Parkinson’s Disease Case Study

Parkinson’s Disease Case Study

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 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 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.

Late phase

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