Gothic Culture And Modern Fashions Cultural Studies Essay

Gothic Culture And Modern Fashions Cultural Studies Essay Towards the end of the seventies there emerged a new youth subculture that stemmed from the fragmenting Punk scene commonly referred to as Goth. Goth appeared to assume the trappings of Gothic literature and film which was primarily based on Baroque art. As such, members of the Goth subculture converted the characteristic features of this literature as well as film wherein they transformed them into a form of resistance to suburban Britain. Subsequently, this resistance by the Goth migrated to other regions including America as well as Australia which were presumably perceived not only to be small minded but also dull. The link between the Goth subculture and Gothic literature is not clear. This is because the translation of literature into street style has often been approached with bemusement or simply overlooked by a significant number of scholars. However, the two subjects draw a strong relation through the medium of fashion. In these respect, the designer Gareth Pugh has emerged out as one of the most interesting as well as unique figures in the world of fashion from London. Pughs style entrenched in Goth subculture quite clearly depends on a spectacular style or sets of styles from which the artist invents his identity. This primarily represents another characteristic feature of Gothics preoccupation with clothes and as such fashion. It is the presumption of this paper that the Goth sub-culture has had tremendous influence on fashion that has changed the way in which clothing is represented in Gothic discourses. Goth History A significant chunk of the Goth subculture and the resurgence of interest in this way of life emphasizes on the mutation of Goth into an autonomous youth subculture towards the close of the seventies. This explains the relatively young age of proponents such as Gareth Pugh who further the ideal of the Goth sub-culture through fashion. During the seventies, the Goth culture was led by post punk groups including the Birthday Party, The Sisters of Mercy, Bauhus, Siouxsie and the Banshees (Spooner and Spooner, 2004). The groups led other Goth adherents to the Goth style that combined the graveyard exorcism of 19th century mourning costume and perverse sexuality of fetish with the nihilism of Punk to create a macabre aesthetic. The garments that the adherents adorned were predominantly black. However, according to Spooner and Spooner, (2004)these were accessorised with memento mori motifs and vampire makeup as fig. 1 illustrates. Fig. 1 Gothic Fashion Although the main period of the popularity of the Goth Spanned in the eighties, the culture has proved to be remarkably long living as it has persisted both in the 1990s and ultimately into the twenty first century. In the mid eighties towards the late 1990s, there however emerged cultural figures that began heralding the revival of the Gothic culture by pointing out the increased number of bands that were largely influenced by the Goth subculture including Garbage, Marilyn Manson together with their black dressed acolytes (Spooner and Spooner, 2004). Commentators also often cited the resurgence of the Goth sub-cultural influence in haute couture, film, literary fiction, as well as fine art and other derived genres of music including hip-hop and techno. Toward the end of the twentieth century, critical discourses that surrounded the Goth subculture illustrated a significant shift away from psychoanalytical methods towards historicism. In this regard, this discourse exhibited an increased level of self-consciousness in relation to the processes of textual and fashion production. Baldwick and Minghall, (2000) pointed out a trend in which 20th century theorisations of the Goth subculture focused on the irrational, the spiritual as well as the subversive at the expense of accurate historical analysis. Such a strategy frequently constitutes a kind of idealisation whereby Gothic subculture is privileged with whatever contravening roles generally associated with the critic. Arguably, such a process of canonical rehabilitation as well as critical appropriation has recorded an increase with the advent of millennium celebrations (Stevens, 2000). Gothic art has developed a trend in which it resurfaces at the fin de sià ¨cle whereby as the fin to end all siecles approaches swiftly, the fervour of the subculture reaches a peculiar climax (Spooner and Spooner, 2004). This aspect was captured well by Grunenberg, (1997) who postulated that the modern society exists in a particularly dire time. This period according to Grunenberg constitutes the Gothic period of fear, moral disintegration, horror as well as the perverse indulgence in extreme pleasures. Gothic fashion as such, has evolved to be a quid pro quo for disturbing and sombre moods, events and places as well as cultural by products of the contemporary society in America (Steele and Park, 2008). Despite the fact that a low number of individuals carried with them the expectation of the world ending at the turn of the 21st century, a true fin-de sià ¨cle feeling wrought with elements of cultural pessimism as well as spiritual malaise permeated society at the time. This spirit persists in modern day societys fashion. The Goth Culture One problem that arises when discussing the Goth subculture is that it draws a profound connection to punk and also emphasizes on dramatic visual style (Spoooner and Spooner, 2004; Polhemus, 1995). Ultimately, this has resulted into the Goth subculture being regarded as a spectacular culture despite it being a fan culture as well. Fan communities have to a significant degree been regarded in relation to media texts for instance, the Star Trek series. However, there exist various similarities between communities described by Jenkins, (1992) and common practices usually associated with the Goth sub-culture. Fan communities actively develop their own ways of life from fragments and scrap that are usually scavenged from the media. Jenkins, (1992) describes this process of creative appropriation as textual poaching. Much in the same light, Goth fashion as an element of Goth subculture is particularly focused on consumption. This consumption does not only constitute clothing, but also incl udes cinematic and literary narratives, sub-cultural commodities and music. Much in the same way that television series fans like Doctor Who or Star Trek develop their identities through their love for the aforementioned series, Goth such as Pugh suture their identity from a complicated system of cinematic and literary affiliations through integrating several archetypes and characters they meet during their fantasy lives, ultimately realizing them through costume or fashion. While some Goths may come across as more literate compared to others in the overall tradition of Gothic representation, all have to either a lesser or greater extent constructed their identities, Frankenstein like, from the fragments and scraps of that way of life. This process of developing identity is demonstrated by Tim Burtons early short film by the name Vincent. In this production, Vincent Molloy, a seven year old boy imagined himself