Case Study 1: The Case of Mrs. Mendez 1. Assess aspects of the quality of life (QOL) using the model of physical, psychological, social and spiritual well-being. How are these quality-of-life dimensions interrelated? What other information would be helpful to assess quality of life at the end of life and in planning care for Mrs Mendez?…
Mendez’s case. Her physical condition is deteriorating, which affects her psychologically. Her children will not let her talk about her impending death, which creates an imbalance in her psychological condition and she copes with this by withdrawing. Drake (2012) presents an adaptation model to understand how cancer patients should be taken care of as they are going through the process of living and dying. Some of the things that would be important to know, according to this scale include in this model are: why her shortness of breath is affecting her intake of fluids and food. Her physical appearance may be important to her as she lays in her bed, is better, which can effect QOL for many patients. There is no mention of church for her, though she “seems” to be religious, or at least superstitious. This should be explored. Drake (2012) states that nurses must understand early whether their patients are feeling depressed and help them receive treatment for it. Palliative care will need to be discussed and end of life arrangements. 1. Discuss how a nurse can foster hope in this scenario? When and how can the concepts of palliative care be introduced in the scenario? How can you explain the differences between Palliative care and Hospice care? Fostering hope can be difficult in a situation with the Mendez family, because they are not willing to talk about the impending death of their mother. They are also not open to helping her prepare for death. Butt (2011) states that hope is a multidimensional and it changes as the terminally ill patient continues through their illness. Butt (2011) also states that hope is a factor that creates a better quality of life for the individual. In this situation, more has to be known about the family. Mrs. Mendez seems to be losing hope because the family cannot talk about the impending death. It is important to help the patient feel hopeful, despite what is happening, because it keeps them from being depressed or feeling despair (Turco, 1998). A nurse can foster hope by maintaining a positive relationship with the patient, helping the patient see humor whenever they can, touching the patient appropriately and reassuring them, and helping them control pain (Turco, 1998). In the Mendez family, the nurse can foster hope by providing good care for Mrs. Mendez, which includes making sure that she is comfortable as her pain increases. The nurse may also need to intervene for Mrs. Mendez by contacting the primary care physician and describing the situation as it stands now. According to Tyson (2001) the Hippocratic Oath states that the individual healthcare provider will consult with others who are more expert in situations when necessary, to help their clients. In this situation, Mrs. Mendez needs help from the nurse to create the resources needed for the family to thrive, and for Mrs. Mendez to have the quality of life that she needs as she moves toward death. Palliative care was important to talk about as soon as Mrs. Mendez refused chemotherapy. She and her family must understand Mrs. Mendez’s needs as her health decreases. The family must face the inevitable and they may need to see a therapist or a priest or minister to deal with the situation. In a study done by Hermann and Looney (2011), the authors found that patients need a thorough understanding of their symptoms and what to expect as becomes more debilitating. ...
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