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The case of Mr. Pierce presents an example of a patient who wishes to spend his last days at home and not in a medical facility. Such decisions should be respected, and it is critical to provide a patient with the necessary comfort. Mr. Pierce’s potential outcomes are determined by his choice to refuse any aggressive treatment as he is likely to spend some weeks at home, receiving care that eases his condition. A healthcare professional should address such concerns as the patient’s physical health, mental comfort, and spiritual needs. Also, an advanced practice nurse should support the family members in terms of preparedness for the death of a loved one.
Mr. Pierce has deep vein thrombosis (DVT) and pulmonary emboli which cause such problems as shortness of breath and pain. The agreement for supportive drug therapy will ensure that the levels of pain induced by the identified disorders will be reduced significantly. Also, it is highly important to provide sufficient levels of care in the home setting so that the quality of treatment would meet clinical standards at least to some extent. One of the outcomes includes the patient dying from pulmonary embolism due to breathing difficulties (Jiménez et al., 2016). Another outcome is the patient’s death, which will be painless if the patient follows the treatment plan successfully. Overall, the patient’s stay at home should be made comfortable to support his choice.
Care, Treatment, and Support
The patient’s treatment should consider Mr. Pierce’s mental and physical health. First of all, his symptoms should be addressed with medications and additional procedures. Pain can be managed with drug therapy including pain relievers and topical creams (NIA, 2017). These medications, as well as keeping the air in the house fresh and humid enough, can also relieve the patient’s breathing problems. It is also possible that the patient will lose mobility in the following days which means that he may develop skin problems (NIA, 2017). It is necessary to assist the patient and encourage him to move or change positions while he stays in bed.
Due to the increased stress, the patient’s mental health should be addressed as well. Family support is crucial to the patients’ well-being – everyday interactions with his family and his caregivers can help Mr. Pierce remain calm and relaxed. It is also suggested that the family members should address the patient’s religious concerns, reading him spiritual texts or discussion questions related to faith and the afterlife (NIA, 2017). If Mr. Pierce wants to spend time with family, friends, or by himself, his choices should be respected. Family members can also discuss some future considerations such as property and burial with Mr. Pierce, ensuring that his wishes are acknowledged (Garrido, Balboi, Maciejewski, Bao, & Prigerson, 2015).
It is crucial for the health care provider to prepare the family members to assist Mr. Pierce in daily tasks and medical therapy. They should be aware of complications, exacerbations, and potential loss of mobility and conscience. Moreover, their mental health should also be considered because the death of a loved one is a serious situation that leads to emotional distress (Aoun et al., 2015). Thus, caretakers should be encouraged to share their responsibilities and ask for professional help if necessary. One can offer grief counseling to the children if it is necessary. If Mr. Pierce agrees to the help of a medical assistant, family members can be asked to participate in some daily activities while relieving their burden from some tasks.
Mr. Pierce’s physical and mental health treatment should focus on comfort and emotional support. The communication of family members with the patient is crucial as they can provide significant support. Some medical assistance can be offered to the patient, and family members may benefit from agreeing to participate in grief counseling. Mr. Pierce’s decision to stay at home can help him to remain close to his loved ones.
Aoun, S., Deas, K., Toye, C., Ewing, G., Grande, G., & Stajduhar, K. (2015). Supporting family caregivers to identify their own needs in end-of-life care: Qualitative findings from a stepped wedge cluster trial. Palliative Medicine, 29(6), 508-517.
Garrido, M. M., Balboni, T. A., Maciejewski, P. K., Bao, Y., & Prigerson, H. G. (2015). Quality of life and cost of care at the end of life: The role of advance directives. Journal of Pain and Symptom Management, 49(5), 828-835.
Jiménez, D., de Miguel-Díez, J., Guijarro, R., Trujillo-Santos, J., Otero, R., Barba, R.,… Monreal, M. (2016). Trends in the management and outcomes of acute pulmonary embolism: Analysis from the RIETE registry. Journal of the American College of Cardiology, 67(2), 162-170.
National Institute of Aging [NIA]. (2017). Providing comfort at the end of life. Web.