CHCPAL001: Deliver Care Services using a Palliative Approach - Management Assignment Help

Assignment Task :

Case Scenario 1
Bob and his wife Margaret have two children - two girls aged 24 and 27. All the family members live in the same city.
Bob was diagnosed with Motor Neurone Disease 12 months ago. He was working as an electrician but was forced to retire when he was diagnosed.Bob's illness has progressed over the last three months. He has severe weakness in his arms but is still able to walk around.
He's been referred to a physiotherapist and occupational therapist to determine what can be done to improve his physical and social functioning. The occupational therapist visits him at home to discuss some modifications to the house. Bob has his own ideas about the types of modifications he needs around the house but they are not within his financial capabilities at this time and Margaret is not sure how to tell Bob that the modifications will only be temporary as he has a life-limiting illness. 
Bob’s condition is deteriorating and he is finding that most day-to-day activities are becoming increasingly difficult. Margaret admits that "it’s been very hard" and says, "I know I should be stronger but I can’t". She is visibly upset.
A palliative care team has been assigned to Bob to manage his physical deterioration and pain management and a support worker will provide daily assistance with activities of daily living, tube feeding, transportation to specialist visits and palliative care needs. The palliative care team also explore the options for respite care for Bob and some ’time out” for Margaret.
 
It has now been 16 months since Bob’s diagnosis and his family have managed to keep up a regular routine of home care and respite for Margaret and assist with Bob’s financial and medical concerns. Bob is deteriorating and the support worker feels is might be time to involve the palliative care team in assessing Bob’s care needs as Bob may need to be placed in a Hospice full time to meet his increasing health care needs as he has severe pneumonia and is now completely bedridden. 
The support worker suggests that Bob and Margaret should have a visit from the palliative care nurse to discuss ongoing pain management, advance care directives and planning for end of life. The support worker has built a strong relationship with Bob and Margaret and often sits and listens and comforts them when they are upset. 
The support worker will continue to provides ongoing palliative care needs for Bob until he is placed in a Palliative Care Hospice and continue to support the use of pain relieving medications given by the palliative nurse, however the support worker is concerned that Bob will soon become addicted to the morphine and it will not be effective.
 
This case scenario has been adapted form the following resources: Palliative Care Curriculum for undergraduates PCC4U this resource was funded by the Australian GovtDept of health. http://www.pcc4u.org/learning-modules/core-modules/module-1-principles/2-caring/activity-10-william-s-illness-progresses/

Respond to the following questions based on this case scenario.

How could the support worker recognise the holistic care planning support needs for Bob extending over time, not just end-of-life, including nutritional and hydration needs? (PC 1.1, 1.2, KE.7) (Min 100 words)

A palliative approach to care specifically aims to improve the quality of life for the client who has a life-limiting illness by reducing the suffering through early identification, assessment  and recognising holistic needs of the person. Some assessment are as follows:
Monitoring vital signs such as; lowering BP, weak pulse rate and also for urinary volume and thirst for hydration.
Special assessment regarding swallowing and assistance to eat.
Oral intake of food and fluids can be significantly weaken at the end of life so that focus can be given on stimulating appetite, mouth care and also can give chips of ice to prevent mouth sores.
Ensure to follow all the care plan routines instructions made for bob, if says no to  any kinds of food then it should be avoided.
Make sure to respect cultural and religious beliefs  during food selection, preparation and service.
Active listening, building rapport, empathising and using open ended questions which will encourage expression of anxieties and preferences from patients as well as families. Also thes upport worker can provide information and support in a relevant way to meet their needs.
 

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