Student Name

Maryville University

NURS600

Professor Name

Submission Date

Introduction

Key Facts and Findings Developmental theories play an important role in patient care, irrespective of the patient’s age (Damis, 2022). This assignment aims at identifying, analyzing, and describing how a chosen developmental theory applies to a fictional patient scenario, and then connecting it to the treatment and management of an aging patient. I am a Nurse Practitioner in the Geriatric Population and also have a specialty in Nurse Management to explain how all the above-mentioned theories can be applied to the care plan of an elderly patient with advanced Alzheimer’s disease. Conclusively, it can be argued that by fostering the developmental and psychosocial needs of patients, their quality of life can be improved in regard to health.

Patient Case

• Patient Profile

Mr. John Doe is a 78-year-old man who has been diagnosed with an advanced case of Alzheimer’s disease. He is diagnosed with diabetes and lives with his daughter, who takes care of him. He also has a son who resides in a different state, and he rarely visits him. Mr. Doe is a type-2 diabetic patient who is hypertensive and has been on regular maintenance medicine, and is a retired engineer. Being a victim of this kind of illness, which has recently turned him into a widower, he is unable to cope with this disease with the assistance of his family. He has a daughter, who is also engaged in his daily care, and she is nearly always present to keep observing his physical and, even more, his psychological state, taking into consideration his constantly weakening dementia.

Developmental Stage Analysis and Integration of Theories

• Freud’s Theory (Psychosexual Stages)

He is now much older than the age range usually associated with psychosexual staging; these theories can still be potentially helpful in implementing Mr. John Doe’s care. When it comes to Alzheimer’s disease, the problem of anxiety and behavior issues in a patient may be related to the external fears and conflict, which are implicit (Godena et al., 2023). Although stress related to cognitive function may overwhelm him, the use of another defense mechanism, like repression or denial, may help. The caregiver should identify these automated aspects and act on them by speaking soothingly, making the environment in the best state possible, and being involved in other activities that would deactivate the anxiety system and activate the security system.

• Erikson’s Theory (Psychosocial Stages)

Using Erikson’s psychosocial theory, the person in the case, the patient, Mr. John Doe, is at the Integrity vs. Despair stage. Despair. It presents the paradox for end-of-life care to apprehend him in his heightened advanced Alzheimer’s Disease, yet there is a kind time to help him reclaim his integrity, as you discover and distill the accomplishments of his life and the part he played in creating his story. It has been proven that reminiscence therapy may help patients uphold their dignity and self-image, so it would be beneficial to talk about the positive aspects of the patient and evoke the memory of his or her achievements (Trejo-Lopez et al., 2021). Moreover, the elderly continue to require emotional support in aspects of life, such as disappointment management associated with undesirable cognitive alterations, as studied in the emotional development during old age, to facilitate their quality of life during old age.

• Piaget’s Theory (Cognitive Development)

The Piaget stages of cognitive development cannot be applied to Mr. John Doe completely, due to the fact that the patient is elderly and may likely be affected by Alzheimer’s disease, which impairs his cognitive abilities; however, the most important aspect in his treatment plan is the knowledge of cognitive processes. It causes dementia, which causes the mental faculty to degenerate progressively, e.g., forgetfulness and confusion. To integrate Piaget’s assumption, one has to acknowledge such cognitive alterations and adapt to their occurrence accordingly (Lei et al., 2021). This can include having Mr. Doe adhere to a similar schedule as a form of structuring his day, reminding Mr. Doe about his activities and tasks on a daily basis, getting Mr. Doe to perform various activities that challenge his state of mind, and developing a routine that will assist him as much as possible as a way of improving his quality of life.

• Vygotsky’s Theory (Sociocultural Development)

As Vygotsky and the Socio-cultural theory of development elucidate the value of social interaction in the development, the level that Mr. John Doe is at with regard to learning has put emphasis on the issue. Nevertheless, as one has Alzheimer’s disease, social interaction is very crucial since it helps in general welfare. Applying the theory of Vygotsky in his care, it is necessary to mention that the members of the family are to engage in significant and effective relationships with Mr. Doe. Normal visitation and maintenance of conversations that reference prior experiences, and use of hobbies and interests may be an important social exposing, enabling, and cognitive challenge that aids more learning and wellbeing of the patient even with the presence of the condition (Mintun et al., 2021).

• Smilansky’s Play Theory

Although Mr. John Doe cannot be directly analyzed using Smilansky’s theory of play because he is too young to be called an elder, he is not dextrous enough physically to do it, and his memory has deteriorated too much because of the effects of Alzheimer’s disease, this theory can be reduced and adapted to support his care. By organizing and planning activities and play-like therapies, for instance, music therapy as well as arts, or recalling events that took place in the past, it becomes possible to help Mr. Doe to recall the information that he received earlier and, at the same time, experience pleasure. These interventions give an opportunity to feel the sensuous textures of his surroundings, to express or not show feelings, to connect with others, and thus have a more fruitful life regardless of the ASD (Juan Carlos Ruiz et al., 2020). In this case, it will be possible to make use of play intervention to improve Mr. Doe’s cognition and psychosocial well-being using various individualized techniques.