as taking the identity of another person, Vincent Price whereby he condu cted himself as Price would. This fan tribute to the oeuvre of Price does not draw any contradictions in relation to attitude and the kind of fan fiction produced around fantasy series and science fiction. However, this does not imply that Goth is a fan culture in any straight-forward way. This is because it is possible for an individual to be a fan of horror films or Gothic novels without necessary being a Goth. On the contrary, Goth is a combination of the elements of spectacular culture and fan culture ultimately creating a monstrous hybrid between the two ways of life. The resulting culture is one in which symbolic resistance is not only enacted through fashion or spectacular style but also embraces narratives that are generally perceived to be dangerous and as such, falling out of general societal conventions. The development of Gothic as an anti-canonical marginalised subgenre as such, propels the cultures sense of resistance to a cultural hegemony of the bland (Hannaham, 1997). Such acts of self-definition constitute the concurrent definition of a mainstream that has been developed as the other by its respective subculture. According to Thornton, (2008) this fantasised mainstrea m may or may not bear any link to what is real. However, it is the product of the subculture out of a desire for difference. Thornton contends that vague opposition can be outwardly stated to be that questioning the number of members of youth subcultures characterising their own activities. Significant to note is the fact that youthful discourses can not be taken literally. This is because these discourses are not mere transparent windows that reflect on the world. A significant number of cultural critics have been insufficiently critical of sub cultural ideologies. This trend is firstly attributed to the fact that they were diverted by the task of contesting and puncturing dominant ideologies and secondly owing to the fact that their biases have tended to agree with the anti mass society discourses of the youth sub-cultural groups they study. This is to say, while the formulations of power in given subcultures are potentially fertile topics for research, investing in subcultures that have been known for their transgression as well as subversion has often proved to be problematic. This is because research in addition to leading to a better understanding of the phenomenon under study, also highlights such phenomenon from obscurity. This implies that aspects that were overlooked in the past owing to the low degree of societal subscription to such doctrines have the potential of becoming famous. This new-born fame is often attributed to researchers. Due to the fact that society loathes aspects of subversive and transgressing elements, researchers have the tendency to steer away from such elements and cultures including Goth. Holmes, (1997) illustrates this element in Gothic culture in his essay coming out of the coffin. He contends that punk and Goth cultures in contrast to exhibiting stability as many would like them to, exi st by way of suturing both the anti-canonical and the canonical as well as the high and low, the romantic and cynical in addition to the straight and the queer. Embracing these aspects in most circumstances is through the Gothic tradition in general as well as through one of the cultures prominent figures, the vampire (Fig 2) (Auerbach, 1995; Goddzu, 2007). In many ways, this is an accurate evocation of Goth, capturing the complexity of its several poses. Fig 2. Barnabas Collins, Vampire: Jonathan Frid in the television series Dark Shadows Costume Gothic fashion is a form of clothing that is usually associated with members of the Goth subculture. It is a dark form of art which sometimes tends to be highly insensitive and morbid with some quarters terming it as an eroticised form of fashion or style of dress. In its typical form, Gothic fashion is characterised with black hips, dyed black hair, and black clothes (Grunenberg, 1997). Additionally, both male and female members of the Goths subculture wear dark fingernails as well as dark eyeliners. The function of clothes within Goth subculture is largely dependent on who is wearing them (Spooner and Spooner, 2004). It was custom for the 1980s middle class individuals to enact rebellion only through implicit and stereotyped ridiculous dress codes while the avant-garde classless individual of the modern day fashion like Gareth Pugh is stylishly subversive of convention. Gareth Pugh as a new generation figure is both glamorous and confident. Pugh is constructed as an individual that is always aiming for the top and forward as opposed to relying on the past to provide him with a referral page for his design. In fact, his world of design is framed in a way that it conforms to utopian principles where both intellectual and irrational forces intermingle in the creation of form. When Gareth Pughs work is perceived under a lens with such an understanding, it takes on a new significance for the designers fans. The implication here is that other designers subscribe to conventional lines of thought and as such, design. An individual that adorns Pughs design on the contrary is stylish and belongs to the new variety. In other words, wearing Pughs design has the capability of transforming an individual from a conventional person to a Gaultier Goth (Spooner and Spooner, 2004). Design in itself is an artistic impression integrated with certain tastes that the artist fancies as ideal (Gardner, Kleiner and Mamiya, 2005). These impressions as expressed in garments draw from a wide history in the long established tradition of art. As such, artists such as Pugh have the tendency to look back at elements that were embraced in the past to which they base their form of art. Subsequently, art and design integrate, ultimately combining inflatable garments, black and white colours as well as geometric shapes in addition to materials such as PVC and plastics (Fargis, 1998). These forms are characteristic of classical Gothic and baroque art. Fig. 3 Conclusion In conclusion, the complexity of Gareth Pughs images is accompanied by an increasing sense of Gothicism in the design themselves. The designer has deliberately courted the Gothic in his work frequently returning to themes of automata, prosthesis and automata (Spooner and Spooner, 2004). While garments that were featured in earlier images in the 90s would be reasonably wearable by most of consumers in the mainstream, most of Pughs are increasingly perverse and esoteric Fig. 3. These later images however particularly resonate Gothic themes. These are not only limited to the characteristic features of imprisonment, vampirism and torture but upon a closer scrutiny also resonate with the kind of structural conventions Eve Sedgwick identifies as characteristic features of Gothic literature (Spooner and Spooner, 2004). Vampirism as portrayed in these images is ostentatiously a surface effect implying no illusion of realism. By conflating the penetrating gaze with the penetrating fangs, Pugh s designs seem to have undergone what Sedgwick referred to as contagion or the manner Gothic literature contends that aspects of a given element are transferred to another. List of figures Fig. 1. Gothic Fashion., Otherclothing.co.uk, online Fig. 2 Barnabas Collins, Vampire: Jonathan Frid in the television series Dark Shadows by William Patrick Day (2002), p.37 Fig.3. Vogue.com (2008) Wicked with a capital W by Gareth Pugh in Vogue Magazine Autumn/Winter 2008-9, online

