CHE-325 final project

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Jan 9, 2024

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Harley Scott SNHU CHE-325 October 25,2023 1-3 Final Project: Milestone One For my final project I have chosen to focus on Joseph who is a 68 year old male Vietnam War Veteran for the client. This particular client has suffered with issues when dealing with his mental health issues for most of his adult life. Due to these issues he has not been able to maintain employment. Joseph has one daughter who is 40 years old that he does not have contact with from a marriage that did not last very long. In finding ways to work with treating his addiction as well as dealing with his mental health it can be possible to find strong resources when it comes to offering this client the best help. In looking at the word health through the World Health Organization they state is as being, “a state of total physical, mental, and social well-being and not just the absence of illness or infirmity.”(World Health Organization,2023). It is vital for providers to be aware of certain mental health issues or diseases their patients might suffer from, as well as, their physical health and their overall wellbeing. In most older individuals it is common for them to suffer from a certain mood disorder called depression. This tends to be caused by any form of distress as well as the patient and any suffering they have endured. In looking at the client Joseph we can notice that he has been located in his own room after struggling to get along with other potential roommates. He tends to stay in the confinement of his own room and does not often join in on the events happening within the home. Joseph tends to

be frightened by loud noises and in those times he becomes a danger to himself as well as those who are around him in those moments. Joseph has suffered from the disease of depression for quite some time and that can be seen as the reason he prefers to be left in his room, alone. He was also a member of the military for a part of his life and this can be seen as a possible reason for his current medical issues. More often than not individuals who served in the armed forces tend to develop a condition called post-traumatic stress disorder, also called PTSD. They develop this most times because of the things they endure while serving. Veterans tend to be diagnosed with more mental health problems compared to their civilian counterparts. Such as the use of drugs, injuries to their brain also called TBI’s, and the inability to receive a proper sleep. “There are many parts of military life that do not transition to civilian life seamlessly and this leads to many veterans not being able to reacclimate into society after their service has ended.”(Olenick & Flowers, 2015). In the United States we have a program called the Veterans Health Administration, also known as the VHA. This program specifically makes sure that those who served our country are given access to healthcare. Thanks to something called the Choice Act, there has been more of a voice in making sure healthcare is included in there as well as offering the treatment needed for those issues. It has also been made easier for those veterans to seek this help within their own homes and in their local areas. It is also now a requirement that this treatment is given within thirty days after it is asked for. This will allow them to find ways to cope with things like PTSD and what they can do to help balance this issue within their lives. This is a massive step in helping our veterans who are suffering with mental health issues. There is also more effort in making sure that there are facilities for these veterans to see even if they live within a rural area. It is important for this treatment not to be too far out of the way but

offered within their community. If this kind of care is not offered in a reasonable distance most of these veterans find ways to cope in other ways like illegal drugs in order to find some sense of peace. Trauma can cause issues within several parts of a person’s life. For example, issues within the family and causing separations. It can cause a financial issue in finding different and illegal ways to deal with the trauma. “Veterans who do not suffer from debilitating effects are more likely to see a positive financial effort.”(National Veterans Foundation,2018). Specific Health Domain* Recommendations * Resources Required Order of Implementation Desired Outcomes (Improvement Measures) Justification Social Patient join a support group with other individuals who suffer from PTSD and could offer the encouragement and support patient might need in order to get more social with other Veterans within the home. A community center or a VA center where other individuals who suffer from PTSD hold their meetings at. Second. I believe seeing a therapist would be the best first step in starting the process of treating and coping with PTSD. This should possibly help with the depression and help with the isolation the patient currently does to himself. It will allow him to make friends within the home and not keep to his room and possible get him out and joining in activities. I believe this will allow the patient, Joseph to become more social which seems to be a major issue as of now. It is keeping him from having roommates and getting out of his room. If he knows there are others who are experiencing some of the same things that he is going through he might not feel so alone at the home. Psychological Patient begin speaking with a licensed therapist who could help find the things that trigger the patient and A VA approved therapist that will be able to help the patient talk through the issues as well as find healthy ways to cope with First. I believe this step will be the most beneficial in helping the patient deal with this disorder and find ways to cope This will help with the patient and dealing with his triggers. This will help with the outburst and help the patient no longer be a This will help the patient and him having outburst at unexpected sounds and things that are happening around him. It

