In need of a 250 word response/discussion to each of the following forum posts. Agreement/disagreement/and/or continuing the discussion.
Original forum discussion/topic post is as follows:
- Select a chronic or terminal illness notdiscussed in the text readings and identify the symptoms, underlying pathological physiology, and stages of the illness. Discuss the experience of the patient with this condition and your approach as a crisis manager or counselor. How would you assist the individual, family members and loved ones?
- Outline your list of the common or “pat” responses to a person experiencing the crisis of death, or with suicidal intentions. What are the potential unintentional consequences? List your top six therapeutic approaches to the crisis of death, and then to the suicidal individual.
- Discuss the instinct for survival, and your analysis of appropriate crisis approaches for suicide prevention in children, teens, adults, and the geriatric population.
Forum post response #1
- For the first part of this post I chose the terminal illness of Huntingtons disease. Symptoms of the disease include an inability to control movements, behavioral changes, and body posture abnormalities. Also included in this list are changes in a persons judgement, cognition and emotions. This disease is caused by the degeneration and death of neurons in various areas of the brain that are involved in the control of voluntary movements. As the neurons die and a person progresses through the stages of the disease, they begin to lose control of their movements, exhibit a very rigid body posture, have issues with hand eye coordination, and become very jerky in their motions. They may also develop seizures and have difficulty with cognitive processing of information or events. Due to the unpredictable progression of the disease, people who develop Huntingtons will “usually die within 10 to 30 years following diagnosis.” (www.ninds.nih.gov) Since this disease will end with the death of the person, I would consider doing treatment that incorporated hospice care. Depending on the persons spirituality, I would consider suggesting they seek spiritual guidance and counseling to help cope with their inevitable death. I would also suggest the person seek counseling that incorporates the family and loved ones of those closest to the patient. This way they can all seek closure and understanding of the events about to come and start to work through the grieving process. Incorporating the family will also make it possible for all involved to be able to spend as much time together as possible before the persons passing. An understanding of the disorder, what their loved one will be going through and experiencing, as well as ways for all to cope will help guide them through this difficult time.
- Some of my automatic responses when someone tells me they are suicidal is to try and fix the issue. I tend to press too much in wanting to know what is going on and why and what I can do to fix it. I have to stop myself from doing this because I have to realize I cannot fix their issues. This can be extremely detrimental because I unintentionally make it more about what I want to do than what the person needs. This might push them more into a hole where they feel no one really cares about their real issues or reason for their suicidal ideations. My top six choices for the therapeutic process for suicidal person and to cope with death would be behavioral, cognitive, humanistic, psychodynamic, existential and integrative.
- The survival instinct is a drive that we are born with that keeps us safe. It alerts us to danger in the environment and enacts our fight, flight or freeze response. Children do not necessarily understand the concept of death or dying so trying to get them to understand the permanency of suicide would be the main focus. Choosing the words right and the way it is explained is vital to getting the message through. One does not want to use the same verbiage with a geriatric patient as they would a young child or teen. For geriatric patients I believe it would be more focused on comfort and having them connect with their family to establish their importance. They are at the end of their life and might feel they are unimportant, so suicide would be their option. If we can get them to connect with their family more or become more involved, it might sway their thinking.
Forum post response #2
Forum post response #3
A terminal illness would be Alzheimer’s Disease. This is defined as the most common cause of dementia and other cognitive abilities serious enough to intervene with daily life. There is also an early onset of Alzheimer’s that can be caught early on but there is no cure for this disease unfortunately. There are three different stages which are mild, moderate, and severe. In the mild stage the symptoms may be problems with coming up with the right word or name, trouble remember names when introduced, challenges performing tasks in a social or work setting, forgetting material that one has just read, losing or misplacing a valuable object, and increasing trouble with planning or organizing. The moderate stage is usually the longest stage that a person is in. Some of the symptoms are more noticeable during this stage as well. Some of the symptoms may be forgetting events or about one’s own personal history, feeling moody or withdrawn, being unable to recall their address, number, and other basic information, confusion about where they are or what day it is, trouble controlling bladder and bowels, the need for choosing proper clothing, changes in sleep patterns, increased risk of wandering or becoming lost, and personality and behavioral changes. The severe stage is the worse stage where the person will need extensive help to get through the day. They will need round-the-clock assistance with daily activities, lose awareness of recent experiences, experience changes in physical abilities, an increase in difficulty communicating, and becoming vulnerable to infections.