A Narrative of the Captivity and Restoration of Mrs. Mary Rowlandson Es

The Pressure to Assimilate in Mary Rowlandson’s A Narrative of the Captivity and Restoration of Mrs. Mary Rowlandson There are times when assimilation is not a choice but rather something is forced. In circumstances such as being taken hostage, the ability to survive must come at the price of assimilating one's own customs into another lifestyle. In February of 1675 the Native Americans who were at war with the Puritans obtained hostage Mary Rowlandson of the Plymouth colony. During this time she must perform a role that is uncommon to a colonial woman's way of life so that she may live among them. With the need to survive, how can a person accommodate a second culture? The actions of Mary Rowlandson demonstrate how a person can gain, retain, and end up examining their own beliefs for logical validity. Due to a limited food supply in the tribe, it can't be generosity given to Rowlandson; doing so would cause the entire tribe to become hungry. Rowlandson hand makes clothes for Native Americans in exchange for essentials. She trades with her caretakers and even the well-known King of the tribe. On several occasions she argues with the Natives, attempting not to lose what is her property. Trading and arguing with others was not a job performed by women in her colony; however, in her situation, a change of role is needed in order for her to live with her captors. In the seventeenth century, her change of role might have been seen as a sign of weakness, but today, it's much easier to see her change of role as being a sign of strength; After all, it takes a strong willed person to carry out a change in their life. An altering of one's religion alone could be a difficult task for some, but for Puritans in everyday situations... ...lture expects her to be. In summary, what Mary Rowlandson understands about the Native Americans changes greatly during her confinement. This change in her day-to-day life enables her to live among a Native American tribe while still being a faithful Puritan. The change in her viewpoint gives her not only an understanding of the Native culture, but also her own as well. Although it was never written that her role in the Plymouth colony changed after her return, one could speculate that she may have at least questioned her own beliefs and questioned what God may truly be looking for in a Puritan. Works Cited: Rowlandson, Mary. "A Narrative of the Captivity and Restoration of Mrs. Mary Rowlandson." Negotiating Difference: Cultural Case Studies for Composition. Ed. Patricia Bizzell and Bruce Herzberg. Boston: Bedford Books of St. Martin's Press, 1996. 67-83.

Married Women who Cheat on their Husbands Essay -- Marriage

Married Women who Cheat on their Husbands Marriage is a bond between two people who love each other. These are two people, who decide to become one, unite their love, start a family together, and spend the rest of their lives with each other. After explaining the significance of such an immense obligation, the question still remains .Why should a person place themselves in a situation they are not truly committed to? The answer can be one or many explanations, and just one solution may not always be the case. Love, sex, and confidence are just some of the reasons that women cheat. Some women don’t receive these things from their husbands so they feel the need to search for them in other places. In the bond of marriage a woman is giving herself to her husband .She is offering him all of her love. What happens if the love becomes weak, grows old, or turns sour? She will yearn for romance, or whatever it was that made her happy. She will search for the missing part of her marriage, and the aspects that her husband lacks will be found in another man. This will be her search to fulfillment or completion. â€Å"She wants to be dined, courted, and romanced. When she tries to be romantic with her husband, he ignores her and continues to read the newspaper or watch sports on the television.†(Norment).The same degree of love that was there in the beginning of the marriage has slowly depleted. Small factors in a marriage may lead to bigger problems in the future. If a woman’s hus...

Marketing intelligence: Final Exam Essay

1) Which of the following is NOT a step that might be used to improve the quality of a firm’s marketing intelligence? A. Watching how the stock market reacts to interest rate changes B. Motivating distributors to pass along important intelligence from the marketplace. C. Collecting competitive intelligence by buying a competitor’s products D. Setting up a consumer panel 2) When Molly’s parents retired, they decided they wanted to travel. They found an ideal job that allows them to travel for free, but the only catch is they have to stay at Holiday Inns. During each stay, they test all the amenities offered by the motel and evaluate each. The evaluation forms are sent to the motel headquarters where it becomes part of the motel’s __________ systems. A. Accountability information system (AIS) B. Marketing intelligence C. Experiential research data D. Marketing research 3) Typically, companies budget about 11-12 percent of company sales for marketing research. A. True B. Fasle 4) Which of the following is NOT a component part of total customer value? A. Psychic value B. Image value C. Product value D. Services value 5) Lee is constantly begging his mother to buy him an iPod because the most popular kids at his school all have one. His mother contends that he’ll just break it or lose the music player if she buys it for him. For Lee, the most popular kids in his school are examples of a _______________. A. Social class B. Demographic group C. Subculture D. Reference group 6) A(n) ________________ is likely to offer informal advice and information about a product or product category. A. Opinion leader B. Diversity marketing program C. Primary reference group D. Aspirational reference group 7) Which factors have the broadest and deepest influence on consumer behavior? A. Cultural B. Psychological C. Personal D. Social 8) Painting and consulting are considered industrial goods because ______________. A. Most firms do not seek them directly B. They are specialty goods C. They facilitate developing and managing the finished product D. They are considered â€Å"component materials† 9) When SAP software added a Windows-style â€Å"back† button to its industrial invoice management software, the new product ___________. A. Improved upon an existing product B. Used a new product line C. Used a marketing diversification strategy D. Added to an existing product line 10) Ayal and Zif argue that going into fewer countries is advisable when ___________. A. Population is low, and income size and growth are high in the initial countries chosen. B. Population and income size are high, and population growth is low in the initial countries chosen. C. Population, income size, and growth are high in the initial countries chosen. D. Population, income size and growth are low in the initial countries chosen. 