Care Plan for Old Aged Woman with Lung Cancer - Assignment Example

 Care Plan for old aged woman with Lung Cancer Introduction The care management plan for patients diagnosed with terminal ailment require a comprehensive and multidisciplinary approach to ensure consistency in the care given to the patient by all the parties involved in the management process. The following is a care management plan for a client named Barbara James. The client was recently diagnosed with end stage lung cancer with a less that six month prognosis. The diagnosis changes all aspect of the patient’s normal life. Besides, the patient recently lost a spouse whom they have been married for a period of sixty year and required help concerning how can cope with her grief situation through grief counseling and more so how she can gain financial support to help her through this situation. The plan begins with the demographic information of the patient; following is our clients care plan details and the recommendations given to help her during her period of grieving and management of the diagnosed condition (Weber & Kelley, 2003). The following are the demographic information of the patient Clients Name: Barbara James Age: 77 Years Old. Gender: Female Race: Mediterranean Culture: Spanish Religion: Christian Primary Language Spoken: Spanish Secondary Language Spoken: English City Of Residence: Madrid Living Arrangement: Lives Alone Financial Status: Stable Insurance Coverage: None Employment History: Higher Social Support System: The state has an international plan of action for the aging through public aid. Financial support and guidance is offered to the old. Familial Support System: Friends help her make healthier choices Mental Health History: No mental health history Personal Interest: Reading inspirational books and travelling. Sexual Orientation: Heterosexual Relationship Status: Widowed Family Dynamics Issue: Nuclear family with two children a daughter and a son. Legal Issues: She had no legal issues Unique Circumstances: Grew up with grandparents because she lost her mother at an early age. Information on Coping with Grief and Loss Resources to Seek Grief Counseling: Joined a counseling center organization in one of the hospitals in Madrid that helped her cope with the grief of lost of her husband. Financial Support: She had a retirement benefit pension plan that has been helping her manage her financial needs. She also gets advice on her entitlements from her Benefits Agency. Client’s Care Plan Introduction to Barbara James Barbara James is a retired teacher who was just diagnosed with lung cancer. Besides, the patient lost her long-term partner of sixty years. The diagnosis has changed her entire life because it has changed her mood and emotional status. This brought many changes in her life especially when it came to coping on how to start living life by her when she was used to living with her husband. This prompted her to seek assistance from the hospice on how to cope with the disease, the grief, and resource to help her in it together with financial help. The plan developed will help the patient, the friends of the patient, and other parties take effective measures in helping the patient manage conditions. Cultural and emotional attachment Madrid is a football loving region and Barbara James as a resided said, “ I would love to watch a Real Madrid match at least once per month or just one of their matches now that am a great Madrid fan.” This shows that she has attachment to the cultural and social aspect of the city, because the region has a massive following of sporting activities with football taking a largest share. The plan will ensure Barbara get to view her preferred team play by ensuring she has a for the matches played at home ground and occasionally attending selected away games (Tompkins, 2003). Physical assessment and the plan Li et al (2014) ascribe that care giving should meet the preferences and goals of the customer. Therefore, the hospice team must tailor the approach to meet any goal identified. In fact, creating intervention that uses a multidisciplinary approach is the most appropriate way of helping and taking care of the old adult going through the grieving process. Assessment of muscoskeletal changes was based on general observation of the patient walking, stance, and posture. The assessment was based on determining whether the patient favored walking on one side. The assessment was carried out using a timed up-and-go test, which involved asking questions related to back pains, joint pains, and height loss would help in the assessment. The appropriate intervention would involve designing exercise regimes. The patient will be taken through regular exercise like walking to decrease the muscoskeletal deterioration. The exercise also decreases the risk of falling down in old adults (Miller, et al, 2010). However, since Barbara, likes watching the Madrid games, the plan will aim to prepare her to walk to the stadium during the matches since her house is not very far from the stadium, about 3 kilometers. Outline of the role of the client support system Role of family member The family members will be educated on how to take care of the patient. The family members will be taken through counseling session to prepare them on how to take care of Barbara. Counseling session is important not for the patient but also for the family members. It also prepares the family to identify legal and financial plans appropriate for the patient. Legal issues prepare the family members to respect the wishes of the patient. It also makes it easy for the patients to avoid having trouble in making decisions that may coincide with the patient wishes. The plan will educate the family members in setting realistic goals. However, the most important item is the maintenance of a sense of humor while with the patient. In fact, what Barbara needs the most is the company or people that keep her a live through meaningful conversation. Identifying items that makes her happy should form the main items of conversation. The plan will ensure emotional health improves because poor health leads to problems like poor physical health, anxiety and depression (Touhy and Jett, 2014). Role of caregivers Caregivers for the old adults who pay attention on health literacy of the adult must understand that the patients are prone to cognitive decline and social isolation. These factors determine their ability to learn and remember. Therefore, the support and education offered by the caregivers to the relatives and friends of the patient should not be aligned together with the approach required from the patient. Educating the parties on issues related to appropriate medication. Inappropriate administration of medications can lead to drug related complications and contraindications. Caregivers should adopt directives by following criteria listed in American society beers guideline that helps with the identification of the medications that need caution for the old adult