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cause the outburst. those triggers and possible offer a medication to help with the anxiety. with it in a healthy manner. danger to himself or others in the home. will offer him healthy way to deal with those things as well as possibly give him the option of medication that can help with the constant anxiety. Physical Patient begin to receive acupuncture as well as exercising the body at least twice a week. A gym within the VA home or a community center that is located in a close distance that will be easy for the patient to use and have access to. Third. This will help with the patient. However, it falls last compared to the other two solutions. This will allow him to feel better about himself as well as offering a solution in becoming more active and helping work his body and his mind. I think this will just help the patient feel better about himself. It will give him a sense of accomplishment and allow him to help his physical and mental state be in better standing. The patient at hand is an older gentleman named Joseph who currently resides in a VA home located in Baltimore. He is having some issues with getting along with possible roommates which makes his living situation rather difficult. He also prefers to spend more time alone and in his room versus getting involved in the group activities that are being offered for the residents. If Joseph happens to be startled with loud noises or unexpected sounds it can cause him to act rather strange and become very erratic. This is dangerous because it could cause him to harm himself or do some serious damage to those around him. Although it is not stated within his paperwork it is clear he could suffer from something called PTSD, also known as post traumatic stress disorder. This can be assumed because most of the symptoms that Joseph presents tend to be related to PTSD. It also tends to be rather common in those who have served for our country. It would appear to be true that as of now the only help Joseph is receiving from the VA would be the housing situation. If he continues to go without receiving help for his current condition it can

cause some rather serious issues. This particular disorder if it goes untreated will continue to make the patient decline. “PTSD can cause life-altering consequences, including hospitalization, unemployment, and poverty; about 30 percent of Veterans with untreated PTSD take a more chronic course.”(U.S. Department of Veterans Affairs,2018). Around 2017 there was a study done that took about 5,826 Veterans that stated, “12.9% were diagnosed with PTSD; this is a striking high rate compared to the incidence of PTSD among the general population as just 6.8% of the U.S. population will experience PTSD at any point in their lives.”(Hill & Ponton,2021). When it comes to treating the condition known as PTSD we can currently see the traditional approach as different forms of drugs as well as therapy sessions with a licensed psychologist. Some of the pills that can be used are things such as Zoloft and Prozac which have been proven to allow the patient to relax and find a form of peace. There is also the treatment for PTSD with things like therapy, “another treatment option is trauma-focused psychotherapies; trauma focused means the treatment focuses on the memory of the traumatic event or its meaning, these treatments use different techniques to help individuals process their traumatic experience.”(U.S. Department of Affairs,2018). However, it is important to also look at Complementary and Alternative Medicine that can be used to treat PTSD in patients. CAM usually talks about the techniques that can be used with or completely replace regular western medicine. CAM techniques that can be used to treat PTSD can be things like meditation, certain breathing exercises, acupuncture methods, and so on. These techniques have started to become more popular and more used to treat certain mental health issues. The most common one used is acupuncture. This came from Chinese culture and is a process that takes extremely small,sharp needles that are placed on certain areas on the body that help isolate certain areas to possibly eliminate or relieve certain problems a patient may be

facing. The Department of Veterans Affairs have found this to be a cheap treatment method and have approved it as a form of treatment for Veterans. This has allowed the patients to start eliminating stress as well as anxiety. It has been shown to also help the body’s autonomic nervous system and the structure of different areas of the brain. This has helped the symptoms that come from PTSD. “Another effective CAM therapy is trauma-sensitive yoga, it has shown to offer wonderful healing benefit to a variety of populations, including those with mental health conditions, and is widely known for stress relief as it has been proven to reduce physiological arousal in PTSD patient and is believed to affect the pathology of PTSD by improving somatic regulation and body awareness, which are imperative to emotion regulation.”(Gallegos,2017). There are certain lifestyle changes that can also be made in order to help with the symptoms and side effects of PTSD. One of those things can be joining a support group of those who suffer from the same issues and offer a sense of understanding and can give some valuable information. Another lifestyle change would just be moving and exercising your body. This will allow for the physical body to feel good and in return can allow the mental part of our bodies to feel better. A patient recovering from PTSD can be a long but beneficial process. This type of healing can take time but the patient has to remind themselves that though it seems hard at times it will be worth it in the end. It could be seen that healing the relationship between the patient and the daughter would play a rather important role on the patient’s mental health. This disconnection between the patient and his daughter can be known as emotional disconnect “people managing their unresolved emotional issues with parents and siblings, and other family members by reducing or totally cutting off emotional contact with them, in order to reduce their anxiety.”(Babbel,2011). We are not entirely sure if the reasoning behind the distance was to allow Joseph to maintain a healthy

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mental state or even the daughter trying to maintain her mental health and understanding this relationship was not a healthy one. It can be seen that some of the relationships in Joseph's life might not be beneficial to bring back up but his relationship with his daughter could be seen as savable. We could look at a couple of wellness strategies when it comes to the patient. It would be important for him to start by seeking professional help. Based on the National Center for PTSD, “trauma-focused psychotherapies that focus on the traumatic events the patient went through are most effective for treating PTSD. PE will allow the patient to focus on thoughts, feelings, and situations that they have been avoiding.”(National Center of PTSD,2018). CPT will have the patient take the more negative thoughts and put them to a more positive outlook. It is important to avoid negative thoughts and focus on positivity. EMDR will be a therapy that involves the use of sounds and vibrations while the patient is focusing on the memories. It allows for the brain to recreate these memories and see why these events happened. The patient can also focus on creating a healthier lifestyle. He can do this by finding support groups to join and seeking an exercise program. The patient can also be given a healthy diet which will allow the brain to work properly. “PTSD involves inflammation, oxidative stress, brain chemical irregularities, gut microbiome dysbiosis, and mitochondrial dysfunction. Building evidence suggests that diets, such as the Mediterranean diet, can have a positive influence on each of these mechanisms.”(Howland,2018). There is plenty of research that has been done to show how beneficial it is for individuals who suffer from PTSD to take on a healthy diet in order to help the brain function more properly. The first plan of action for our patient will be to get him signed up for VA insurance if he is not already signed up. After he is officially on some form of health care it is important to find him a