There are two pathological hallmarks of Alzheimer’s disease which are the extracellular beta-amyloid deposits and the intracellular neurofibrillary tangles. The beta-amyloid deposition and neurofibrillary tangles lead to loss of synapses and neurons, which results in gross atrophy of the affected areas of the brain, typically starting at the mesial temporal lobe. The mechanism by which beta-amyloid peptide and neurofibrillary tangles cause such damage is incompletely understood. There are several theories. The amyloid hypothesis posits that progressive accumulation of beta-amyloid in the brain triggers a complex cascade of events ending in neuronal cell death, loss of neuronal synapses, and progressive neurotransmitter deficits; all of these effects contribute to the clinical symptoms of dementia. Prion mechanisms have been identified in Alzheimer disease. In prion diseases, a normal cell-surface brain protein called prion protein becomes misfolded into a pathogenic form termed a prion. The prion then causes other prion proteins to mis fold similarly, resulting in a marked increase in the abnormal proteins, which leads to brain damage. In Alzheimer disease, it is thought that the beta-amyloid in cerebral amyloid deposits and tau in neurofibrillary tangles have prion-like, self-replicating properties. This is interesting how the brain works.
The crisis of death is something that is going to happen we just do not know when and sometimes it is unexpected which is when it is the hardest. The most common symptoms of someone experiencing the crisis of death are grief, depression, anger, hostile reactions, guilt, acute mourning, shock or denial, bargaining, and closure. I think for the crisis of death that the ongoing crisis counseling is what would be needed because this is something that would take time to heal from. This is where you will establish a supportive and empowering counseling relationship and do a complete assessment to see what is going on, helping the survivors to express and process memories and emotions related to the crisis of death, help to make and sustain necessary behavioral changes, help them to utilize different tools such as their beliefs, expectations, and personal meanings that optimize and reconciliation the death, look at their stage-of life needs, and help them to make healthy changes in their personal ecosystem.
The best therapeutic approaches to the suicidal individual would be immediate counseling to look and see the identity of the target is, the anger felt towards that target. You have to know what symptoms to look for with a person who is suicidal. Usually depression is one and anger outburst is another. Back in 2008 when I tried to commit suicide I wanted my life to end because I didn’t have a reason for living and felt unworthy in life. I know several soldiers who can’t deal with their war experiences that end up committing suicide. Cognitive approach is good to use because it allows you to see where they are at and break down everything. My counselor told me that these feelings of suicide are not permanent and gave me ways to look at things more positive and told me to not think about the things that I cannot control and to meditate to help push out the negative thoughts I would have. I think it is important that they know that you are on their side and you aren’t just another client to them. Some of the unintentional consequences would be that no matter what you try they may still commit suicide. There are so many different types of therapy out there that can be used but it is all dependent on the individual’s case.
The instinct for survival goes all the way back to survival of the fittest. It also depends on the person’s reason for wanting to live or die. I watched a show one time where a soldier was in pain all the time and could not handle not getting any treatment that he deserved and more medications shoved down him so he committed suicide. He felt that it was better to die because he could not get the help that he needed to get better and just gave up. Instinct allows us to have the will power to keep going on in life or whatever it may be. I think it is important to respond as soon as possible when you are dealing with death or suicide because the longer you wait the worse the symptoms can get. In order to help children and adolescents the crisis worker must have a working knowledge of normal development tasks for each age group (Collins, 2005). It is important to make sure can have an available adult there with the child as well. Play therapy from Adlerian has been known to work great for children because it allows them to work on something while talking the same time. When it comes to the elderly, the crisis worker should gain an understanding of the acquisitions, losses, and changes they have experienced. There are so many approaches that could be taken for each age group but it really depends on the person.