Reference no: EM133530086

Case Study: Mrs. Jones: Could Palliative Care be Relevant? Ms. Jones is a 78-year-old African American woman who lives with her daughter and is enrolled in an adult day program for patients with dementia. Ms. Jones is unable to ambulate but can be transferred from bed to chair and is transported to the day program via wheelchair. She is unable to complete any activities of daily living, and utters groaning sounds, but is unable to speak; she continues to be able to eat a pureed diet with full assistance. Her co-morbidities include hypertension, heart failure, chronic renal failure, and anemia, requiring two units of red blood cells monthly to manage shortness of breath. Her daughter, Ms. Carey, is a 62-yea r-old retired schoolteacher who states that, "taking care of mama is the most important thing I do in my life. She took care of her own mother who lived to be 104." M5. Carey has no siblings and her only son died of a heart attack at age 39. She suffers from osteoarthritis of the knees and spine, type II diabetes, hypertension, and most recently severe, painful post-herpetic neuralgia after an outbreak of shingles. She gets some caregiver respite, when her mother is at the day care from 9am-3pm but is up every two hours at night responding to her mother's frequent crying out and restlessness. She describes herself as a religious woman but is unable to get to her community church on Sundays, because she must care for her mother.

Discussion Questions:

1. Is Ms. Jones an appropriate candidate for palliative care? For hospice? Explain your rationale for each.

2. How could palliative care services benefit Ms. Jones and her daughter? Address each domain in your answer - physical, social, psychological, and spiritual well-being.

3. What might be potential barriers to transitioning this patient to palliative care?

4. What strategies would you consider to address these barriers?