11) Which is the last major decision in international marketing? A. Deciding on the marketing program B. Deciding which markets to enter C. Deciding how to enter the market D. Deciding on the marketing organization 12) Which of the following is NOT a step that might be used to improve the quality of a firm’s marketing intelligence? A. Watching how the stock market reacts to interest rate changes B. Motivating distributors to pass along  important intelligence from the marketplace. C. Collecting competitive intelligence by buying a competitor’s products D. Setting up a consumer panel 13) Which is correct about â€Å"noise† in the communication process? A. It mostly happens during the decoding stage B. It interferes with intended communication C. It is controllable D. It has only one source 14) Marketing __________ is the art and science of choosing target markets and getting, keeping, and growing customers through creating, delivering, and communicating superior customer value. A. segmentation B. integration C. internally D. management 15) Public policy makers have developed a substantial body of laws and regulations to govern advertising. For these reasons, an important step in developing anadvertising campaign is _____________. A. The social responsibility review B. Asking network censors what to cut out of the communication C. Preparing a copy strategy statement D. The creative development of the message 16) Which of the following is an example of primary data that would be used by Topps card company to determine popularity of its new hologram baseball card series? A. Sales records for baseball cards gathered by the industry’s trade council. B. An article about the hologram cards in a recent issue of Sports Illustrated C. Data from sales records kept by exclusive dealers of Topp’s hologram series D. Input from focus groups that was put together specifically to discuss their perception of popularity of the hologram card series 17) A marketing information system (MIS) consists of ___________. A. An organized collection of comprehensive data about individual customers, prospects, or suspects that is currently accessible for marketing purposes. B. The systematic design, collection, analysis, and reporting of data and findings relevant to a specific marketing situation. C. The people,  equipment, and procedures to gather, sort, analyze, evaluate, and distribute needed, timely, and accurate information to marketing decision makers. D. A set of procedures and sources used by managers to obtain everyday information and relevant developments in the marketing environment. 18) The step in the marketing research process thatincludes determining who will be sampled is to _______________. A. Collect the information B. Develop the research plan C. Define the problem and research objectives D. Make the decision based on the project outcomes 19) All of the following are steps in the marketing research process EXCEPT: A. Compare data to government sources B. Collect the information C. Define the problem and research objectives D. Present the findings 20) The ____________ consists of all the organizations that acquire goods and services used in the production of other products or services that are sold, rented, or supplied to other customers. A. Consumer market B. Institutional market C. Government market D. Business market 21) Toyota, the maker of the Scion brand, using what kind of brand strategy with Scion products? A. Individual names B. Blanket family names C. Corporate names D. Separate family names 22) When SAP software added a Windows-style â€Å"back† button to its industrial invoice management software, the new product ___________. A. Improved upon an existing product B. Used a marketing diversification strategy C. Added to an existing product line D. Used a new product line 23) When customers buy on the basis of a reference price or because the price conveys a particular quality image to them, they are being influenced by ____________. A. The going rates of competitors B. Value augmented by perception C. The psychology of pricing D. Value pricing 24) A __________ pricing objective is suitable for a company that has overcapacity, intense competition, and changing customer needs. A. Maximum current revenue B. Maximum sales growth C. Survival D. Maximum current profit 25) A concept in retailing that helps explain the emergence of new retailers is called the ___________ hypothesis. A. Service-assortment B. Product life-cycle C. Retail life cycle D. Wheel-of-retailing 26) Which of the following would NOT be considered part of a marketing communications program? A. An event sponsorship B. Personal selling C. A sales promotion D. Brand contact 27) McDonald’s franchisees get a small discount when they pay their bills for supplies within the first seven days (when the due date is 30 days after delivery). This is an example of ___________ within channel relations. A. Sharing the risks B. Territorial rights C. Price policies D. Conditions of sales 28) __________________ are the means by which firms attempt to inform, persuade, and remind customers about the products and brands they sell. A. Marketing communications B. Sales promotions C. Mass communications D. Brand images 29) Which of the following is most closely associated with a proactive marketing orientation? A. It represents the â€Å"make and sellâ€Å"philosophy. B. The marketer focuses on the customers’ latent needs. C. It is about understanding and meeting customers’ expressed needs. D. It involves delivering superior value 30) Marketing __________ is the art and science of choosing target markets and getting, keeping, and growing customers through creating, delivering, and communicating superior customer value. A. segmentation B. integration C. management D. internally 31) Which of the following is NOT a component part of total customer value? A.Product value B.Services value C.Psychic value D.Image value 32) About a year ago, Echo began renting her movies from Netflix. She perceived Netflix to be a better source because of the enhanced selection, the responsive customer service emails she has received in answer to her online queries, better pricing, and less effort compared to renting from the store in her town. Netflix has offered Echo better _________ than the local competition. A.Total customer cost B.Customer perceived value C.Customer delivered value D.Total customer value 33) Lowe’s home improvement stores strive to have nicer, more knowledgeable salespeople, a better product selection, and to maintain an impeccable image. These are all part of improving the offer via _____________. A.Reducing the buyer’s nonmonetary costs B.Reducing the product’s monetary costs to the buyers. C.Increasing the service value D.Increasing total customer value 34) _____________ are relatively homogeneous and enduring divisions in society, and may exhibit distinct product, brand, and media preferences. A.Subcultures B.Social classes C.Demographic groups D.Cultures 35) Lee is constantly begging his mother to buy him an iPod because the most popular kids at his school all have one. His mother contends that he’ll just break it or lose the music player if she buys it for him. For Lee, the most popular kids in his school are examples of a _______________. A.Social class B.Subculture C.Demographic group D.Reference group 36) Business buying behavior differs from consumer buying behavior in that _________. A.