patients, classes of inappropriate medications for the old adults and the likely symptoms they can generate. Besides, older patients experience challenges in metabolism and excretion. The caregivers will take keen interest in prescribing the appropriate medication that conforms to the slow excretion and metabolism. Emotional and psychological support from the hospice care members When patient in old experience life changing situations like loss of a partner and diagnosis with a terminal ailment, they are likely to experience depression and change of mood. Therefore, assessment of mood changes and institution of appropriate measure is critical in assisting the patient. Assessment of depression will be based on symptoms like fatigue, sleep disturbances, hopelessness, and thoughts of suicide, loss in appetite, lack of concentration, and ease to agitation Verbal and Non-Verbal Responses The lung cancer has a potential effect on how Barbara James communicates because of the shortening of breath and getting tired in the midst of conversation. Therefore, using both the verbal and non-verbal responses is important to enable the patient communicate her thoughts. For instance, she had a lot of physical contact whenever she communicated; therefore, these changes should not be seen as an invasion to one’s personal space. The caregivers will help the patient continue using the appropriate strategy of communication by educating the family members and friends to help the patient have a meaningful life. Maintaining eye contact with her while communicating is a considerable way of showing integrity because it encourages the patient to gain confidence with the people she communicated with (Booyen, 1998). Recommendation and Interventions The involvement of all parties including the assessment report from the patient, the friends, relatives, and the hospice caregivers was paramount in developing the plan to ensure consistency and implementation of the strategy without contradiction. Therefore, the care plan was prepared in the presence of all the associates that were available to help the patient adopt and tailored to the new condition. It was done so that to give her the necessary guiding and counseling to keep her strong during the medication process as well as providing the required financial support and advice because the patient financial status was not sustainable with her current condition (Sparks-Ralph & Taylor, 2013). The plan will make her realize that she still has a meaningful life to live and give her motivation in life while at the same time enabling her give commands to the management of her businesses and other meaningful issues of her life. Resource Attainment Plan Cancer treatment is an expensive journey because it will require enough resource, which is a challenge to most patients. Since the patient does not have enough resources for the medication, seeking assistance from alternative sources will enable improve the success of the plan. According to Dows (2000), the best approach is to seek the intervention of the government’s public aid because the customer is old enough to receive the aid on offer by the government for the elderly diagnosed with terminal disease. Through the financial assistance, the hospice group will link the patient to a counseling centre that will provide her with professional guidance. However, given that the patient already has a running business, through a well banking system, the team will help her find a trust worth financial resources and reinvest it back to the business to increase chances of gaining additional profits. With all this in place, the plan aims to ensure that the patient enjoys her life in the last days. All this will be done in a weeks’ time and will be reviewed on a monthly basis to make sure that everything is at course and to get her feedback on the areas that she needs change. Clients Strengths That Will Aid in Plan of Care and How They The patient has the drive of acquiring knowledge and learning about the disease she is suffering from. This is a good gesture because it will help her develop hope and resilience. In fact, when the patient have enough knowledge on a particular condition they tend to resolve and improve at a faster rate than when they have no idea of the condition because knowledge helps them in medication and coping mechanisms. She is also willing to learn at her old age. This has been a great advantage as she says, ‘it has been my admiration to learn more about this condition and prepare myself for the worst.” This will enable her better her understanding of the condition (Gulanick& Myers, 2014). When patients have good understanding of the condition, they will have self-motivation and the drive to take drugs and other medications. Perhaps the main challenge to this concept is the potential overdosing. Some patients without proper knowledge on the required dose of the medicine may think increasing the dosage may improve their recovery (Bonwick, 1999). The hospice team will educate all parties on the importance adhering to the required dosage and avoiding overdose. Conclusion From the strength and challenges of the patient, the support from the friends, family members and the hospice team will play a critical role in helping the patient go through the coping mechanism, medication and counseling. It will assist in maintaining the mood and psychological aspects that may disturb the patient. After the initiation of the care plan for the patient will improve tremendously by applying using medication that suits the slow metabolism and excretion process. These interventions will also need the counseling and appropriate education of all the parties to ensure improvement in the quality of life given to the patient. References Bonwick, J. ( 1999). Managing Care Plans. New York: McGraw- Hill Booyen, S. (1998).Dimensions of Nursing Management. Juta and Company Ltd. Dows, D. (2000).Retirement and Benefits. Chicago: Archaeological Institute of America Gulanick, M., & Myers, J. L. (2014).Nursing care plans: Diagnoses, interventions, & outcomes (8thed.). St. Louis, MO: Mosby. Li, J., Young, R., Williams, M.V. (2014). Optimizing transitions of care to reduce hospitalizations. Cleveland Clinic Journal of Medicine, 81(5), 312–20. Miller, K.L., Magel, J.R., Hayes, J.G. (2010). The effects of a home-based exercise program on balance confidence, balance performance, and gait in debilitated, ambulatory community- dwelling older adults: a pilot study. Journal of Geriatric Physical Therapy, 33, 85–91 Sparks-Ralph, S. & Taylor, C. M. (2013).Sparks & Taylor’s nursing diagnosis pocket guide (2nd ed.). Philadelphia, PA: Lippincott, Williams, & Wilkins. Tompkins, P. (2003). Madrid Demography. Newbury Park, California; Sage Publications, Inc. Touhy TA & Jett KF. (2014). Ebersole and Hess’ gerontological nursing & healthy aging (4th ed.). St. Louis: Elsevier Mosby. Weber, J., & Kelley, J. (2003).Health assessment in nursing (2nded.). Philadelphia, PA: Lippincott Williams & Wilkins. Read More