What are the palliative care issues presented in the case

Reference no: EM133481454

Assignment: Palliative Care Case Study

Pete is a 24 year-old African American man who was diagnosed with sickle cell disease when he was 3 years-old. He has a history of acute chest syndrome, necrosis of the hip, and has had recurrent chronic leg ulcers for 3 years. He had been receiving his treatment from a Pediatric hematology group and recently transferred to the adult hematology clinic. Since the transfer, he has been hospitalized monthly for sickle cell pain crisis, with back, leg and chest pain which does not respond to his home pain regimen of Dilaudid. Pete has monthly pain crises at home, despite following an oral pain regimen that seemed to be working at home. After being admitted to the hospital via the ER, Pete is usually hospitalized for 1-2 weeks on an IV pain regimen, which he heard about from his peers with sickle cell disease. This specific combination of medication that he asks for is known to cause a temporary "high" and Pete reports it is effective. He has asked that the palliative medicine physician be removed from his case because they consistently push back on prescribing this combination of medication. Pete has a good relationship with the palliative care social worker and consents to them continuing to follow. Pete has been offered home health care services, but he refuses. He is cared for at home by his mother, who also cares for his two younger siblings, ages 14 and 17. He has good support from his mother. Pete is Christian and considers himself very religious. During one social work interaction, Pete revealed an incident of sexual harassment by an authority figure during his adolescence but refused to discuss further when pushed.

Question I. What additional information would you need to assess the client, including the family?

Question II. What NJ federal or state laws or regulations are relevant to this case?

Question III. How would you address them?

Question IV. How do these affect the intervention that you have chosen for this case?

Question V. What are the palliative care issues presented in this case?

Question VI. What interventions or decision would you recommend for this patient, (and family, if appropriate) based on the information included in the case and information that you would obtain? If information not included in the case is necessary to make a decision about treatment, discuss how the information you obtain would affect your recommendation for treatment.

Question VII. What is the role of the social worker for this case?

Question VIII. What is the role of the other members of the Palliative Care Team? Why?

Question IX. What is in the evidence base about how individuals from this cultural group approach serious illness and end of life, including:

i. Engaging in advance care planning
ii. Preferred communication style about diagnosis and prognosis
iii. Preferences regarding aggressive life-prolonging treatment

Question X. What are the ethical issues to consider in this case, including:

i. Relevant ethical values
ii. Potential ethical dilemmas

Question XI. What are the religious or spiritual issues that should be considered?

Reference no: EM133481454

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