[Answer Text]Businesses buy products to accomplish a single goal, which varies by industry and business. B.The buyers for the business market are typically more geographically dispersed than those for the consumer market and the demand for products and services in the consumer market is unaffected by price fluctuations. C.The demand for business goods and services is derived from consumer’s final demand. D.Fewer people typically participate in or influence business buying decisions than in the consumer market. 37) The institutional market is best described as having _____________. A.Contract negotiations and fluctuating demand B.Low budgets and a captive clientele C.Derived demand, geographically concentratedsuppliers, and budgetary constraints. D.Demand elasticity and geographically concentrated suppliers 38) The ____________ consists of all the organizations that acquire goods and services used in the production of other products or services that are sold, rented, or supplied to other customers. A.Consumer market B.Business market C.Government market D.Institutional market 39) Toyota, the maker of the Scion brand, using what kind of brand strategy with Scion products? A.Individual names B.Separate family names C.Corporate names D.Blanket family names

Long Term Conditions

The aim of this essay is to consider approaches to promoting the self-management of a long-term condition. The focus will be linked to module content and based on a patient that I have provided nursing care for during my clinical practice. There will be a brief introduction of the patient and the context in which I was involved in their nursing care. The pathophysiology of the chosen LTC along with the related physical, psychological and social needs of the patient will be considered. There will be a discussion of principles of self-management that will link to national LTC policies.This will also include initiatives and analysis of the evidence of the underlying principles for an approach to providing self-management support, for the chosen LTC, including benefits and challenges. To conclude I will use evidence-based recommendations of how the patient could be supported to self-manage their condition. A wide range of evidence will be used to support my discussion. The patient chosen to explore, is one who lives with the LTC of Parkinson’s. The patient had started to experience Motor Fluctuations, also referred to as â€Å"off â€Å" periods.Motor Fluctuations are associated with long-term use of levodopa and usually appear in people who have had Parkinson’s for some time, patients experience â€Å"end-of-dose deterioration† meaning that the dose does not last until the next dose is due (Parkinson’s. org 2008). This patient spent one week on a neurology rehabilitation unit. The context in which I worked with this patient was to assist with the teaching of an apomorphine syringe driver and to assess â€Å"on and off† periods before the use of the pump and then when the pump was in use and also to ensure that there were no side effects to its use.During this week I worked alongside a team of occupational therapists and physiotherapists, as it was essential that the patient regained confidence with daily activities, personal ca res, dressing and food preparation. The aim of the teaching was to enable the patient to become independent with the apomorphine pump from being able to perform a subcutaneous injection to its removal when medication had finished.It was vital that the patient became competent and confident in the process as they had been very active throughout their life and wanted to remain so for as long as possible. Parkinsons. org (2010) describe Parkinson’s as the disease with no obvious cause and is the most common form of Parkinsonism; the other forms of Parkinsonism are vascular, Drug-induced Parkinsonism, dementia with Lewy bodies, inherited and Juvenile. Vascular is an uncharacteristic form of Parkinsonism and usually presents with difficulties in speaking, swallowing and the ability in making facial expressions.Drug-induced Parkinsonism occurs in 7% of people and is attributed to neuroleptic medication which block dopamine these drugs normally treat schizophrenia and other psychoti c conditions and once the problem has been diagnosed then the person will recover in hours, days or months after ceasing taking the medication. Dementia with Lewy bodies has no cure and symptoms include difficulties with concentration, memory, language and the ability to carry out straightforward actions. Many people suffer from hallucinations, sluggishness of movement, rigidity and tremors.Dementia with Lewy bodies is similar to Alzheimer’s. Inherited Parkinson’s is rare and there is no evidence that is can be passed on in families, however it is estimated that 5% of people with Parkinson’s may have a genetic cause. Juvenile is a term used for persons diagnosed under the age of twenty years. As NICE clinical guidelines 35 (2006) states, Parkinson’s disease is a progressive neurodegenerative long-term condition and mainly affects those of middle to old age. Parkinson’s occurs when the cells containing dopamine die off.At present there is no consist ent test that can define if a patient has Parkinson’s due to the close clinical resemblances of other conditions. Parkinson’s is diagnosed mainly through history based information and examination. The main symptoms and signs of Parkinson’s are bradykinesia, rigidity and rest tremor. Parkinson’s is mainly seen as a movement disorder, but other areas of health problems are associated with it. These include depression and dementia along with autonomic disturbances and pain, although considered to be rare they can present at a later stage of the condition.These rarer symptoms, as they progress, can lead to substantial disability and handicap which harms quality of life for the person living with Parkinson’s, this also has an impact on families and carer’s. The physical symptoms of Parkinson’s can be debilitating for the patient and may include pain, falls/dizziness, dietary problems, bladder and bowels problems, swallowing and saliva cont rol, speech/ communication problems, eye problems, freezing, skin, scalp and sweating problems. It is not possible to discuss all of these physical elements in detail within this essay.I therefore intend to focus on one specific physical aspect of the disease and discuss how this affects the client’s needs, along with the psychological and social aspects. The area I will discuss is freezing. As identified by Parkinson’s. org (2010), freezing will be experienced by every Parkinson’s patient at some point, but becomes more apparent in patients who have had Parkinson’s for numerous years and also if levodopa has been used for long periods of time within their treatment, however it must be noted that freezing can occur in Parkinson patients