Methods to Incorporate Palliative Care into a Patient-Family-Centered Care Plan
A. Discuss methods to incorporate palliative care into a patient-family–centered care plan for the patient in the scenario.
1. Describe reasons why palliative care support and services are an appropriate intervention for the patient in the scenario.
B. Describe strategies to improve the quality of life for the patient and family in the scenario.
C. Discuss ways to utilize the strengths-based perspective within the context of the scenario.
1. Describe strategies to honor the patient’s autonomy and self-determination in the scenario.
D. Describe cultural dynamics that may need to be addressed when coordinating care for the family in the scenario.
E. Complete a risk-benefit analysis of cultural, socioeconomic, developmental, and physical factors in the scenario to inform interventions to improve health outcomes.
F. Discuss verbal and nonverbal methods of communication that you as the care coordinator could implement to benefit the patient in the scenario.
G. Describe referrals and community connections that could promote patient-centered care and meet the needs of the patient in the scenario as a chronically ill individual and her family.
1. Describe methods to assess a patient’s safety in the home environment, processes for making appropriate referrals or recommendations, and referrals and recommendations appropriate to the patient in the scenario.
H. Recommend strategies for successful care transitions based on an assessment of biopsychosocial-cultural factors of the patient and family in the scenario.
I. Describe each of the four levels of hospice care.
1. Discuss which of the four levels of hospice care is most appropriate to the patient in the scenario.
J. Discuss how to address legal considerations and ethical dilemmas specific to the scenario, including those related to advance care planning and decision-making.
K. Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized
Patient-Family-Centered Care Plan
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Patient-Family-Centered Care Plan
A: Methods to Incorporate Palliative Care
One method of incorporating palliative care into a patient-family-centered care plan is information sharing. According to Cherny et al. (2021), patients and families need access to the relevant information about the medical condition, how extensive it is, and the expected outcomes. This allows them to understand and come to terms with the illness. The patient and family in the scenario struggle to understand the prognosis and manage their expectations. Another method is enhanced family participation and cooperation in the patient’s care. Cherny et al. (2021) reveal that family participation and cooperation provide the patient and their family some sense of intimacy and comfort. Also, Cherny et al. (2021) recommend open communication when integrating palliative care into the care plan. It allows patients and families access to information.
A1: Palliative Care Support and Services
Palliative care support and services are appropriate for the patient for several reasons. The patient’s quality of life has been declining as she has reported decreased mobility and appetite and increased forgetfulness. As Cherny et al. (2018) reveal, palliative care support and services can help improve the patient’s quality of life. Two, the patient is in great pain and discomfort, mainly the reason for her current hospitalization. Palliative care focuses on managing pain and enhancing patients’ comfort and function (Cherny et al., 2018). Three, the patient’s family is also struggling with her condition. Her daughter gets upset when the patient is unwell, and she can also benefit from palliative care support and services.
B: Strategies to Improve Quality Of Life
To improve the quality of life of the patient and her family, strategies such as psychoeducation, specialized social support, and mindfulness activities can be used. According to Mokhatri-Hesari & Montazeri (2020), psychoeducational interventions provide cancer patients with tools to help manage their pain and enhance their emotional well-being, thus improving their quality of life. They provide education and support to patients and their families. The patient does not have an adequate support system, and her daughter, who is her primary source of support, is overwhelmed with other responsibilities. Both can benefit from specialized social support, which involves receiving support from trained nurses. In addition to medical help, nurses in such interventions also support social and personal issues (Frick et al., 2019).
Also, mindfulness interventions allow patients and their families to focus on the now instead of worrying about the future (Mokhatri-Hesari & Montazeri, 2020). The individuals in the scenario can use mindfulness to help them navigate through the patient’s condition.
C: Utilizing a Strengths-Based Perspective
The strength-based perspective (SBP) is grounded on the capabilities and resources that a patient has. According to Yan et al. (2020), it involves enhancing patients’ quality of life and their families by helping them identify and utilize their strengths. Within the scenario, the patient can be given specific feedback about their strong areas and then asked to pick one area of strength and focus on it each day. Yan et al. (2020) refer to this as the “using signature strengths in a new way” way of utilizing SBP. Also, the patient can be asked to identify three positive things that happen to them each day. Yan et al. (2020) refer to this as the “three good things” method of utilizing SBP. The strengths that can be utilized include the patient and family’s optimism, the patient’s social support from her daughter, and the patient’s intermittent alertness. The latter can be used to help her develop her advance directives.
C1: Strategies to Honor Autonomy
The patient seems to have conflicting wishes about the next step because she agrees with her daughter about seeking treatment and privately shares that she is ready to die. Her healthcare team must respect her wishes to seek treatment to honor her autonomy and self-determination since she does not have an advance directive stating otherwise. After sharing all the relevant information with the patient, they can obtain informed consent, which will honor her autonomy (Olejarczyk & Young, 2021). What she has shared with the team privately should be kept confidential. As Olejarczyk and Young (2021) reveal, autonomy is granted when confidential patient information.
D: Cultural Dynamics
The cultural dynamics that need to be addressed in this scenario include religion, beliefs about death and dying, and the value/importance of family, which influence the delivery of care, according to Matzo and Sherman (2019). The patient seems to be religious and has a strong belief in God. She also believes that there is life after death (hence her readiness to “be with God”). Additionally, her need to consult her daughter and agree with what she wants shows that she values family more than herself, which might explain why she has not talked with her daughter about death.
E: Risk-Benefit Analysis
Factors
Risks
Benefits
Cultural
Cultural values and perception about the body –Aggressive treatment mat alter her appearance; loss of hair, weight.
Preservation of cultural perception about body
Socioeconomic
Financial loss- If the patient pursues aggressive, futile treatment.
Reduced social support- If she does not receive palliative care.
Preservation of finances through effective, non-futile approaches to care
Developmental
Loss of mobility and cognitive function if she does not receive palliative care
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