Question

Alana’s husband and sons are now in her room. They are speaking very loudly and crying. They insist that Mai ‘do something’ quickly. They direct their anger towards her. Mai listens patiently and speaks calmly. The doctor arrives accompanied by an interpreter. He suggests that Alana take a dose of morphine orally at regular intervals to help settle her pain and make her last hours comfortable Alana’s family are worried that increasing the dose of morphine will hasten Alana’s death. Shortly after, Alana’s breathing becomes irregular and Alana is not able to be roused. Alana’s husband notices that Alana’s legs are mottled and her finger feel cool to the touch. He requests that Alana be given more blankets. Although the family members know Alana is dying, it is still a shock when it happens. They are pleased that Alana’s wishes were respected. Alana’s family starts to wail, a traditional Italian expression of open grief. Mai had developed a caring relationship with Alana during her time caring for her. She is sad, as she thought Alana would have lived a little longer; however, she has often thought about death and dying and is comforted by her own beliefs. She follows the organisation’s protocols for maintaining Alana’s dignity after death and comforts Alana’s family members and makes sure her sadness doesn’t affect anyone else. The team leader is impressed by how Mai handles her grief, especially as she is a new worker. He asks Mai to prepare five helpful hints about handling personal grief, which the organisation can provide to new workers in the future.

Q1 - When explaining that the doctor has ordered morphine as a pain-relief measure for Alana, her family become very upset and do not want this intervention. What should a support worker do in this instance? (Approx. 50 words)

Q2 - Why is it important for Mai to regularly check that Alana’s care plan has been updated? (Approx. 35 words that you can present in a bullet point list if you wish).

Q3 - Support is very important for all of the palliative care team. Mai recognises that Alana’s family requires more support and information regarding the increased need for pain relief. Which member of the team should explain the reason for the increased pain-relief medication to Alana’s family? (Approx. 35 words).

Answer 1

1. In this instance the support worker should listen to what the family has to say and then calmly assure them that morphine does not fasten death but it makes death rather painless. So it is important to respect Alana's feelings before death and we need to make her happy. So it is in her best interest that morphine is provided and it helps her to die peacefully.

2.

• To prolong time before death if possible
• To make her death painless and comfortable
• Any interventions that benefit her or her family.
• To make sure that they did everything they can for her and her family.

3. The leader of the team should explain to them the need for increased pain relief medications. The leader should make the family understand that it helps the patient to have a peaceful death and makes sure she doesn't suffer.