whom do not take levodopa and should not be seen as a side effect of taking levodopa.When freezing occurs it is a frightening experience and also a cause of embarrassment for the individual. Freezing is not just linked wit h gait movement it also includes speech freezing or repetitive activities such as combing hair or the thought process for example when a patient is trying to remember something i. e. the name of a place. Along side this is also ‘start hesitation’ this is associated with drinking from a cup, getting out of bed or when a patient wants to step forward.Freezing is still not fully understood and may be attributed to interruptions to the sequence of movement, group situations or ineffective medication. Parkinson’s brings many social problems, becoming less confident can bring low self-esteem that can lead to withdrawal from social activities. The individual may worry about how they look, talk or even the way they move, this can inhibit the person from entering into normal activities and they may decide to stay at home to avoid potential awkwardness.Reduced socialisation may increase the likelihood of the individual suffering from depression; fatigue and mood swings can be potentially be harmful to personal or close relationships. The individual may become unsure of their social position within the family, workplace or any groups, as they feel lost or less important. Self-management of a LTC is strategically important to the long-term sustainability of the NHS, and it is therefore essential to be clear on the principles of self-management and to have a clear approach to achieving a successful outcome.In response to the increasing levels of LTC’s across England the Department of Health (2012) have established a dedicated LTC team who has built a compendium to explain why pro-active management of LTC’s is so important to the future of the NHS. This compendium provides compelling evidence and information to help support and drive a transformational change to the way in which LTC’s are managed, and the document states clearly that self-management is central to this transformation, the principles of self-management have been outlin ed by the Health Foundation (2011) and these will now be discussed.Self-management can have very positive effects on people who live with a long-term condition that affects their normal function of daily activities, as The Health Foundation (2011) suggests the use of self-management can have positive effects on behaviours and outlooks that an individual faces and how their quality of life can either be enhanced or depleted. In order to achieve a successful self-management outcome it is essential that time is invested early in the programme to explain to the individual involved the many benefits that self-management can bring.Ensuring that they fully understand these benefits will greatly increase the likelihood that they fully engage into the programme and truly take an increased responsibility for managing their LTC. Evidence suggests that self-management leads to a more positive health outcome and championing people to look after themselves can improve motivation, engagement and h ow they use and access the health service. It also describes to how habits change towards healthy eating and exercise, which results in better clinical outcomes.Failure to establish genuine engagement at an early stage will most likely result in limited transfer of responsibility and may lead to the patient failing to realise the benefits to themselves and also benefits to the NHS. They also stated that there is an extensive range of initiatives and one size does not fit all. As Brighton and Hove City PCT (2006) state, planning and having a certain level of power is crucial to making lifestyle changes when living with a LTC.It is also necessary to understand the connection of why changes to lifestyles need to be made, and why planning carefully for change is fundamental to change actually being accomplished. It is important to support the individual through the change process as this can often create a degree of anxiety for them. Promoting the benefits of a healthy lifestyle and edu cating individuals on their condition, will boost confidence and help the patient understand the benefits of self-management in the context of potentially slowing down the progression of their condition, improved quality of life and remaining independent for as long as possible.Education is another key principle of self-management. An individual needs help and support to understand their condition, how it affects them and what they can do to help to pro-actively manage it. There are a number of options available here to help educate an individual on their LTC such as reputable websites specifically set up for their condition. They are an excellent source of information, which is continuously updated, and enable the person to access easy to understand information in the privacy of their own home.Additionally, advice helplines add greater support for individual needs, without being confrontational. Support is also available for carer’s through courses run by the Expert Patients Programme Community Interest Company (EPP CIC). Leaflets are available to answer basic questions and give further information on where to find more support and advice that is available in their area. The Parkinson’s Specialist Nurse is also a good resource as the nurse can provide their expertise along with the expertise of multi-disciplinary teams (www. parkinson’s. rg 2012) It is important to ensure that the level of education and training provided is appropriate to the capability of the individual and also the state of their condition. Insufficient information could lead to poor decision making by the individual or a lack of confidence if they are uncertain about certain aspects of their condition. Similarly, providing training and education beyond the means of the individual may result in confusion or unrealistic expectations being established – this would not be beneficial for either the individual or the NHS.Good training and education should be targeted at increasing the individuals understanding of their condition such that they are able to successfully monitor their symptoms and take appropriate, pro-active action to ensure treatment is sought quickly and to avoid potentially unnecessary admissions to hospital. One of the principles of self-management is to ensure sufficient emphasis is placed on problem solving. If an individual is to become increasingly capable of self-managing their LTC then an ability to solve problems is fundamental to achieving this.Without this it will prove difficult to change the behaviours necessary to allow a health care professional to move into a more supportive and assisting role, as oppose to the current situation where they are managing the care of the individual (Health Foundation 2011). Another area for consideration is that a patient must know when to seek medical advice and intervention and feel comfortable with their decision-making techniques. It is also vital that the individual does not al low a situation becomes acute.The Health Foundation (2011) also states that, engagement and education are important to ensuring that the