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2807NRS : Chronic Illness Management : Smithton's Amyotrophic Lateral


1. Based on the information in the case study (pg 418-420), is Mr. Smithon's uncertainty a danger or an opportunity? Please explain your selection.
2. Do a search on gold treatment for ALS using both the internet and the EBhost academic database. Describe the types of information found in regards to this treatment. Is the information credible?
3. Based on the information provided, what factors could be contributing to Mr. Smithon’s powerlessness?
4. As a member of the health care team, what kinds of actions could you take or strategies could you use to support this family?


1. In reference to Mr. Smithton's Amyotrophic Lateral Sclerosis case in Kramer-Kile et al., (2014), it is not wise to conclude whether the associated uncertainty is an opportunity or a danger. However, to a large extent, it can be regarded as being a danger because of the associated complication, whose treatment and cure are medically not a possibility according to (Noh et al., 2010). The uncertainty associated with Mr. Smithton's disease leaves him with no practical solution to overcome the disease and places Ms. Mason into a position where she has to go against the nursing code of practice to sanction a Gold treatment given the close relationship that she has with the family (Wigert & Bry, 2018). Moreover, any action would be associated with a legal implication in the case of third party intervention. His wife Patricia is further placed in a situation where she has requested for a leave to take care of the husband given his condition. Any attempt to avail Mr. Thomas with treatment that would improve the quality of his life presents with dangerous implication for Ms. Mason. Therefore, all th

e ethical issues, legal, financial implications, and family tremors that are as a result of Mr. Thomas's uncertainty create danger for the associated parties. It is therefore wise to note that the case is not an opportunity but a danger. The feasible opportunity, in this case, is applying a Gold treatment, which would offer a better life even though to be administered, it present quite a number of ethical and legal implications. Thus, concluding that the uncertainty creates more danger that opportunities in the above case. In comparison with the current literature, Bojanowska, Zatorski, Gazdowska & Durlik, (2017) assert that, uncertainty is a common characteristic among most of the chronically ill patients.  Moreover, mist if the associated complications or uncertainties present with negative impacts on the victims.

2. According to Gordon, (2013), ALS is a disorder the comes with age and results in motor neuron degeneration. Most patients die in about 3 years after the onset of the disease due to the weaknesses associated with the respiratory system. The disease has no cure, but there are therapies that are symptomatic aimed at improving the quality of the patient's life and having it extended. However, one of the treatments that are widely considered to correct some of the disabilities in ALS is Gold treatment (Gordon, 2013). It is asserted that lack of Gold in the body renders it unable to effectively replenish all the muscle forces associated with the nerves. Moreover, according to the author, Gold deficiency makes the body unable to nourish the inside of the horn cells associated with the brain. Therefore, with the Gold treatment for patients with ALS may somewhat correct the neurological disorders it present with among the patients. Keaton (2012), further recommends that Gold treatment has somewhat proved to be one of the treatments for ALS. Therefore, it is clear to note that the information found in the above articles emphasizes the fact that Gold treatment is a practical therapy that helps to correct some of the neurological conditions that are associated with ALS patient (Sakowski, Schuyler & Feldman, 2009). Most of the information provided is credible given the experimental design of the provided information along with the number of scholars that have been consulted to reach the different conclusions in the articles.

3. Smithton's powerlessness is largely associated with quite a number of factors that range from his inability to perform the different duties that he used to engage in before being attacked by the illness. The first factor is being unable to perform his normal duties like he used to before being attacked by the disease. Being unable to feed by himself, using a motorized wheelchair, closing of his business, being on quite many treatments and rehabilitation endeavors, among others create an undesirable environment for him and thus leading to powerlessness  (Foley, 2011). Secondly, knowing that the chances of surviving death are very minimal to none, no matter all the involved struggles. The above leads to depression which is the main causes of powerlessness that Mr. Smithton presents within his current medical condition (Foley, 2011). The above weakens a patient that never had a record of illness and complied effectively with the medical examination.  Thirdly, as a family head, the stress of his close children, wife, and relatives and the kind of model life that he left up the time when he could no longer perform his daily activities are some of the other factors that increase his powerlessness(Foley, 2011). His thoughts of being unable to fend for his family is an issue that creates a depression state, leading to powerlessness.  In comparison with the current literature, Simukoko, Mulenga & Mwanakasale, (2017) assert that powerlessness is common characteristic that is associated with most chronically ill patients. Moreover, it is a common characteristic among most chronically ill patients due to the stress and depression associated with the recovery process.

