Topic 5 DQ 3
Dad Dad-Jack Lemmon Son-ted danson Grandson-ethan hawke Overview • Background of the Movie DAD •
Functional Assessments • Analysis of Health Assessments • Additional Observations • Nursing Considerations and Interventions • Conclusion Background of Dad • • Jack Lemmon, Dad, plays the aging father of Ted Danson, his son. Always proud of being able to fend for himself, Lemmon despises being reliant upon others, but his enfeebled state does not allow him his old independence. For his part, Danson resents having to care for his dad, who is in early stages of Alzheimer’s disease. Things take an upward turn when Jack Lemmon becomes filled with self-confidence. But then Lemmon is stricken with cancer, an affliction that he can’t jolly himself out of, and as the reality of his imminent death strikes everyone around him, Lemmon retreats into fantasy, recalling the past happy events of his life as though they’re happening here and now. The rest of the family humors their dying dad, and in so doing draws them closer together than they’ve been in years. “Right click” in the image above, hit preview and play for trailer of movie. Functional Assessment • • • Health Perception/Health Management • • 78-year old man in general good health • • Nonsmoker and occasionally drinks wine at dinner settings Able to walk w/o assistance, dress and bath self, and no history of falls Early stages of Alzheimer’s disease, and during the movie is diagnosed with cancer Nutrition/Metabolic • • • Regular diet with appetite, drinks plenty of fluids No recent weight loss and skin appears pink and intact No dentures and wears reading glasses Pattern of Elimination • • One bowel movement every 1-2 days Urine is clear until blood occurs in the urine before he is diagnosed with cancer Functional Assessment • Pattern of Activity/Exercise • • • • • • Daily walks, except when hospitalized (then stiff with limited activity) Enjoys gardening, chess, bingo and other leisure games Able to groom self and use toilet Normal range of motion and able to grip items Conceptual/Perceptual Pattern • • • • • Steady gait and able to walk 0.5-1.o miles Alert and oriented x3, with periods of forgetfulness (Jarvis) No dentures and uses glasses to read Clear speech After diagnosis of cancer he is traumatized and is alert, but has loss of memory of people and surroundings with limited speech Pattern of Sleep and Rest • • Normal sleep patterns After diagnosis of cancer has periods of sleeplessness and occasionally sleeps under bed because of fear of dying Functional Assessment • Pattern of Self Perception and Self Concept • • • • Makes good eye contact and clear speech when talking with family and others Once diagnosed with cancer has decreased perception of self and unable to recognize self, others, and surroundings Role/Relationship Patterns • • • • Is upbeat and feels good about self always wanting to do activities with family • Lives with spouse and has family support Decreased relationship with son in the beginning of the movie until relationship becomes resolved as son takes care of Dad Towards end of movie family relationships are healthy and supportive Social outings to events like bingo, dining Sexuality/Reproductive Patterns • Sexual relationship is appropriate to age Functional Assessment • • Pattern of Coping and Stress Tolerance • • • • Unable to cope with diagnosis of cancer Temporarily loses perception of self, people, and surrounds Periods of shaking/rocking back and forth, unable to sleep in own bed (Goldberg) Family unable calm Dad down during bouts of stress Pattern of Values and Beliefs • • • Doctor diagnosis him with “Successful schizophrenia” after he regains memory from cancer diagnosis Has a temporary period of retreating back in time 20-40 years ago from suppressed memory and wants to go dancing, fishing, and other activities. Catholic, but not actively attending church Analysis of Health Assessment • Normal assessment findings • • • • • • • Alert and oriented x3 and skin is intact Free from pain and distress Steady gait and walks 0.5-1.0 miles often Good appetite with regular bowel movements Enjoys family and social activities (chess, bingo, walks) Good relationships with family Abnormal or risk-based findings • • • • Early onset Alzheimer’s disease as evidenced by periods of forgetfulness Recent diagnosis of bladder cancer Unable to cope as evidenced by loss of perception of family and surroundings Recent diagnosis of successful schizophrenia Additional Observations • • • • • Cultural • • • Heterosexual Caucasian with American values Likes family gatherings and social events Believes in individual independence Geographical • Setting is located in Los Angeles, California Religious • Catholic family, however not actively attending church Ethnic • Retired Caucasian living in a primarily white middle class community and socializes with an elder group Spiritual • • Believes in God Prays for family and medical condition Nursing Considerations • • Anxiety related to uncertainty about outcomes, feelings of helplessness and hopelessness, and insufficient knowledge about cancer (Carpentito). Interventions • • • • Expect initial shock and disbelief following diagnosis of cancer and traumatizing procedures (disfiguring surgery, death). Reinforce teaching regarding disease process and treatments and provide information as appropriate about dying. Be honest; do not give false hope while providing emotional support. Encourage verbalization of thoughts or concerns and accept expressions of sadness, anger, rejection. Acknowledge normality of these feelings. Resources • • American Cancer Society. www.cancer.org American Cancer Society is on a mission to free the world from cancer. They fund and conduct research, share expert information, support patients, and spread the word about prevention. Nevada Cancer Research. www.cccnevada.com This is a large research program in the state of Nevada to help cancer patients. Conclusion • Dad is a heart felt movie that draws family closer after a family crisis occurs. The crisis draws the dad and son closer from a relationship that appeared broken. In addition, the son, Ted Danson, reestablishes a relationship with his own son that he left when the son was 5-years old. After early onset Alzheimer’s disease, Dad is diagnosed with cancer at the age of 78. Dad is unable to cope after hearing the news and is unaware of family and surroundings. Weeks later he finally becomes aware of everything and then lives in a fantasy world from suppressed positive experiences he’s held inside for 20-40 years. He starts reliving past experiences and becomes happy and energetic. This period bonds the family closer. In the end, dad finally loses his battle to cancer that spread to the lymph nodes. References • Carpenito, Lynda., (2013). Handbook of Nursing Diagnosis. 14th Edition. Wolters Kluwer/Lippincott Williams & Wilkins. • Goldberg, Gary., (1989). Dad. United States. Amblin Entertainment. • Jarvis, Carolyn, (2016). Physical Examination and Health Assessment. 7th Edition. St. Louis, MO: Elsevier.
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