- Nicoline Bromwell
Scenarios
1) A 65-year-old female, recently diagnosed with Alzheimer’s Disease. She has previously been a very active and vibrant woman, living on her own since her husband of 35 years died 5 years ago.
2) A 14-year-old minority female, facing the very real possibility that she may be pregnant. She has always struggled in school (she has been failed a grade already), and is currently a freshman in high school.
Address the following questions/issues for each of the two scenarios you selected:
1) How would you design an environment to improve this person’s situation and future development?
2) What kind of environmental factors would hinder this person’s development? In other words, what environmental issues would make their situation worse, or what would you hope not happen in this person’s world?
3) Discuss how the person is affected in the three domains of development (Biosocial (Physical), Cognitive, and Psychosocial). How might decreases or increases in development/maturity/ability affect the person? Basically, do several “ If/then” discussions for each of the three domains. For example, “ If this woman has a poor psychosocial support network (like have no family or having an unsupportive family), then I would think that she may experience…”
A love one diagnosed with Alzheimer can be very troubling for a family. Alzheimer’s disease can be a challenging journey, for all those who are involved both family members and loved ones. Taking care of someone with Alzheimer’s is overwhelming at times, but the more knowlegde and support the individual has, the better he/she will be prepared for the challenging road ahead and is able to seek the best long-term care options for a loved one.
The best environment to help the individual development as time progresses would be one that provide loving care whether at home or in a designated facility for Alzheimer’s patients. Firstly, if she is still lucid enough, since she’s recently diagnosed I would encourage her family to get her wishes down on paper so they’ll be preserved and respected by all members of the family. I would then recommend that the family discuss the situation with her doctor , keeping in mind her wishes , see what would be the best treatment for her. They would then be armed with the knowledge of how to care for that love one.
She will at some time need around-the-clock care and family members usually have their own health issues, jobs, and responsibilities. I would advise them to communication with each other to make sure that the wants and needs of the Alzheimer’s patient is met. If they cannot provide the care at home, since she was living alone, she could be relocated to live with a family member, which I would recommend, although it may be difficult, a care giver could be employed to care for her and that the caregiver would have the support of the family member to meet her needs. It will be diificult for her and her family as they have to watch her deteriorate slowly, but at home she will be monitored by love ones and most likely get the care she needs, although as the disease progresses, she may need to be hospitalized in a facility, if it becomes too hard for the family and caregiver. However for now the home environment is best.
I would suggest that a sense of structure and familiarity is kept. A daily time for activities such as waking up, mealtimes, bathing, dressing, sharing family time, and bedtime. Keeping these things at the same time and place can bring a sense of familiarity to her.
Let her know what is going to happen even if there is no certainty that she’ll truly understands. Use cues to start the various times of day. For example, when she wakes up you can say, “ Rise and shine Mary , it’s another wonderful day.” At bedtime, you can play some quiet music or read to her, to indicate its bedtime. Also get her involved in daily activities as much as possible, as long as it is safe. For example, water the plants, folding clothing, or any other simple thing that she can do. These things will not improve her condition. But it will aim in making her more comfortably as she struggles with this disease The most that can be done for her is to make her feel loved.
The worse care scenario would be if her family members are not able to get her a caregiver or put her in an institution for Alzheimer’s patient and they have to take care of her, with little or no training or knowledge of her condition. This would definitely worsen the situation. As her Alzheimer’s progresses, there will be changes in her communication skills, she’ll have trouble finding words, her hand gestures will increase, she’ll be easily confused, she’lldisplay behavior you never would have thought possible. Alzheimer’s will cause substantial changes in how she behaves, such as embarrassing or inappropriate outbursts, wandering, hallucinations, and violent behavior. Everyday tasks like eating, bathing, and dressing can become major challenges. This will become frustrating for the family members, as they don’t know how to deal with it. Imagine watching your mother change before your eyes, worsening daily and you cannot do anything about it. The family member offering care can become overwhelm and depress, he/she may even start blaming him/herself and may become too embarrass to go out, so he/she may isolate himself, or even harm the patient not willingly but as a result of being overwhelm. At some point, the care giver won’t be able to leave her one alone. Nighttime behaviors may not allow the care giver to sleep, confrontational or aggressive behaviors may exceed her ability to cope or feel safe. As the disease progresses help will definitely be needed and possible placing her in a facility that is better able to take care of her. Therefore, if this can’t be done the situation would not be hopeful.
Alzheimer’s disease is an irreversible, progressive brain disease that slowly destroys memory and thinking skills, and eventually even the ability to carry out the simplest tasks. Cognitive, physical, and psychosocial development is decreased. There is decline in memory and other aspects of cognition, such as word-finding, vision/spatial issues, and impaired reasoning or judgment, getting lost, trouble handling money and paying bills, repeating questions, taking longer to complete normal daily tasks, using poor judgment, and having some mood and personality changes. She’ll have problems recognizing family and friends. She’ll be unable to learn new things, carry out tasks that involve multiple steps (such as getting dressed), or cope with new situations. People with severe Alzheimer’s cannot communicate and are completely dependent on others for their care. Taking all of this in consideration whether if she has a strong or poor psychosocial support, it would not make much of a difference to her as all her cognitive skills are declining and will soon be gone. Physically she’ll may soon be bed ridden, Knowing no one and not able to take care of herself. The disease takes everything away from her.
