Itec Nutrition Case Study

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Profile
Johann is a 66 year old lady living in rural ireland. She lives by herself in a small cottage in the centre of her village. She is within walking distance to two grocery shops, a national school, a church and two pubs. Her daughter lives on the other side of the village which is within walking distance also. Johann has two daughters and one son that she sees regularly and one son from a previous relationship that she sees occasionally. She was diagnosed with bi-polar (manic) depression at the age of 18 and has been medicated every since. Her colesterol is very high and she hopes that i might be able to reduce her weight. She is 5 foot 1 inch and weights 14 stone. Along with Bi-polar she was also diagnosed with ceoliac disease. This causes dificulties with her other condition due to the sensitivity of her medication. Her symptoms of ceoliac disease is dioraogh and vomotting and if this occurs her medications designed for bi-polar cannot be absorbed and loose the affect. For this among other reasons her moods are rarely stable. Johann then finds herself in a cycle. Her moods are irratic so her diet suffers. When she neglects her diet her mood suffers. She does however have a great deal of support. Her daughter hopes that if johann can controll her diet she can deal with her depression more easily. Johann gets 2 hours of homehelp per day. One in the morning and one in the evening. Martha cooks and cleans for johann and is willing to incorpoate any diet changes into her routine. 4 days per week johann attends a day centre where they do activities and she eats her dinner there. Here she meets her doctors and health care team. It is always a nutritious and gluten free meal. Johann enjoys visiting friends and spends most of her time walking to one or another of her friends house’s, she finds it very hard to sit still for very long but sleeps well each night. When she is at home she uses that time to chat on the phone. Other than visiting friends and talking on the phone johann does no other activity so i hope to find something that she will enjoy through my meetings with her.

Medical
Bi-polar disease or Manic Depression
What is it?
Bipolar disorder causes serious shifts in mood, energy, thinking, and behavior–from the highs of mania on one extreme, to the lows of depression on the other. More than just a fleeting good or bad mood, the cycles of bipolar disorder last for days, weeks, or months. And unlike ordinary mood swings, the mood changes of bipolar disorder are so intense that they interfere with your ability to function.

How its Treated?
Medication is the primary route of treatment for most people presenting with Bi-Polar disorder. There are a huge amout to choose from and johann has given me a list of her medications for my research. In the past Johann has recieved 18 sessions of Electroconvulsive therapy (ECT). While medication is the foundation of bipolar disorder treatment, therapy and self-help strategies also play important roles. Some are known to help control their symptoms by exercising regularly, getting enough sleep, eating right, monitoring your moods, keeping stress to a minimum, and surrounding themselves with supportive people. One to note is Gareth O'Callaghan who wrote “A day called hope”. Johanns symptoms.

In the manic phase of bipolar disorder johann feels heightened energy, creativity, and a sense of euphoria. During a manic episode she often talks a mile a minute, sleeps very little, and is hyperactive. She sometimes feels invincible which can lead to recklessness, for example with money. Occasionally she becomes angry, irritable, and aggressive, lashing out when others don’t go along with her plans, and blaming anyone who criticizes her behaviour. In contrast the depressed phase of bi-polar disease is very bleak. Johann feels very tired and miserable and feels worthless and depressed. She gets very anxious and often believes something bad has happened to her loved ones. During this...
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