This section will feature an analytical exploration of the PICO questions while discussing the intervention and providing information that supports the claim. The essay writer topic is relevant due to the need to come up with an appropriate intervention for patients who are living with ALS. Ultimately, the paper will decide in favour of coming up with various coping mechanisms, versus the alternative of not taking action. Several effective coping mechanisms are available, and while combined they can be effective in improving the overall well-being of their patient and the family. It is vital to come up with strategies that provide the greatest support to the physical and emotional well-being of the patient. For those who are caring for these individuals, an understanding of the coping mechanisms also provides some relief to them. Throughout the duration of the terminal illness, various strategies can be put into place that can make the entire process easier. The specific PICO questions are (P) For patients living with ALS, (I) how does teaching coping strategies support physical and emotional well-being, (O) reduce the risk for depression and improve quality of life, (C) compared to not teaching these strategies? Essentially, this section will take into consideration patient-specific details, such as age and gender, which are important to consider when developing the best coping strategies. The purpose of this analysis is to provide the best response to the issues that are being faced by those who are suffering from ALS.
Intervention
Demographic Factors
In developing an appropriate intervention, it is important to take into account demographical components in developing intervention strategies that illicit the best outcomes for the specific patient (King, 2009, p. 23). According to O et al.(2021) “significant relationships between participants’ demographics (age and sex) and any coping strategy ‘that had an impact on ‘patient’s’ [quality of life] and mental health outcomes,” (p. 1839). When discussing “coping” it should be considered that there are two categories: problem-focused and emotion-focused. Oh et al., note that it is important to take both factors into consideration for the overall well-being of the patient.
Supporting Physical and Emotional Well-Being
Since ALS can have such detrimental effects on the entire family, developing a program that takes everyone into consideration, as well as the family dynamics of the patient, is so important. Typically, the patient is in her 40s to 60s, and is often a mother or grandmother. Considering this demographical component, it is often the case that the patient wants independence and is used to caring for the younger members of the family. Losing this ability can worsen the symptoms of depression (Judge, et. al., 2019, p. 82). As time goes on, the families and patients are juggling various confusing emotions that generate challenges about the roles they play in their families and in their social circles as well. Nurses are there to provide guidelines that a caregiver can use to complete the daily living tasks, taking them to appointments, assisting them in decision making that can impact their care, and keeping them company (Matuz, 2010, p. 292). Being a caregiver can be a rewarding process, but it can have an emotional and physical toll on the person who is providing the care.
Certainly, ALS is a progressive condition that takes a toll on the nerve cells in the spinal cord and brain, which calls for the patient to keep moving in order to help the chances of slowing the deterioration (Matuz, 2010, p. 293). With ALS, the patient needs to move even if that means they need assistance in doing so. Caregivers can help with flexibility and strength even after full function of the muscles has completely deteriorated. Ongoing psychical therapy is important (Matuz, 2010, p. 293). Physical therapy can include a schedule for at-home activities. Home exercises that involve stretching, for example, can play a key role in coping with ALS.
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Occupational therapy can also help in the coping of ALS. An evaluation of the ways that the patients move on their own in their environments will help determine the best program to put patients with ALS on. Various movement devices can be used to help patients find independence as much as possible. Nurses can do things like provide equipment, teach different ways of doing things, suggest technology that can improve the quality of life. Caregivers can watch the patient in their home and keep track of all the challenges they face in completing their daily activities. Providing additional ways for the patient to be self-sufficient will often improve their overall emotional state (Oberstadt, et. al., 2018).
Reducing Risk for Depression and Improving Quality of Life
Various psychological interventions can help address the depression that comes along with the overall diagnoses of ALS and the conditions that comes with it. “These interventions intend to help the patient and family in coping with the fear of death and dying, managing anxiety, and reducing feelings of isolation, sadness, despair and depression (Moritz…). A psychotherapeutic short-term intervention has shown to have some positive impact on the psychological state of patients with ALS, and they decrease depression and anxiety in many patients (Matuz, 2010, p. 294). Meetings with a psychotherapist play a significant role in alleviating some of the depressive symptoms, and thus it is important for patients with ALS to see a psychotherapist as frequently as is permitted. When the patient is not able to see a psychotherapist as frequently as they’d like, due to budgetary restraints, and other obligations, it is important that caregivers are giving ALS patients support and independence (Jakobsson, et. al, 2014, p. 21).
Not Teaching these Strategies
Without developing the coping strategies that have helped people with ALS, and their families, the condition can cause more grief on the stakeholders than necessary. The patients and families of those struggling with ALS can go through severe depression due to the unrelenting nature of this terminal illness. That is why it is important to have coping strategies that can help ensure anyone who suffers from the illness is able to cope in the best way possible. Without taking measures to utilize the muscles through exercises and stretching, the muscles will atrophy and waste away at a quicker rate (Maiser and Tiryaki, 2016, p. 260). This will make it even more difficult to breathe, walk, swallow and talk. The vast majority of people with ALS die due to respiratory failure, so the lack of exercise can make the problem appear at a much quicker rate (Maiser and Tiryaki, 2016, p. 260). Not teaching these strategies is an inferior option compared to teaching the coping strategies as much as possible.
Conclusion
Certainly, it is imperative that people suffering from ALS go through a care plan that helps ensure they are slowing the process of their muscle deterioration. A regular program that promotes the caregiver providing support to the patient while also giving them independence can result in a better overall quality of life for the person who is suffering from ALS. Augmenting the at-home care program with psychotherapeutics would be ideal. Additionally, developing a routine around the concept of support and independence will help the caregiver and the entire family of the person suffering from ALS to navigate through this terminal illness. As this paper has shown, various studies have been conducted and much of the research agrees with the strategies that have been put in place to help those suffering from ALS. Greater independence helps deal with the emotional trauma that typically accompanies ALS, and the support by the caregiver in conducting the stretching and other exercise will help keep the patient as healthy as possible, for as long as possible. The care program is definitely more beneficial that not intervening in a care program at all. After all, when this disease is tackled in a team effort, it becomes much easier for the patient to enjoy their final years of life with as little sadness and pain as possible.
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