• Bandura’s Social Learning Theory

Particularly in the case involving Mr. John Doe, the social learning theory by Bandura, with a focus on observational learning and modeling, has provided some valuable information on the possibility of providing care to him, despite his degeneration. By applying modeling and observational learning intervention, the caregivers in providing care to Mr. Doe must believe that they are attending to behaviors that encourage positive behaviors, and not those that lead to aggressive behaviors like agitation. As a loving caregiver, one can make sure Mr. Doe observes and repeats the desirable behaviors of a calm person, in teaching the conditional use of positive language and leading by example. Besides, scheduling and incorporating specific patterns and recognizable tasks will also help him to feel safe and comfortable, implying that additional proper communication with him can be enhanced, and distress experiences can be successfully minimized (Rumjaun & Narod, 2020). By implementing the theory of Bandura, observational learning can be employed by the caregivers as a way of developing an effective approach to improve the right behavior and improve the quality of life of Mr. Doe in spite of the low volume of PT that Alzheimer’s disease offers.

• Bowlby’s Attachment Theory

Observing the vital points of Bowlby’s attachment theory, it is possible to emphasize that the securely attached individuals’ states contribute to their overall well-being and resourcefulness at any stage of their life, even when it comes to such a period as elderliness, for example, Mr. John Doe, without any doubt. At the implementation of this theory, it is important that Mr Doe be assured and at ease with his daughter and the nursing and healthcare team through constant loving attention. Based on the readings of the attachment theory, therefore, by being mindful of the emotional sensitivity and bodily proximity that he has developed with Mr. Doe, the narrator builds a setting of fatherly trust and security in this context. This strengthened attachment results in buffering him from distress and enhances his capacity to deal with the strains of Alzheimer’s disease, thus strengthening his general psychological and emotional well-being (Granqvist, 2020).

Anticipated Treatment and Care Plan

• Medical Management

Continuous medication for Mr. John Doe’s Alzheimer’s, hypertension, and diabetes has to be addressed to adequately cater to his medical needs. Thus, the outcome of the process and potential side effects are effectively controlled by healthcare professionals with the help of routine follow-up on the medication schedule of the patient and modifications in the doses of the different chemicals. His health status supplementation allows a nurse to notice any changes prior to the emergence of complications and to prevent complications associated with his comorbid conditions (Yiannopoulou and Papageorgiou, 2020).

• Psychosocial Support

Organizing the reminiscence therapy could be a unique chance to contribute to the improvement of Mr. Doe’s sense of identity loss due to his dementia condition. Through the discussions and activities that make the patient recall good things in his life, Mr. Doe can have hope in life and a purpose to live due to the personal stories he hears or sees daily. Therefore, considering the needs of the carers as well as offering education and support to the carers will go a long way in controlling and preventing carer stress, hence promoting good caregiving (Pasquini et al., 2022). Empowerment of self-care resources to caregivers improves the ability of caregivers to address the caregiving tasks, as they would better address the needs of their caregivers.

• Cognitive and Behavioral Strategies

Applying various visible cognitive challenging tasks based on the ability of Mr. Doe is efficient in that it boosts cognitive qualities and preserves proper mental health. The brain activities, such as solving puzzles, word games, or perhaps music and singing-related games, assist in establishing neural pathways and, perhaps, prevent the process of cognitive degradation (Iodice et al., 2021). Also, behavior modification strategies like redirection and environmental modification are effective in sustaining signs of aggression and confused behavior patterns, hence enhancing the quality of life of Mr. Doe and making sure that he is safe.

• Social and Environmental Modifications

It is essential that Mr. Doe considers the safety and appropriateness of the alternative living arrangements because of his disability. His disability has contributed to the majority of these risks; thus, by eliminating the factors that pose danger and adding a few facilities, Mr. Doe will be less likely to fall or be involved in an accident. In this respect, engagement of the elderly with the rest of the family members or friends will assist in alleviating the feeling of loneliness, as it is a common feeling that most of the elderly experience (Iodice et al., 2021). In the same way, these social activities are vital in supporting his or her psychological needs as well as enabling meaningful interaction to improve his or her general social interaction skills as a human.

Conclusion

To sum up, the realization of the role of development theories in the treatment of the elderly, particularly those like Mr. John Doe, with a case of Alzheimer’s disease, has been vividly brought to light in this specific assignment. Thus, as per some of the related theories, such as those posited by Freud, Erikson, and other theories on the development of children, such as Vygotsky, etc., caregivers ought to offer certain and more rigorous interventions that will satisfy the perceived developmental/psychosocial needs of Mr. Doe. This is a more holistic approach of offering not only a plus to his medical needs but also the social-emotional and cognitive level. Therefore, appreciating the developmental theories and integrating them in the care closely to patients such as Mr. Doe will enable healthcare providers to make the later years of the lives of a number of patients, such as Mr. Doe, to be of a higher quality.