Parkinson’s Disease Case Study [WLOs: 1, 2, 3] [CLOs: 1, 2, 3, 4, 5, 6, 7] Prior to beginning this assignment, read Chapter 9 from the course textbook, The Stigma of Parkinson’s Disease (Links to an external site.) blog post, Neurodegenerative Diseases (Links to an external site.) web page, and the Instructor Guidance. As the average life span increases, the likelihood of developing a chronic disease increases as well. This assignment focuses on 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 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 kno.

1. Parkinson’s Disease Case Study
[WLOs: 1, 2, 3] [CLOs: 1, 2, 3, 4, 5, 6, 7]
Prior to beginning this assignment, read Chapter 9 from the
course textbook,
The Stigma of Parkinson’s Disease (Links to an external site.)
blog post,
Neurodegenerative Diseases (Links to an external site.)
web page, and the Instructor Guidance.
As the average life span increases, the likelihood of developing
a chronic disease increases as well. This assignment focuses on
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

2. 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
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

3. 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
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.

4. 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
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.

5. Address the following within the required
Parkinson’s Disease Case Study template
:
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.

6. 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

7. 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.
Use a minimum of three scholarly sources. List references in
APA format within the response box on the template.
The Parkinson’s Disease Case Study assignment
Must be completed within the
Parkinson’s Disease Case Study template
.
Must be at least five double-spaced pages in length and
formatted according to APA style as outlined in the

8. Ashford Writing Center (Links to an external site.)
’s
APA Style (Links to an external site.)
resource.
Must utilize academic voice. See the
Academic Voice (Links to an external site.)
resource for additional guidance.
Must use at least three scholarly sources in addition to the
course textbook.
The
Scholarly, Peer Reviewed, and Other Credible Sources (Links to
an external site.)
table offers additional guidance on appropriate source types. If
you have questions about whether a specific source is
appropriate for this assignment, please contact your instructor.
Your instructor has the final say about the appropriateness of a
specific source for a particular assignment.
Must document any information used from sources in APA style
as outlined in the Ashford Writing Center’s
Citing Within Your Paper (Links to an external site.)
See the
Formatting Your References List (Links to an external site.)
resource in the Ashford Writing Center for specifications.
Carefully review the
Grading Rubric (Links to an external site.)
for the criteria that will be used to evaluate your assignment.

9. Waypoint Assignment Submission
The assignments in this course will be submitted to Waypoint.
Please refer to the instructions below to submit your
assignment.
Click on the
Assignment Submission
button below. The Waypoint "Student Dashboard" will open in
a new browser window.
Browse
for your assignment.
Click
Upload
.
Confirm that your assignment was successfully submitted by
viewing the appropriate week's assignment tab in Waypoint.
For more detailed instructions, refer to the
Waypoint Tutorial (Links to an external site.)
.