Chronic Disease Discussion Assessment Answer

Concern 1: Emotional Isolation and Separation from Family

Mr. W's emotional isolation and sense of being cut off from his family are his primary worries. He feels empty and lonely because he is estranged from his wife and separated physically from his children. In addition, the fact that he was unable to visit his kids for three years due to tense interactions with them adds to his sense of failure as a parent. Mr.W is also bothered by the fact that he is not seen as an important part of his children's lives, which has left him feeling constantly abandoned. He also feels physically trapped by the walls of his apartment because of his limited physical mobility. His mobility and this mental restriction together have further worsened his connection with the outer world. Due to all this, he feels lonely and suffocated as his condition is having a detrimental impact on his emotional and physical health.

Concern 2: Lost Self-Worth and Purpose

The second major concern in the case of Mr.W is his physical inability and unemployment. His inability to provide for his family makes him feel insufficient for them. This surrounds him with a loss of self-worth in life and makes him raise questions related to his own existence and its purpose. The house in which he currently lives reminds him of materialistic accomplishments, which is accompanied by a reminder of his failure with respect to his personal relationships. This also makes Mr.W doubt his own accomplishments and forces him to come to terms with the difference between his current life and the one he used to live at a certain point in his life. Lastly, this also affects his motivation to lose weight and work towards improving his health.

Concern 3: Stopping Antidepressant Medications and Neglecting Overall Health

The third and final concern that presents itself in this case study is the decision taken by Mr. W to stop taking his antidepressant medications. He firmly believes that these medications have had no effect on his condition and has lost all hope regarding any improvement with respect to his current state. In addition to this, his habit of smoking eight cigarettes a day and heavy consumption of alcohol, i.e., two bottles of beer at night and wine after dinner, indicate coping mechanisms used by Mr.W to deal with his emotional distress and sense of longing and abandonment. However, this routine also highlights his self-destructive attitude.

Potential complication 1

The first potential complication that can arise from untreated separation and emotional isolation is the risk of going into depression which would lead to increased dependence on substances, further deteriorating his emotional health. In additon to this, the worsening of emotional health can also have an adverse impact on Mr W’s physical health. For instance, a study by Tragantzopoulou & Giannouli (2021) revealed that social isolation affects emotional and physical health in older adults and increases vulnerability to other related health issues. This can result in further complications with respect to other health problems and weaken his will to actively participate in diabetes management or follow the treatment plan for his kidney failure.

Potential complication 2

The second complication can be due to neglecting the emotions of lost self-worth and purpose in life. This can, too, exacerbate the symptoms of depression, and Mr.W can find himself trapped in an endless cycle of unpleasant and negative emotions and thoughts. This can have an impact on his motivation and willingness to get involved in activities related to his self-care. A study by Lee et al. ( 2020) found that loss of self-worth can lead to depression in older individuals and give rise to the development of other mental health problems. In action to this, it would also prevent Mr.W from seeking appropriate help or getting in touch with suitable healthcare professionals for the management and treatment of his existing health issues. For instance, Mr.W might not act on the reference given by his GP to a vascular surgeon for a review of a black discolouration on his right big toe.

Potential complication 3

The third and final potential complication would stem from Mr.W’s decision to discontinue his medications and pay no attention to his mental health. This would lead to the deterioration of his mental health condition and also give rise to thoughts of suicide and self-harm. In addition to this, the consumption of cigarettes and alcohol on a daily basis as a conscious strategy for coping with the emotional distress would have a negative impact on his already existing conditions of kidney failure and diabetes. This would also affect his cardiovascular health taking into account his recent diagnosis of coronary artery disease. For instance, in their study, Liang et al. (2022) revealed that smoking and alcohol consumption had higher risks and worsening of diabetes, chronic kidney disease, and cardiovascular disease among older adults.

References

Lee, K., Jeong, G. C., & Yim, J. (2020). Consideration of the psychological and mental health of the elderly during COVID-19: A theoretical review. International Journal of Environmental Research and Public Health, 17(21), 8098. https://doi.org/10.3390/ijerph17218098

Liang, Y., Chen, H., Liu, Y., Hou, X., Wei, L., Bao, Y., & Jia, W. (2022). Association of MAFLD with diabetes, chronic kidney disease, and cardiovascular disease: A 4.6-year cohort study in China. The Journal of Clinical Endocrinology & Metabolism, 107(1), 88-97. https://doi.org/10.1210/clinem/dgab641

Tragantzopoulou, P., & Giannouli, V. (2021). Social isolation and loneliness in old age: Exploring their role in mental and physical health. Psychiatriki, 32(1), 59-66. https://psychiatriki-journal.gr/documents/psychiatry/32.1-EN-2021.pdf#page=51

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