Hospice Experiences and Approaches, Case Study Example

Patient/Problem

Mr. Jones, a 75 year-old male widower who currently lives alone without a caretaker has been diagnosed with Adeno Carcinoma of the left lung with metastasis to the liver, spleen, and brain. His prior medical history also includes hypertension, atrial fibrillation, and COPD, all treated with medication, and prior smoking behavior. His financial situation is relatively poor, he does not wish to be admitted to an acute care facility for treatment, and he wishes to die in peace in his own home. Based upon the nursing assessment, he is gentle and appreciative, his pain levels are high, he is experiencing cyanosis, he has severe shortness of breath and a high respiratory rate at rest, and uses pain medication in the home environment on an as needed basis. He has children whom he does not wish to be involved in his current plan of care and is provided with an explanation of Hospice and what it has to offer.

Intervention

Upon acceptance of Hospice care, Mr. Jones is willing to move forward with this option on a trial basis and is provided with information regarding the options that are available to coordinate his plan of care. He is provided with the appropriate medications and is also provided with a diary to manage his pain and activities, and is required to use medications only under the strict guidance of a medical professional. Based upon prior evidence, it is believed that medication adherence will be a priority and will support his overall level of comfort at this stage (Sanders et.al, 2013). In addition, an order for oxygen and daily home health support are likely to have an impact on his health in anticipation of manageable pain and quality of life at this stage of the illness (Sanders et.al, 2013). It is believed that medication guidance will also promote effective adherence to the recommended guidelines and will provide the patient with the resources that are necessary to gain as much comfort as possible at this level of his care and treatment (Sanders et.al, 2013).

Comparison

The role of hospice care in treating Mr. Jones cannot be undermined, as his care is dependent upon a high level of coordination and communication regarding his care that will have a lasting impact on his overall health and wellbeing (Lau et.al, 2012). Most importantly, his medication administration must be properly managed so that he is able to benefit from this process, while also experiencing a greater sense of comfort from the hospice team during this transition period (Lau et.al, 2012). Quality of life at this stage is of critical importance, and although the patient’s health is extremely poor, he is nonetheless entitled to a level of care and treatment that will support his quality of life as best as possible (Lau et.al, 2012). It is necessary for all staff involved in this case to effectively communicate and share any changes regarding the patient’s condition so that his care is optimized as best as possible.

Outcome

The proper medication education and adherence for Mr. Jones must be a critical priority; therefore, it is important to identify these tools and to be able to work effectively as a team to ensure that the patient receives the proper guidance and oversight (Joyce & Lau, 2012). This process will also encourage the patient to be proactive in his own medication administration and to work cooperatively with the team when they visit his home on a daily basis. It is expected that this process will enable the patient to alleviate some of his pain and will also provide him with a level of comfort that he was not experiencing prior to his hospitalization. Therefore, hospice care must provide the tools and resources that are necessary to support this framework as best as possible.

References

Joyce, B. T., & Lau, D. T. (2012). Hospice experiences and approaches to support and assess family caregivers in managing medications for home hospice patients: a providers survey. Palliative medicine, 0269216312465650.

Lau, D. T., Joyce, B., Clayman, M. L., Dy, S., Ehrlich-Jones, L., Emanuel, L., … & Shega, J. W. (2012). Hospice providers’ key approaches to support informal caregivers in managing medications for patients in private residences. Journal of pain and symptom management, 43(6), 1060-1071.

Sanders, S., Herr, K. A., Fine, P. G., Fiala, C., Tang, X., & Forcucci, C. (2013). An examination of adherence to pain medication plans in older cancer patients in hospice care. Journal of pain and symptom management, 45(1), 43-55.