Question

Alana is entering the end-of-life stage. She often has difficulty breathing. She likes Mai to stroke her arm and apply massage oil. One morning she whispers to Mai that she doesn’t have the energy to see her friends and extended family anymore. She asks if Mai can tell them that she loves them but she can’t see them anymore. As Mai is helping her out of bed, Alana says, ‘I don’t think I can have a shower today’. Mai tells her that is all right and that she can bathe her in her room instead. Just as Mai is reassuring her, Alana groans with pain. She clutches her chest and starts to cry. Mai knows she is allowed to watch Alana self-medicate so she makes sure the pain-relief tablet is taken. Alana’s family is aware that Alana is entering the end of her life and Alana’s husband would like Alana to die at home surrounded by her family members. Alana expresses that she is more comfortable in the hospice and would prefer to remain there.

1. To whom should Mai report Alana’s changing needs and issues in relation to end of life

2. When a person accessing services makes a decision that impacts the families, carers and/or significant other, what course of action should the support worker follow?

3. How can the support worker assist the person accessing services to choose the location of their end-of-life care?

4. What might a support worker observe and document about pain for a person and how should this be reported

5. Identify two strategies that Mai implements to manage Alana’s pain and provide comfort.

6. Identify a problem-solving strategy that Mai implements to manage Alana’s pain and still maintain personal hygiene

Answer 1

1) Mai should report Alna's changing needs to physician or nurse or other health care provider.

2)• Provide psychological counseling both patient and her family member.

• Assist the client to perform daily living activities.

•provide assurance that client and family is not alone in crisis situation.

•The patient should be encouraged to be surrounded by her family member and belongings.

• Patient should be provided an environment which permits her to return to her own schedule of daily living.

3) The support worker should inform about the strategies provided in hospice care to choose the location of their end of life care, such as-

•They allow the family member to take part in care of dying patient.

• Availability of care 24hours a day.

• Availability of physicians and health care provider.

•Meeting of the primary wishes of dying patient.

4) The support worker should observe the facial expression, posture, gesture of the patient and document as pain score.

The pain level of the patient is reported by showing pain score of the patient.

5) Two strategies are-

•Mai applies massage oil on the Alna's arm.

• Mai provides pain relief medication to Alna.

6)• Mai apples massage oil on the Alna's arm.

• Mai instructs Alna to take bathe in her room.

•Mai observes if Alna took pain relief medication.

•Mai allows Alna to remain in hospice care.

• Mai wanted to given mind diversional therapy to Alna to make comfortable her by inviting her friends, though Alna refused it.