Reference no: EM133423264

THE COST OF COMFORT?

Carla, a case manager in the home care setting, is currently coordinating the care of Amelia, a patient with cancer, who is dying at home. Amelia is expected to die within the next few days. Community nurses visit daily, but Amelia's daughters and husband are providing most of her care. Although she receives morphine on a regular basis, she is still in great discomfort. Amelia is emaciated; the skin over her coccyx has broken down, and the cancer has metastasized to her bones.

One daughter comments to Carla that during a recent hospital admission, the nurses placed her mother on a special mattress that relieved her discomfort con-siderably. Carla explains that this mattress is not covered by home care and instead offers the services of special-duty nurses for the next few nights. Because Amelia's death is imminent, Carla is concerned that the family will need their rest. The family refuses the offer of assistance from nurses because they want to remain with Amelia and ensure they are with her when she dies. They make arrangements to rent the mattress themselves at their own cost.

Questions

What responsibilities does Carla have to ensure that Amelia's care needs are met?'

Does it make sense that a more cost-effective and practical intervention (the mattress) be denied? How can nurses change agency policies in order to introduce guidelines that focus on individual needs? (Or should all clients be treated the same way?)