GRADUATE SCHOOL MASTER IN NURSING

NRS 209 Nursing Concepts III Advanced Medical-Surgical Nursing

Submitted by: Arnold L. De Guzman Jr. RN MN Student

Submitted to: Anna Lyn M. Paano, RN, MAN Professor

A MOMENT TO REMEMBER MOVIE ANALYSIS I. SUMMARY The movie begins with a 27-year-old fashion designer named Kim Su-Jin. She is waiting for her lover, a colleague who is also a married man, at the train station. They plan to elope with her lover but the guy did not showed up. Disheartened, she goes to a convenience store where she bumps into a man with whom she has a slight misunderstanding. Subsequently, she returns home and receiving the forgiveness of her father, decides to have a fresh start. One day, while accompanying her father, who is the head of a construction site, in making his rounds, she inadvertently meets the man whom she earlier bumped into at the convenience store. He is Choi Chul-Soo, a foreman at the construction site, who is also aiming to become an architect. Su-Jin instantly takes a liking to Chul-Soo and in what is a refreshing change, actively courts Chul-Soo. There are many sweet events that take place in the event of their courtship which eventually lead to their marriage. Shortly after, things quickly go downhill. Su-Jin soon finds that she has Alzheimers disease and the rest of the movie depicts how she slowly and painfully loses bits of her memory until she totally cannot remember anything. Even more painful is seeing Chul-Soo agonize while watching the wife he loves dearly forget even who he is. II. DIAGNOSIS / DISORDER PRESENTED IN THE MOVIE 1. Brief discussion of the disorder Alzheimers disease is the most common cause of dementia, which is a progressive neurologic disorder wherein the brain leads to an irrevocable loss of neurons and loss of intellectual fand social abilities severe enough to interfere with daily functioning as well as occupational functioning. Dementia occurs in people with Alzheimers disease because healthy brain tissue degenerates, causing a steady decline in memory and mental abilities. Alzheimers disease initially involves the parts of the brain that control thought, memory, and language.

TYPES OF ALZHEIMERS DISEASE Early-onset Alzheimer's. This is a rare form of Alzheimer's disease in which people are diagnosed with the disease before age 65. Less than 10% of all Alzheimer's disease patients have this type. Because they experience premature aging, people with Down syndrome are particularly at risk for a form of early onset Alzheimer's disease. Adults with Down syndrome are often in their mid- to late 40s or early 50s when symptoms first appear. Younger people who develop Alzheimer's disease have more of the brain abnormalities that are associated with it. Earlyonset Alzheimer's appears to be linked with a genetic defect on chromosome 14, to which late-onset Alzheimer's is not linked. A condition called myoclonus -- a form of muscle twitching and spasm -- is also more commonly seen in early-onset Alzheimer's than in late-onset Alzheimer's. Late-onset Alzheimer's. This is the most common form of Alzheimer's disease, accounting for about 90% of cases, and usually occurs after age 65. Late-onset Alzheimer's disease strikes almost half of all people over the age of 85 and may or may not be hereditary. Late-onset dementia is also called sporadic Alzheimer's disease. Familial Alzheimer's disease (FAD). This is a form of Alzheimer's disease that is known to be entirely inherited. In affected families, members of at least two generations have had Alzheimer's disease. FAD is extremely rare, accounting for less than 1% of all cases of Alzheimer's disease. It has a much earlier onset (often in the 40s).

PATHOPHYSIOLOGY OF ALZHEIMERS DISEASE

Non-modifiable Factors: Heredity / Family History Sex: Female Modifiable Factors: Head Injury Stress Depression

Progressive Cortical Atrophy

Dilation of Ventricles & Widening of Sulci

Deposition & fragmentation of betaamyloid precursor protein

Progressive Cortical Atrophy Development of plaques

Neurofibrillary tangles in neurons

Neuronal damage

Disruption of neural conduction

Affectation of cells that use neurotransmitter Acetylcholine

Impairment of cognitive function

Decrease in memory process

Gradual loss of memory & concentration

Decrease in cognitive function, memory and language

2. Discuss how the disorder was portrayed The disorder was portrayed as Kim Su-Kin gradually and painfully loses bits and pieces of her memory until she can no longer work, tend to herself and remember anything about her life with her husband. Initially, Kim Su-Jin had trouble remembering recent happenings or names of the people as well as misplacing items and

getting lost on familiar routes. Over time, it gets worse. She no longer recognize family or friends and have difficulty speaking, reading or writing. She also tends to have trouble doing basic tasks such as brushing their teeth or changing their clothes. One scene in the movie depicting this is when Su-Jin pees herself and barely even notices. 3. Identify specific scenes for the manifestations o Su-Jin forgets to get her wallet and drink after buying at the convenience store. o Su-Jin keeps losing pens and pencils o She keeps getting lost on familiar streets and admits that she has difficulty finding her way home. o She loses track of time when the doctor told her to come back in a week, she came back after two. o When the doctor asks her basic questions such as her sisters age and birthday, she is quite confused and barely remembers the right answer. o She seems to be lost most of the time and forgets recent events and conversations, like when she and Chul-Soo were in the living room, she was putting glue on the picture and then she suddenly gets up, walks around like shes looking for something, and then sees her husband and asked him where he went, when he was just there the whole time. She then gets back to the picture and thanked her husband for putting glue on it. o She eventually has difficulty performing basic tasks that take some thought, but used to come easily such as arranging the shoes properly and cooking a delicious viand for her husband for lunch at work only to pack 2 boxes with both rice in them. o In formalizing her resignation to work, she suddenly forgets where she was going and upon seeing him, she thought they were still dating. She completely forgets that she was already married to another man. o She has trouble doing basic activities. She even peed herself and barely notices it. o In the nursing home, the drawing of Chul-Soo were becoming less and less structured.

4. Identify specific scenes for the treatment o Giving of medications to slow down the progression of the disease. o Posting of notes or instructions in the wall in case there will be episodes of memory loss o Patience, care, support and affection from friends and family. o Assistance of the nurse in the nursing home when eating walking, and in her psychosocial treatment. III. REACTION / CONCLUSION

Losing a loved one is definitely unbearable, more likely if that loved one is struggling in a helpless fight against a disease such as Alzheimers. All we can do is to give our outmost support, understanding, patience, care and love. They need us to be on their side no matter what happens, no matter how hard it is, no matter what the consequences or struggles are. They need us to be their memory. As in the movie says, Get up. Leave it to me. I'm your memory. I'm your heart. Got that? No more tears. After watching this movie, I realized the importance of family, friends and loved ones. I was able to reminiscence some of the things I have done which I enjoyed and memories or events I cherished most. I really cannot imagine how life would be if one day my memory will be lost. Its like my own identity is taken away from me even my soul. This movie opened my eyes to the possibility of things that may happen which gave me a message of enjoying what I have, whom I am with, and who I am now.