Reference no: EM133405820

Case Study
Debra is a 67-year-old female of Italian descent. She was diagnosed with stage IV non-small cell lung cancer (NSCLC) that has metastasized to her bones a year ago. In the past year, she was treated on a therapeutic randomized clinical trial, which consisted of standard chemotherapy and immunotherapy. When her cancer responded poorly to the therapy, she was randomized to receive additional "experimental" chemotherapy. Debra and her husband, Robert, live in a house they have owned for 30 years. Debra was a counselor and had a private practice until she was diagnosed with lung cancer. Robert owned a construction company, which he sold two years ago. He has had diabetes for more than 20 years and had one foot amputated three years ago. Debra was Robert's primary caregiver before she was diagnosed with lung cancer. Both of them were very active in the community, hosting weekly "Tea and Culture Lovers" event at their house.
Debra has a very close relationship with her oldest son Michael (40 y.o.), and he has been an active participant in every treatment conference. Michael lives 5 miles away from his parents, and has been coming to visit his parents daily since she was diagnosed. Michael reduced his working hours and withdrew from a few projects as a construction manager to allow more time to care for his parents. Michael used to bring his 11 y.o. daughter to visit as well. Debra enjoyed having her granddaughter around. However, his daughter has been "acting weird" lately and does not want to visit her grandparents. For the most part, Debra tolerated the treatment; however, she struggled both physically and emotionally with the last 3 months of treatment. Debra's end-of-therapy scans confirmed that tumor was still present in both the bone and the lungs. Michael wanted to proceed with an (unproven) experimental therapy in an effort to prolong her life. Debra, on the other hand, did not desire this intervention. She asked the doctor not to administer the drug and to allow her to die on her "own terms" at home. She does not want to be a burden on the family.
Debra and Robert have two daughters, Jenny and Stephanie, who live in other states. They flew in two days ago to see their mother, after Debra was admitted to a progressive care unit as she fell at home and broke her left hip. Jenny still would not talk to her father because she thinks Debra has lung cancer because of his long-term smoking habit. Stephanie is a nurse. She is upset because she insisted before that her mother should be put in a care facility rather than living at home with Robert, but nobody in the family agreed. The hospital's palliative care team came earlier today and wanted to talk to the family, but Michael refused and would not allow his sisters to talk to them either.

Questions: Address the following points

1. Defining at least one outcome associated with measuring care coordination. Use one peer-reviewed sources to support your statements.

2. Defining both the roles and required attributes for RN coordinators to influence the outcome(s) identified.

3. Identify, explain, and adopt one of the four Elder-Appropriate Models of Care Coordination in table 4 of the Scholz & Minaudo (2015) article that you think is the most appropriate for the case.