Long Term Care and Alzheimers Disease

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Develop 2-4 pages Memorandum to evaluate the managerial issue and to answer the questions. Make sure to provide credible evidence supporting your recommendations and conclusions. Do not copy the case in the memo, but make sure to refer to its number for the faculty to have a reference for grading.
Mr. Parker is an 88-year-old resident of your LTC home with end-stage Alzheimer’s. He is wheelchair bound and spends most of his days sleeping in his wheelchair near a window facing the garden. He needs to be spoon fed but has recently started to refuse to eat. Mr. Parker has three children, one of whom is very involved in the care of her father. The team approaches the daughter about her father refusing to eat, and feels that his refusal is legitimate. Thus, they propose changing the plan of care to palliation. The daughter absolutely refuses, claiming that “you cannot kill my father, I want everything done to keep him living!”
What are some of the ethical issues in this case?
 Do we know whether the resident is capable to make his own health care decisions?
 Are there any known wishes from Mr. Parker? What would he want? What are his values?
 Is his daughter the substitute decision-maker? Can she, in this role, demand treatment and expect that you comply?

Sample Solution

eading is the ability to decode and understand the printed information. Though for most typically developed people reading is an effortless ability, it involves a range of sophisticated cognitive skills and processes, for example: the ability to decipher the printed words, ability to grasp the words meaning and then combine these two for retrieving the contextual meaning and complete understanding of the whole text (Cain, 2010). Reading involves two major levels, one is phonological and decoding level and another is comprehension level. However, Most of the early research of reading development emphasise on the phonological and decoding level for developing reading ability (Brady & Shankweiler, 1991; Goswami & Bryant, 1990; Snowling, 2000, cited in (Nation & Snowling, 2004))

Why are phonological awareness and decoding skills necessary but not sufficient for becoming a skilled reader? To answer this question, first the key concepts and relationship among phonological awareness, decoding and reading skills will be discussed in conjunction with relevant literature and research. Next, a critical evaluation will be made for explaining why these two skills are not adequate for efficient readers.
Finally, by summarizing the importance of phonological awareness and decoding skills as well as to what extent other skills are also essential for becoming skilled reader the conclusion will be drawn.

Overview of reading

Reading emprises a range of knowledge, skills and strategy. Cain (2010) argued that to read and understand a text readers engage with couple of activities. At first their eyes focus on printed lines of the text for accessing the meaning of individual words, While reading some words may seems unfamiliar with can interrupt the understanding of meaning. In addition, some words may not follow the conventional rules of pronunciation for example: ‘meat’, ‘feat’ and ‘cheat’ contain the similar sequence of letters and pronounce in the same way, the word ‘threat’ has same letter string ‘eat’ but is not pronounced same as the meat, feat or cheat spelled. In a text some words may be ambiguous for example: the word bank, If we say- John goes to the bank. Here ‘bank’ is an ambiguous word that means the word contains more than one meaning. In such cases, for skilled reading context should be considered. It is also important to co

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