Biopsychosocial Assessment: Morris S. Schwartz
Morris Schwartz, a former sociology professor, was diagnosed recently with amyotrophic lateral sclerosis (ALS) and presented in the clinic expressing concern about morning bouts of atypical anxiety, fear, self-pity, and crying (Albom, 1997, p. 56). Mr. Schwartz's day-to-day medical needs are provided by a palliative care nurse in his home and has no desire to be transitioned into a nursing home or hospice center as he reaches the end of his life. What follows is a biopsychosocial assessment of Mr. Schwartz, or Morrie as he prefers.
Biological
Morrie was in his mid-70s when diagnosed with ALS ("Morris S. Schwartz," 1995) and was probably already experiencing many of the physical symptoms of aging (Zasrow & Kirst-Ashman, 1997, p. 546-555). ALS is a progressive neurodegenerative disease of the central nervous system, resulting in the gradual paralysis of the limb, respiratory, and bulbar muscles (Foley, Timonen, & Hardiman, 2014). Although 15 and 35% of ALS patients will develop frontotemporal dementia or cognitive impairment, respectively, Morrie does not suffer from these symptoms. The expected life expectancy following diagnosis is 2-4 years, but in reality this period is much shorter. The peak age of onset for most ALS patients is in the 60s, so Morrie developed the disease at a more advanced age and will probably progress at a faster rate.
At the micro level, Morrie can no longer meet all of his physiological needs and over time his inability to engage in daily living activities will rapidly decline (Albom, 1997); therefore, he will grow increasingly dependent on the mezzo systems with his wife, nurse, friends, and other family members to meet his feeding, bathing, and other needs. The interventions ALS patient would typically receive today, depending on need, would be the drug riluzole, feeding tubes, and respiratory assistance devices (Sreedharan & Brown, 2013). On a macro...
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