4. One of the most severe characteristics of patients that are associated with chronic illness is exhaustion, being overwhelmed, and feeling discouraged. It is therefore important that as a healthcare team, strategies the help to overcome powerlessness feeling are formulated. Therefore, relevant and appropriate interventions which are based on the current observations and assessments of the patient in his environment. This needs to be done in the manner that helps the patient to cope and manage the illness. Therefore, the first action is ensuring that psychosocial life dimensions are availed along with a very conducive physical environment for the patient (Soundy & Condon, 2015). The patient needs to be evaluated continuously in order to modify the interventions being used to cope with the current requirements of the patient. Secondly, it is also important that loneliness is avoided by advocating for an increased family bond from the rest of the family members to help the patient cope with his sickness with limited thoughts of agony(Soundy & Condon, 2015). As member of a healthcare team, it would be prudent to ensure that all the factors that could lead to powerlessness in the patient are eliminated. Thirdly, Soundy & Condon, (2015), further assert ensuring that continuous evaluations to modify the patients needs effectively is done and ensuring proper coordination of all the healthcare team to ensure that they perform their due task, it will, in the end, help the patient to effectively cope with the illness.  This would help the patient to cope with the illness with no much stress and psychological depression. The current literature on the support needed for chronically ill patients,Teston, Silva, Garanhani & Marcon, (2016) stipulate that it is vital to critically conduct assessment of the patient from time to time in order to avail the best therapy and recovery environment. Moreover, it is prudent that the patients are provide with psycho-support and the best physical environment, along with ensuring that they are not left to be lonely.


Noh, E. J., Park, M. I., Park, S. J., Moon, W., & Jung, H. J. (2010). A Case of Amyotrophic Lateral Sclerosis Presented as Oropharyngeal Dysphagia. Journal of Neurogastroenterology and Motility, 16(3), 319–322.

Teston, E., Silva, J., Garanhani, M., & Marcon, S. (2016). Early hospital readmission in the perspective of chronically ill patients. Revista Da Rede De Enfermagem Do Nordeste, 17(3), 330-337. doi: 10.15253/2175-6783.2016000300005

Wigert, H., & Bry, K. (2018). Dealing with parents' existential issues in neonatal intensive care. Journal Of Neonatal Nursing, 24(4), 213-217. doi: 10.1016/j.jnn.2017.09.002

Kramer-Kile. M, Ousuji. J, Larsen. P, Lubkin. I. (2014). Chronic illness in Canada Impact and Intervention, Jones & Bartlett Learning.

Keaton E. (2012).ALS Potential Cure? The Effects of Cayce Alternative Medicine Treatment and Other Treatment on the Neurological Problems of One Person: Possible Implications for ALS and Other Neurodegenerative Diseases[Internet]. Version 25. Available from:

Gordon, P. H. (2013). Amyotrophic Lateral Sclerosis: An update for 2013 Clinical Features, Pathophysiology, Management and Therapeutic Trials. Aging and Disease, 4(5), 295–310.

Simukoko, D., Mulenga, D., & Mwanakasale, V. (2017). Prevalence and correlates for stress among caregivers for chronically ill patients at Ndola teaching hospital. Asian Pacific Journal Of Health Sciences, 4(3), 107-111. doi: 10.21276/apjhs.2017.4.3.18

Soundy, A., & Condon, N. (2015). Patients experiences of maintaining mental well-being and hope within motor neuron disease: a thematic synthesis. Frontiers in Psychology, 6, 606.

Bojanowska, A., Zatorski, M., Gazdowska, J., & Durlik, M. (2017). Adherence to treatment among chronically ill patients. Polish Psychological Bulletin, 48(3), 380-387. doi: 10.1515/ppb-2017-0044

Foley, G. (2011). The complexity of care in amyotrophic lateral sclerosis. Amyotrophic Lateral Sclerosis, 12(3), 160-161. doi: 10.3109/17482968.2011.554556

Sakowski, S., Schuyler, A., & Feldman, E. (2009). Insulin-like growth factor-I for the treatment of amyotrophic lateral sclerosis. Amyotrophic Lateral Sclerosis, 10(2), 63-73. doi: 10.1080/17482960802160370

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