One of the fundamental missions of medicine, nursing, and other medical professions is to ease the suffering caused by people’s physical limitations in their lives and death. However, modern medicine is still rightly accused of not addressing the needs of all the people and choosing to limit its attention to the finiteness of human bodies. Based on the described medical and social situation of Ben, who has an incurable disease and is in a state of frustration, it is evident that many people need palliative care. It includes comprehensive care for terminally ill people, medical and psychological interventions, and providing such patients with social services and social support measures.
Besides that Ben is experiencing physical problems, and his social position has also been affected by it. Moreover, Ben’s wife, Meili, who cannot inform the children about her father’s illness and has financial difficulties, also needs help. Thus, to help Ben, it is advisable to use a bio-psycho-social-spiritual treatment model that takes patients to the entire possible understanding of their integrity as people struggling with their finitude.
Bio-psycho-social spiritual model is a holistic concept that recognizes the interactions between the physical, psychological, social, and spiritual aspects of patient care and well-being. According to this model, illness disrupts relationships both inside and outside the human body. Inside the body, disturbances are twofold: on the one hand, it is the relationship between different body parts and biochemical processes; on the other hand, the relations between mind and body. In turn, outside the body, these disorders are also twofold: first, the relationship between patients and their environment, including the ecological, physical, family, social and political connections of the patient’s relationships. Secondly, there is a relationship between the patient and the transcendent or another world. Therefore, the bio-psycho-social-spiritual model is commonly used in clinical settings, especially in the care of patients dying of life-threatening diseases.
In Ben’s case, it is advisable to draw up a bio-psycho-social-spiritual assessment that will help determine the current state of the patient and his family. As for the physical aspect of the model, the patient has significant health problems associated with incurable diseases. The man was diagnosed with hepatocellular carcinoma (HCC) with cirrhosis on the background of type 2 diabetes mellitus and hypertension. In addition, Ben does not have the best heredity since his father died of cancer two months ago. The situation is complicated because due to advanced disease and cirrhosis, the available treatment options are limited.
In turn, the social aspect of the model involves consideration of issues such as worries about the family, loss of income and role in the family, and social isolation. In this case, both Ben and his wife Meili have significant problems. First, it is difficult for spouses to tell their children about their father’s fatal illness. Second, family incomes suffer as a result of Ben’s illness. It is because Ben was forced to resign from his job as an IT engineer due to worsening symptoms, and Meili has been on short-term personal leave to provide total care for Ben. At the same time, she may even lose her job in the event of her long absence from the workplace.
Ben and Meili’s family also has psychological problems that significantly affect the overall situation. According to Moosavia (2020), psychological aspect of the bio-psycho-social-spiritual model includes anxiety about the future, fear of death, the sorrow of loss, and depression.
The problem of family planning occupies a central role in this aspect. Meili is concerned with discussing practical issues, such as pre-care planning, probate, and financial matters, while Ben is reluctant to discuss future planning. However, Ben is not afraid of death and the sorrow of his coming demise and remains optimistic about children. Special attention in the bio-psycho-social-spiritual model is occupied by the spiritual aspect, which consists of the persons’ reasoning about the value of their life, life after death, and self-exploration, why they found themselves in such a situation. In my opinion, it is in this aspect that Ben and Meili have minor worries since their attention is fully riveted to the rest of the issues.
From this assessment, it can be concluded that Ben and Meili are in a state of frustration and need palliative care. The leading cause of their problems is Ben’s incurable disease, the physical component of the model. This is followed by the social aspect related to the loss of family income, which affects both Ben and Meili, as well as their unwillingness to tell their children about the disease. The psychological aspect also plays a significant role in the family, as Ben and Meili have difficulty planning. The spiritual component of the model is of minor importance since people do not express concern about the afterlife. Based on this, some guidance may be given to ease their feelings of helplessness and loss of control.
In this case, palliative care for Ben and Meili should be provided in all directions: physical, social, psychological, and spiritual. In terms of physical health, the patient can be offered a variety of treatments to help prevent and eliminate pain and other distasteful symptoms, improve well-being and quality of life, and endure with the side effects of cancer treatments. These include chemotherapy, immunotherapy, radiation, hormonal and targeted therapy, pain management, and the side effects of chemotherapy.
It is impossible to alleviate the condition of a dying patient with an incurable disease only with the help of drugs. It is equally essential to provide them with comprehensive psychological, social, and spiritual assistance. Dying patients need to feel protected; they want to be reassured, and told that they would not suffer at the moment of dying. It is necessary to ask, listen and try to understand how the patient feels. Ben’s entourage should help him finish his earthly affairs and promise to fulfill his last wish if he did not have time to do something. The main care for the patient consists of constant communication with him in the joint living of the last period of his earthly life. Ben’s wife should establish the most trusting relationship with him. He should know that he will not be left alone at the moment of death and that someone will help him through this period.
A great deal of responsibility is required in talking with the patient about death. To solve psychological problems, the palliative care nurse should advise Ben to put things in order, including those relating to the will. In turn, about Meili, specialists should talk to her about the natural and inevitable death and help her to accept this information. In the future, it is also vital to help the woman cope with the tragic situation, including, if necessary, using psychological support after Ben’s death.
Therefore, if a personality can be decomposed into some components, there are four main spheres that are closely interconnected, interact and interpenetrate with each other. These include physical, psychological, social, and spiritual components. In turn, a change in one of them invariably entails changes in all the others since a person is an integral being. That is why it is essential to provide comprehensive support to patients with incurable diseases and their loved ones.
Reference
Moosavia, S., Rohanib, C., Borhanic, F. & Akbarid, M. (2020). Spiritual care experiences by cancer patients, their family caregivers and healthcare team members in oncology practice settings: A qualitative study. Explore, 2020. pp.1-8. Web.