disease. · What physical changes occur related to the onset of the disease? · What are the possible psychological changes with PD? · What system(s) are affected? · What are the treatments and therapies? · The case study shared details that indicate Doug is no longer able to identify and resolve problems. · Identify two examples in the study that indicate Doug is losing this ability. · Provide two other examples that may arise as the disease progresses that are related to identifying and resolving problems. · Discuss possible feelings and stressors Doug may be experiencing as the disease progresses and he must rely on caregivers more. · Refer to the required reading list for the topics related to this assignment for ideas. · Discuss the effects of the diagnosis of PD and its progression can have on a spouse and family (micro-level) · Refer to the chapter and required readings regarding caregiving and caregiver burden (e.g., employment, psychological effects, financial stressors, role in the marriage, etc.). · Locate two services in your own community that offer assistance to people with PD and their caregivers (meso-level) · Describe the services available, cost, and eligibility requirements. · In your opinion, are Doug and Maria eligible for the services? Explain your answer based on your findings and the knowledge of Doug and Maria. · At the macro-level, research the state and federal programs, legislation and initiatives that affect chronic illnesses. Discuss the pros and cons of two of the following items as they affect patients and caregivers. · Legislation and lobbying efforts (e.g., changes to the Affordable Care Act [ACA], stem-cell research, etc.) · Requirements to qualify for Social Security Disability Income (SSDI) · Requirements to take advantage of the Family and Medical Leave Act (FMLA) · Requirements to qualify for Medicaid/Medicare · What are the requirements of these programs in terms of paying for skilled nursing for Doug? Do Doug and Maria qualify for assistance through these programs? Why or why not? · Americans with Disabilities Act (ADA). · A program, legislation, or initiative of your finding. As the ave.

1. Chronic Condition: Lupus
Review the websites shown under the required resources and
linked below related to legislation and laws that affect people
with disabilities
Americans with Disabilities Act | U.S. Department of Labor
(dol.gov)
Family and Medical Leave Act | U.S. Department of Labor
(dol.gov)
Disability Benefits | SSA
Who is eligible for Medicaid? | HHS.gov
Who is eligible for Medicare? | HHS.gov
Discuss two challenges and impediments that might occur when
patients try to utilize these laws and services (e.g., cost,
application process, appeals, doctors participating in a timely
manner, patient’s knowledge of health care and the laws, etc.).
300 words
APA formatting
· 6 pages
· Double Spaced
· APA Formatting
· Use a minimum of three scholarly sources
· Briefly define Parkinson’s Disease.
· What physical changes occur related to the onset of the
disease?
· What are the possible psychological changes with PD?
· What system(s) are affected?
· What are the treatments and therapies?
· The case study shared details that indicate Doug is no longer
able to identify and resolve problems.

2. · Identify two examples in the study that indicate Doug is losing
this ability.
· Provide two other examples that may arise as the disease
progresses that are related to identifying and resolving
problems.
· Discuss possible feelings and stressors Doug may be
experiencing as the disease progresses and he must rely on
caregivers more.
· Refer to the required reading list for the topics related to this
assignment for ideas.
· Discuss the effects of the diagnosis of PD and its progression
can have on a spouse and family (micro-level)
· Refer to the chapter and required readings regarding
caregiving and caregiver burden (e.g., employment,
psychological effects, financial stressors, role in the marriage,
etc.).
· Locate two services in your own community that offer
assistance to people with PD and their caregivers (meso-level)
· Describe the services available, cost, and eligibility
requirements.
· In your opinion, are Doug and Maria eligible for the services?
Explain your answer based on your findings and the knowledge
of Doug and Maria.
· At the macro-level, research the state and federal programs,
legislation and initiatives that affect chronic illnesses. Discuss
the pros and cons of two of the following items as they affect
patients and caregivers.
· Legislation and lobbying efforts (e.g., changes to the
Affordable Care Act [ACA], stem-cell research, etc.)
· Requirements to qualify for Social Security Disability Income
(SSDI)
· Requirements to take advantage of the Family and Medical
Leave Act (FMLA)
· Requirements to qualify for Medicaid/Medicare
· What are the requirements of these programs in terms of
paying for skilled nursing for Doug? Do Doug and Maria

3. qualify for assistance through these programs? Why or why not?
· Americans with Disabilities Act (ADA).
· A program, legislation, or initiative of your finding.
As the average life span increases, the likelihood of developing
a chronic disease increases as well. This assignment focuses on