individual is ready and in a position to be empowered with the responsibility for the self-management of their LTC. The principles of self-management support the involvement of the individual in decision making related to their care and also working collaboratively with their health care professionals to build their care plans.This continuous high level of involvement is essential to making sure that there is a real transfer of responsibility from the health care professional to the individual – if there is, then there is a much greater chance that they will take ownership for the long-term self-management of their condition. Failure to truly involve the individual when making decisions about their care could result in a lack of commitment to a care plan and/or false commitment to behavioral changes, ultimately resulting in the continued hea vy reliance on their GP, A&E and other health services to manage their LTC in a reactive and cost inefficient manner.As Randall and Ford (2011) discuss, it is apparent that within the United Kingdom there is an increased transfer of power and choice for users of the health and social care system and policy drivers such as ‘Independence, choice and Risk’ (DH2007) recognise the importance of empowering service users i. e. persons with LTC’s, to ensure they have greater choice and control. When empowering someone, firstly there needs to an acknowledgment that the person has control over an aspect of their care and can make decisions that relate to it.Power can be seen in a variety of forms but is normally defined as having knowledge and being able to make informed decisions and choices. When considering the decision process it is evident that some decisions are taken alone, for example what clothes to wear, or with permission of others for instance using monies from a joint account to buy a new kitchen and there are also decisions that are made which require formal consultation, e. g. implementing a new law. For any individual who is involved in the self-management process it is important to ensure that the degree of decision-making is appropriate to their personal set of circumstances.When empowering a person there are fundamental considerations to be identified. For example, the mental state of the individual, the extent to which their condition has progressed, their physical ability, their socio-economic situation, the extent of their support network (friends and family), their willingness to pro-actively engage in the self-management of their condition – all of these factors may influence the rate and extent to which empowerment may be achieved.Furthermore, empowering an individual with a long-term condition needs to be managed carefully. They will typically be interfacing with many different healthcare professionals and other parts of the NHS and other organisations, and if the views, opinions and approaches of those multiple contacts are not aligned or consistent it is possible this could have a negative impact on the empowerment process for the individual. It is therefore essential that there is one aligned approach and cohesive message.There is strong evidence contained within the study by Luca Camerini et al (2012) that empowerment, combined with health knowledge have been shown to have a great impact on the self-management of chronic conditions, and that if managed well they can have a positive effect on health outcomes. For my chosen patient suffering with Parkinson’s disease, I would recommend supporting them to self-manage through an approach of empowerment, ensuring that this was strongly underpinned by strong support in the provision of health knowledge.As discussed earlier, some of the key needs of an individual suffering with Parkinson’s disease are related to their mobility, dietary requirements and pain relief and I want to explain how this recommended approach could help support the individual to more successfully self-manage these particular aspects of their condition. Firstly, in respect of mobility, freezing is often a situation, which affects PD’s sufferers. In the first instance it is important to help educate the individual on why freezing happens.Ensuring that the individual has a clear understanding of their condition will help them to be more accepting of the effects, less afraid when they experience motor fluctuations or â€Å"off† episodes and crucially help them to make more informed decisions about potential ways of helping them to self-manage this aspect of their condition. As mentioned previously, the extent of knowledge and education needs to be appropriate to the individual’s level of health literacy – this aspect should not be underestimated, as there is a strong link between an individual’s level of healt h literacy and their ability to successfully self-manage.As stated by the World Health Organisation (2009) health literacy is critical to empowerment, therefore this can present a barrier to achieving self-management through an empowerment based approach. An individual’s capacity to access and effectively use information is an area that may need to be considered initially to decide if empowerment is the most suitable approach to adopt. There are a number of options available to help an individual manage motor fluctuation episodes such as medication, mental techniques and physical techniques.Again, the individual will need to be educated on these such that they are able to be involved, or even lead, the decision making process on selecting the most appropriate treatments and solutions for them. Each root may have both advantages and disadvantages for the individual and these need to be made clear, if a patient is aware of the limitations and potential drawbacks of a specific t reatment from the beginning, then they are more mentally prepared to deal with the challenges as they arise, educing the likelihood of failure. There are several approaches to providing education and support to Parkinson patients; the LTC compendium recommends the Expert Education Programme, although not specifically for Parkinson’s it provides courses to help with managing LTC conditions, online courses are available also, it is also possible to add your area to the list, they are free. The Parkinson’s website has vast information both practical and informative and free help lines.In some areas there are Neuro-rehabilitation Units, available through referrals made by the Parkinson’s specialist nurse or consultant, which gives access to multi-disciplinary teams all located within one centre. The Parkinson’s Specialist Nurse holds clinics where discussions can take place for planning the future, medication changes and a point of contact if you need additio nal support before the next scheduled appointment.As part of the Health Foundation Co Creating Health programme (2012), a ‘Buddies to Support Self Management’ scheme has been developed for cancer patients in the Arran and Ayrshire region. The programme has been developed to enable patients who have completed self-management programmes to share their knowledge and skills with others in similar situations, along with helping patients who prefer not to be in a group situation. This could be a possible area to develop for Parkinson’s or all LTC patients.

