Question

Mr. Ahuli is a 60-year-old American Indian man who has been diagnosed with stage 4 lung cancer. Mr. Ahuli is married with two grown children and a large extended family that resides on a local reservation. Although Mr. Ahuli has chosen to use medicine herbal remedies as his treatment of choice, he and his wife would like to explore the possibility of hospice care.

Questions (10 points total)

1. Which members of the interprofessional hospice team would be most appropriate to initially talk with Mr. and Mrs. Ahuli and why? (2 points)

2. What is the difference between palliative care and hospice care? (2 points)

Case Study continued

After learning more about hospice care, Mr. Ahuli and his wife state that they wish to pursue this option. Mr. Ahuli says he would like to continue using the medicinal herbal remedies during hospice care.

3. Will the hospice team be able to incorporate Mr. Ahuli’s medicinal herbal remedies into his plan of care? Why or why not? (2 points)

4. Should the hospice nurse assess the patient’s and family’s ability to cope? Why or why not? (2 points)

Case Study continued:

After receiving hospice care for two weeks, Mr. Ahuli dies a peaceful death with his wife, two children, and a number of extended family members at his side. The family spent 30 minutes following his death saying goodbye and supporting each other. His wife and children stayed at his side for an additional 10 minutes. The nurse is preparing to complete postmortem care.

5. What are best practices for providing postmortem care for Mr. Ahuli? (2 points)

Answer 1

1. Which members of the interprofessional hospice team would be most appropriate to initially talk with Mr. and Mrs. Ahuli and why? (2 points)

Interprofessional hospice Team members included 17 nurses, three social workers, three chaplains, two medical directors, and 18 miscellaneous group members (volunteer coordinators, bereavement coordinators, medical students, home health aides, and an executive director of the hospice).

In this situation it would be most appropriate for Medical Social Worker to talk Mr. and Mrs. Ahuli because Medical Social Worker

1. Assists patients living with terminal conditions such as cancer. They arrange for care to enhance the patient’s qualify of life and counsels him and his family as they adjust to the diagnosis.

2. They remain with the patient from beginning to end, easing some of the family’s burden by handling the day-to-day details of the client’s medical care. They are responsible to connect patient and family members to community health resources available.

2. What is the difference between palliative care and hospice care? (2 points)

1. Palliative care can begin at diagnosis, and at the same time as treatment. Hospice care begins after treatment of the disease is stopped and when it is clear that the person is not going to survive the illness.

2. Hospice care is about easing pain and helping families prepare for the end of life. Palliative care is part of that, but it’s just one part.

3. Will the hospice team be able to incorporate Mr. Ahuli’s medicinal herbal remedies into his plan of care? Why or why not? (2 points)

1. As part of this process, fully assessing herbal medicine and supplement use in hospice patients is crucial, as patients in hospice may be likely to use these medications and may be more vulnerable to their potential adverse effects.

2. Assessing all herbal medicine use is ideal, but thorough detection of herbals may be challenging.

4. Should the hospice nurse assess the patient’s and family’s ability to cope? Why or why not? (2 points)

1. Yes, hospice nurse should assess the patient’s and family’s ability to cope. Nurses help family caregivers understand what to expect as their loved one’s terminal illness progresses and how to adapt their care in accordance with their loved one’s changing needs.

2. Caregiving demands a great deal of physical, mental, emotional, and spiritual effort. Over time, the stress of caregiving, coupled with the daily care responsibilities that the role demands, can lead to full-blown caregiver burnout. Here a hospice nurse visits becomes more impactful, as they become an opportunity for the caregiver to connect with someone other than their terminally-ill loved one.

5. What are best practices for providing postmortem care for Mr. Ahuli? (2 points)

1. To perform the task giving complete honor to the deceased as you provide this final nursing care.

2.The best approach for the nursing staff to meet with the family to offer options for their involvement in postmortem care, address their questions, and develop a plan that is culturally respectful.