4. Parkinson’s Disease (PD), which is a neurodegenerative
disease. Neurodegenerative disease causes dysfunction and
death of nerve cells in the brain and can affect motor, cognitive,
and behavioral or psychological functioning. Usually, such
disease has a profound impact on the family, as well as the
affected individual. The case study below gives you the
opportunity to learn more about issues faced by people who
have PD as well as exploring the impact of PD on the micro-,
meso-, and macro-level systems and the reverse – the micro-,
meso-, and macro-level effects on the individual.
Parkinson’s Disease Case Study Details:
Background
Doug and his wife Maria have three adult children, all of whom
are married with young children of their own. Doug works as a
regional sales representative for a chemical company that
produces plastics, chemicals, and agricultural products. He has
been in the position for 15 years, having moved into this job
after leaving a different company doing similar work. The job
requires him to travel to give demonstrations of the products
across a six-state region. This requires him to fly and drive in
unfamiliar areas. Maria works as a junior high school principal.
Doug and Maria are financially set for retirement at age 65.
Overall, they are in good health. At the age of 60, Doug
received a diagnosis of Parkinson’s Disease (PD).
Early phase
In the year before his diagnosis, Doug had three minor car
accidents while he was traveling in unfamiliar territory. Maria
was suspicious that the accidents were related to his PD and,
after consulting with the neurologist and Doug, they decided he
should no longer travel alone out of his immediate area. After a
few months of traveling with a colleague, he reluctantly stepped
down to a district sales representative position to stay closer to
home. Within the next year, Doug started experiencing
exacerbated (worsened) symptoms related to fine motor
coordination, changes in speech, as well as anger, anxiety, and
depression. The neurologist placed Doug on short-term

5. disability at the age of 61. After six months on short-term
disability, the law mandates that the individual must apply for
Social Security Disability. Therefore, due to Doug’s health
continuing to decline and his inability to return to work, Maria
had to file for long-term disability for Doug. At first, Maria
attempted to work with Doug to complete the disability
paperwork. Doug was easily frustrated with formulating the
responses to the questions on the forms; he did not know how to
answer the questions nor where to find the information within
their household records, so Maria hired a lawyer to complete the
paperwork.
Three months after submitting the application, Doug was
approved for Social Security Disability Income (SSDI). This
was a significant drop in income. Doug’s employment income
was twice that of Maria’s; he was bringing home $7500 per
month. His SSDI income is $2788 per month. Since Doug left
his full-time job, he was no longer eligible for health benefits
from his employer. He is not eligible for Medicare under the
disability guidelines until two years after payments begin.
Maria completed the paperwork to add him to the health
insurance through her job, which doubled her monthly
contribution to health insurance. The decrease in household
income required them to utilize their retirement funds earlier
than planned. In addition, Maria knows, as the disease
progresses, she may have to make decisions about her own full-
time work as a principal, which will further strain their
financial situation.
Middle phase
Doug and Maria enjoyed playing Scrabble with their friends
Susan and Bob, who lived nearby. The two couples would get
together every Saturday for some friendly competition along
with dessert and lively discussion. A year after his diagnosis,
Doug was exhibiting stooped posture and changes in his speech,
which made it difficult to understand what he said. These were
clear signs the disease was progressing. In some aspects of his
life, he appeared to function well enough, such as easily

6. performing most activities of daily living, but it became clear
he struggled with activities in the game of Scrabble. For
example, he was having a difficult time creating words from the
tiles he chose, where to place them on the board, and he could
no longer add up his points correctly. In addition, Doug was
embarrassed because he continually knocked tiles out of place
on the board, struggled to communicate clearly and interact
with friends in a social situation. Doug felt a great deal of
shame due to the changes and told Maria that he no longer
wanted to participate in the weekly game night. This meant that
Doug and Maria had less interaction in their own community
and became more socially isolated, which is not uncommon for
families with a chronically ill member.
Late phase
Doug was in charge of managing his own medications, which he
needs four times a day. One day, about four years after his
diagnosis, Maria was away from home at noon when Doug
called her to ask what he was supposed to do with the noon
pills. “I’m supposed to throw them out, right?” That was an
early sign of dementia. It was a signal for Maria that Doug
could no longer control his own medications and that he
probably shouldn’t be left alone for very long. The incident
marked the start of a steep decline in Doug’s cognitive and
emotional abilities, and the couple’s relationship changed from
one of partners to one of patient and caregiver. Maria relied on
their children and other family members to help with Doug’s
care, and she began looking for support groups to help her
figure out how to handle the deteriorating situation. Even
though she had a rotation of helpers, most of the work of
Doug’s care was Maria’s responsibility.
Doug’s condition progressed to the point of needing full-time
care in a skilled nursing facility a little more than a year later,
after he lost the ability to stand up, even with help. He always
needed two people to help him, and that just wasn’t possible at
home. In addition to the tremendous emotional stress on the
family, moving Doug to a skilled nursing facility further

7. increased the financial burden. Maria made the decision to sell
the house and move to a small apartment by herself. She had to
spend the proceeds from their home to pay for Doug’s nursing
home care before Medicaid would help pay for his care, due to
the Medicaid eligibility spend-down requirements. Doug passed
away five months after moving to the skilled nursing facility.
Maria was still paying for his care out of the proceeds from the
sale of their home, so she never received Medicaid assistance
for Doug’s care.