primary care doctor. This person can begin to treat the anxiety and depression and get him medication, they can also then find him a therapist to start seeing. It will be of utmost importance for his primary care doctor and his therapist to stay in contact and monitor the medication and the therapy. The main goal will be to eventually lower the medication to where he hopefully will not need to be on it at all. It will be important for him to find a support group to join and speak with individuals who are going through the same things. The current recommendations can be kind of difficult for the patient because he has a hard time currently leaving his room and getting out within the home he currently resides in. It is clear that socialization should be the first step in order to get the patient out of his shell and feel comfortable talking with people. After this we can then start the patient on seeing a therapist and helping him find that healthy relationship within himself first. However, Joseph needs to admit that he needs the help and that he is willing to put in work. Most of the individuals who suffer from PTSD do not like to admit that they need help because it makes them seem weak. Unfortunately, for most that have been involved in the war come home with trauma they do not want to talk about. It needs to be talked about more with veterans and finding ways to help with the trauma they face. These plans have been given in a certain order. However, it is important that Joseph does the steps in the order he finds to be most beneficial for him. If he tried to do it all at once it could become far too overwhelming and the treatment could be proven to be unbeneficial. Individuals who were affected by war tend to face several long-term issues. When these individuals face these issues without seeking out help it can cause serious issues like substance abuse or suicide. “In 2020, there were 6,146 ,veteran suicides, which averages 16.8 veterans dying by suicide everyday.”(Hooper,2021). The recommendations that were given for Joseph

will hopefully improve his quality of life. This plan focused on healing his trauma and allowing him to live a full and healthy life. It will also allow him to start working on a relationship with his daughter.

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References American Psychiatric Association. (2020, August).What Is PTSD? Psychiatry.org. https://www.psychiatry.org/patients-families/ptsd/what-is-ptsd Babbel, S. (2011).Effects of Trauma: Estrangement From Family. Psychology Today. https://www.psychologytoday.com/us/blog/somatic-psychology/201107/effects-trauma- estrangement-family Ding, N., Li, L., Song, K., Huang, A., & Zhang, H. (2020). Efficacy and safety of acupuncture in treating post-traumatic stress disorder. Medicine,99(26), e20700.https://doi.org/10.1097/md.0000000000020700 Hooper, C. (2021, July 28).Suicide Among Veterans - Why are Veterans at a Higher Risk of Suicide?American Addiction Centers. https://americanaddictioncenters.org/veterans/suicide- among-veterans Howland, G. (2018, September 17).Ways to conquer PTSD - why diet really matters! Food and Mood Centre. https://foodandmoodcentre.com.au/2018/09/ways-to-conquer-ptsd-why- diet-really-matters/#:~:text=PTSD%20involves%20inflammation%2C%20oxidative%20stress National Center for PTSD. (2018).Understanding PTSD and PTSD Treatment. https://www.ptsd.va.gov/publications/print/understandingptsd_booklet.pdf Song, K., Xiong, F., Ding, N., Huang, A., & Zhang, H. (2020). Complementary and alternative therapies for post-traumatic stress disorder.Medicine,99(28), e21142. https://doi.org/10.1097/md.0000000000021142 National Veterans Foundation. (2018, July 26). Veteran Mental Health – Facts and Stats that need to be addressed. https://nvf.org/veteran-mental-health- facts-statistics/

Olenick, M., Flowers, M., & Diaz, V. (2015, December 1). US veterans and their unique issues: Enhancing health care professional awareness. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4671760/ Tsai, J., Harpaz-Rotem, I., Pietrzak, R. H., & Southwick, S. M. (2012). The Role of Coping, Resilience, and Social Support in Mediating the Relation Between PTSD and Social Functioning in Veterans Returning from Iraq and Afghanistan.Psychiatry: Interpersonal and Biological Processes,75(2), 135-149. https://doi.org/10.1521/psyc.2012.75.2.135 U.S. Department of Veterans Affairs. (2014).VA.gov | Veterans Affairs. Va.gov. https://www.ptsd.va.gov/understand_tx/meds_for_ptsd . Asp Veteran community care eligibility - veterans affairs. (n.d.). https://www.va.gov/COMMUNITYCARE/docs/pubfiles/factsheets/VA-FS_CC Eligibility.pdf World Health Organization. 2023. Health and Well-being. https://www.who.int/data/gho/data/major-themes/health-and-well-being#:~:text=The%20WHO %20constitution%20states%3A%20%22Health,absence%20of%20disease%20or%20infirmity. %22