Ethical Self-Assessment

Healthcare professionals are faced with making multi-faceted decisions on a daily basis. These decisions are not just limited to clinical matters, but they include the total patient care experience. Because of emerging healthcare trends and complex health law and ethics, it is imperative that healthcare administrators have a professional organization that they can belong to. â€Å"The American College of Healthcare Executives (ACHE) is an international professional society of more than 35,000 healthcare executives who lead hospitals, healthcare systems and other healthcare organizations.ACHE is known for its prestigious FACHE ® credential, signifying board certification in healthcare management, and its educational programs including the annual Congress on Healthcare Leadership† (American College of Healthcare Executives, n. d. ). The Ethics Self–Assessment Tool and Individual Decision Making The American College of Healthcare Executives (ACHE) provides an ethics self -assessment which is made up of thought-provoking questions to serve as a moral compass using the ACHE Code of Ethics as its basis.No matter what your role in the healthcare system, the self-assessment provides a standard for various healthcare relationships including, â€Å"Community, Board, Colleagues, Staff, Clinicians, Buyers, Payors and Suppliers. † (American College of Healthcare Executives, n. d. ). Any questions that were not answered with â€Å"always,† identified an area of weakness in which ethics were being compromised. The first lesson learned is that there are numerous situations where healthcare professionals may believe they are being ethical, but the assessment provides examples that some decisions being made are unethical.This gap away from being completely ethical occurs because professional decisions are often influenced by individual ethics. Identifying these gaps allow healthcare administrators to make necessary steps to improve the method in whic h they make decisions. Another lesson learned is the importance of having a tool to compare your organization’s level of ethics to the code of ethics. Paying special attention to minimize outside influences, will allow you to make complex ethical decisions at all times which will promote consistency throughout all team members and the organization.The American College of Healthcare Executives (ACHE), has a strong impact on ethical decision making because they focus on the â€Å"entire being† of the healthcare professional. For example, in ACHE’s preamble of The Code of Ethics it states, â€Å"In fulfilling their commitments and obligations to patients or others served, healthcare executives function as moral advocates and models. † Imagine, when a healthcare administrator recites these few words, he cannot help but acknowledge the depth of his commitment and the high level of morality that is expected from him.Because of the vast number of complex ethical dilemmas that arise, ACHE further promotes the value and importance of strong ethical decision making in ACHE’s Ethics Toolkit. â€Å"When the ethical guidelines are not enough, when there is uncertainty about the proper ethical approach, and when there is a need to develop additional ethical guidelines. ACHE’s Ethics Toolkit provides tools for developing both parts of an ethical culture. † (American College of Healthcare Executives, n. d. ).Influence of Individual Ethics on Decision Making. When it comes to the modern decisions in today’s healthcare system, it is important to be able to identify problems and opportunities and choose the best course of action for the greater good. A strong ethical background helps individuals make the right decision although it may be unpopular. â€Å"Aristotle (Summers, 2009) also teaches about morality when explains how to apply ethics to daily living. Through the idea of practical wisdom and eudemonia, he makes us aw are of the need to apply ethics and behave in a moral way.We develop our moral character so that we use our knowledge of ethics to address challenging new situations. Ethical principles become the center of our lives and we apply them as virtue-centered administrators. † Strategies to Improve Decision Making in the Future The opportunities that being a member of The American College of Healthcare Executives (ACHE) has afforded healthcare professionals, is one that is here to stay. Healthcare administration is a profession that continually evolves with time. Because of the advances in medicine, people are living longer and have a better quality of life.The current self-assessment tools are quickly improving and making it easier for healthcare professionals to obtain the data needed to make prompt ethical decisions. It is important to remember that as a healthcare professional, one must present all of the facts to a patient and preserve his right of autonomy. It is within the co de of ethics that healthcare professionals are not to impose their will on someone else. Remember, to carry out â€Å"the four ethical principles of autonomy, beneficence, nonmaleficence, and justice. †

Agency program for the elderly Essay Example | Topics and Well Written Essays - 750 words

Agency program for the elderly - Essay Example The service that is going to be discussed here is National Long-Term-Care Ombudsman Program. This program is supported by US Administration of Aging and is executed from Ombudsman Resource Center at National Citizens' Coalition for Nursing Home Reform at 1424 16th Street, NW, Suite 202, Washington, DC 20036. This is a joint funding program, where apart from the US Government, the local state governments and community agencies fund it additionally. Separate addresses are there for all state units, with the most common location being the State LTCOP in the State Unit of Aging. Information about them can be accessed at ttp://www.aoa.gov/pro/aoaprog/elder_rights/LTCombudsman/National_and_State_Data or http://www.ltcombudsman.org/ or http://www.ccal.org (LT-COP).As the word Ombudsman indicates, the state Ombudsman works in the area of the long-term care of the elders, where he serves as a trained advocate to protect the health, safety, welfare, and rights of the residents of nursing home, board and care facilities, and the assisted living facilities. The residents of all these facilities are aged, and many of them are frail and most often isolated from their communities. Very often while under care, these resident's rights have a chance to be violated, the quality of care may not match with the required standards, and therefore, their quality of life may not be attained that it is supposed to be attained. In fact literally, this program has been designed to investigate citizen's complaints against local or national government agencies that may be infringing on the citizen's rights. This term, ombudsman means friends who can provide information, advice, and guidance (Capezuti, EA., Siegler, EL., Mezey, MD, 2007). With an aim to review and improve the care processes, these officials facilitate change at local, state, and national levels. Numerous volunteers and paid staff employed in a long-term basis, regularly visit long-term care facilities to monitor care, observe the interactions between the staff and the residents, evaluate the physical environment of the care facility, and act as advocates for the residents who are more vulnerable due to lack of family, cannot speak, or are unable to speak for themselves. To be able to do this, each state designates a long-term care ombudsman who is responsible for developing a state-wide program in order to investigate, identify, and submit complaints on behalf of the residents. Typically, regionally they are located in area agencies on aging, but many of them are sponsored by private programs or legal agencies. The program, therefore, comprises of the work responsibilities of the ombudsman. As opposed to the conventional concepts, they are not surveyors or regulators. They are supposed to identify and solve the problems with care of the elderly in the care facilities. Hence, their role can be to identify and resolve the problems on behalf of the residents. Ideally, the OAA described roles include representation of the interests of the residents before government agencies. If the residents' interests are hampered in any way, they, through this program, are entitled to seek administrative, legal, or other means for redressal of the grievances and issues. The care home residents are consumers, and they have valid consumer rights. This program also facilitates consumer education, and thereby, they also serve as agents of facilitation of public comments on laws, policies, and, actions. This program, through the ombudsman, also seeks to provide technical supports for new or ongoing resident and f amily councils. Perhaps, the most important aspect of