A student who is 14 years old facing a real possibility that she is pregnant and struggling in school faces many challenges. On her own it’s a frightening struggle. She needs supports, guidance and education, At this time family is very important. Therefore, the prefect environment for her would be one where she feels love and support. She needs someone she can talk to and trust, who can offer guidance and support. Sometimes the father is not present and this is usually the case. She is now frightened at the fact that she now has to face this alone, the realization that a new is life growing inside of her is quite unsettling as she is not prepared and she doesn’t know how to cope. She questions herself, “ How am I going to take care of a child?”, “ What are my peers going to think about me?”, “ How are they going to treat me?”, “ Should I keep the baby?”, “ I am failing in school, How can I take care of a child?” ,“ Who is going to take care of me?” She has so many questions; she needs help getting those answers. She needs help finding herself and moving into the right direction.
The environment that would be ideal for her would have to help her deal with the situation she is in and help with her future development. Firstly I would encourage her to make sure she is pregnant before doing anything else, and if she is then I would help her find someone she can trust and is able to talk to, such as a counselor, a family member or a teacher, so that she can make informed decisions. She would now need to tell her parents and if they are willing to help her, we can start from there. If they were not, she would need someone who is willing to offer support, for example an organization for pregnant teens, where she can relate with others in her own situation, or a supporting relative. When this is accomplished, She now needs to continue school, which will be difficult, but quite necessary, and she needs to decided whether or not she is able to keep the baby, and if she chooses not to, she can have an abortion or give the child up for adoption, which I would encourage, then continue on with her schooling. Hopefully, she will learn from her mistakes and get help in order to improve her grades , therefore doing better in school. If she is with a supportive relative, she can get an after school job to help herself and through education she’ll have a better future. However, if she chooses to keep the child, which would not be wise at 14, with her social situation, she’ll need to also finish school and get help in improving her grade. She’ll also need a job to help support herself and her child. However if her parents offer to help she’ll have some support in taking care of the child. Otherwise keeping the child would be a very hard task for 14 years old on her own. Therefore, she would need to make an informed decision taking into consideration what is best for herself and the child. This she would do with the help of a responsible adult. I would advise her if she has no help to give up the child for adoption because at 14 she is a child herself. She is not physically, socially, or emotionally ready to be a mother. It is obvious that she is not able to make responsible decisions on her own, at her age; her cognitive skills are still developing. Throughout the entire process, I would ensure that she has someone to talk to because she needs this kind of support to get through the situation emotionally.
As she is being prepared to deal with her situation and faces the coming obstacles in her pathway, I would hope she learns from her mistakes and realize that this is not the ideal situation for her . If she doesn’t then this could have devastating impact on her future taking in consideration the fact that she is failing in school. This could be as a result of lack of parental guidance, if they are too busy working or doing something else to see what is happening in their daughters life, she has no extrinsic motivation to excel, and she is obviously not intrinsically motivated , she just does what she wants, or is influenced by her peers and at this age teenagers naturally want to explore and try new things, this could be why she is pregnant. Now being faced with and adult issue at an early age, she has to be the one to take her future in her own hand, if she does and decide to move on , she will face , criticism from her peers, and she will stuggle with the fact that she has to give up her first child, she is pregnant at 14, and she faces the danger of herself and the baby being malnourished, or being born with illness and deformity as a result of not having adequate medical care. She also faces a higher risk for postpartum depression than adults who give birth, and if left untreated, postpartum depression in a teen can affect her development and her infant’s quality of care, if she keeps the child. She’ll have to misses school for doctors visit, and she is already failing.. She has to deal with these situation daily, using her teenagers abilities. Hopefully, she is able to overcome these struggles with help from an adult and effectively continue with her life. However if she cannot, she may end up pregnant again not having any education. A Guttenmacher Institute study found that a large percentage of teen moms often find themselves homeless, in non-permanent living situations, as they move between the homes of friends, siblings, other family members and baby’s father. So now she may seek the support of the first person offering her kindness, and this may not necessarily be a good thing, she could end up being used and abused with little hope for the future. Living on the streets, or living with an older man at an early age, prostitution and so much more may result from her situation.
Her situation now greatly impacts her Physical, Cognitive, and Psychosocial development. . During this time the mother is still developing physically, she needs proper nutrition in order develop properly, now with a baby growing inside her she’ll need more food from every food group so that the baby can develop properly, if this is not done them they both could be malnourish causing problem with the baby and placing extra stress on her body. If she drinks alcohol this can cause the baby to develop fetal alcohol syndrome which occurs when alcohol passes through the placenta, causing potential physical and mental defects. However if she is properly nourish then most likely she will develop fine and her baby will be healthy.
Also her cognitive development will be hampers as she will miss school, even drop out and during this stage cognitive development is marked by an increase and missing out will impact the teenagers advancement in knowledge and understanding. Research has shown that“ The dropout rate among teen mothers in the U. S. is high, and this population represents a large percentage of the total high school dropouts. Only about half of teen mothers earn a high school diploma by the time they turn 22, and earning a diploma may be more difficult for teen moms who have a second child.” As a result the teenager is not educated, cannot hold a good job and lives in an impoverish condition. Statistics have shown that this behavior is usually repeated with the teenagers children.
Psychosocial development is also hampered as during this stage of psychosocial development, according to Erickson, teens need to develop a sense of self and personal identity. Success leads to an ability to stay true to yourself, while failure leads to role confusion and a weak sense of self. Being pregnant at this stage , the teen as no sense of self or personal identity, she is struggle with the situation, She is identified as a teenage mother, her sense of self is distorted. She is confused, and frustrated and easily mislead into situations that may be worse for her. However if she has support and someone to offer good council this situation may change, her self-esteem can be build and she will not look at herself through the eyes of others, but she will see her potential and see the present situation as a learning experience.
