Question

Case study

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. 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?

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

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

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

5. 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?

Answer 1

1,    As a support worker we have to provide personal,social,physical and emotional support to patients when they are disabled..Alana is disabled and mai providing services for her as a support worker for stroke her arm and apply massage oil,and she must act as a good communication person..so as per alana wish Mai can convey the message and emotional expressions to family..she could not even go for bath due to pain..so she need emotional support and medication for her illness..As a support worker Mai has to see whether she has taken her pain medication..Alana need emotional support to get them through a difficult time..Mai has to analyse Alana basic needs..Make sure always the family members are around her..It makes alana comfortable and confident over end of her life..
2, Patient own homes and in the community will be the best location of their end-of -life care..As per Alana husband and her wish her home with surrounded by her family members she feels comfortable for her services..It ensure that Alana living in hygeinic and healthy environment..
3, support worker have a major responsibility for patient health care and intellectual disability..Health care support workers(HCSWs) work as a part of a team providing high quality and effective care to individual..pain level and duration must be monitored,checking overall progress,comfort and well being..it must be reported to Alana primary physician when and how long the pain duration she had nd her stability during pain and any other alteration to be done with medication for her pain..
4, Two strategies which Mai implements to manage Alana's pain and provide comfort is she stroke her arm and apply massage oil..it makes her more comfortable and relief pain in her arm..one more solution Mai understand her pain level and she tried to bathe alana in her room itself but Alana could not due to her pain and pain medication was helped her lot from pain..
5, As doctor order Morphine medication but family refused to this medication..they have the rights to avoid the orders..first we must understand why family avoiding morphine medicine..provide education to family about alana health condition and how the medicine will help her from pain..as a support worker you can calmly and rationally speak to family about medication uses and side effects..The patient and family has the right to make decision regarding their treatement but we need to ensure that decisions are informed and try to help them overcome their fears and make the best decision possible for their care..If that deicision in cludes refusing care,then we must come to accept the decision...