Health Care Decision Maker Discussion

Health Care Decision Maker Discussion

Health Care Decision Maker Discussion

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Case Study 3: Mr. Marley, age 91, is admitted to the intensive care unit following a stroke. The stroke progressed from mild hemiparesis and difficulty speaking to complete unresponsiveness and an inability to swallow. His daughter feels certain, based on prior explicit conversations with her father, that he would not want to have any treatment that would prolong his life and leave him in a severely disabled state. Mr. Marley’s oldest son disagrees with his sister’s assessment of their father. The son claims that their father still has a strong desire to live, and that he has been very active in his church until this stroke. Because Mr. Marley cannot swallow, he cannot be fed. The family is asked about insertion of a feeding tube. It is explained to the family that without food and fluids, their father will die fairly quickly. There are no existing advance directives or a designated health care decision maker noted for Mr. Marley. To prepare: Review Chapter 14 of the Holroyd-Leduc and Reddy text. Reflect on the role of the advanced practice nurse in facilitating the discussion of end-of-life care with patients and their families. Think about how you, as an advanced practice nurse, would approach a family who wants “everything” done for a patient with only a limited time to live. Consider when it is appropriate to involve hospice and how to approach patients and/or families who refuse hospice services. Select one of the three provided case studies related to the end-of-life care of the frail elderly. Reflect on potential patient outcomes and how you would facilitate the discussion of care with this patient’s family. Post on or before Day 3 an explanation of the role of the advanced practice nurse in facilitating the discussion of end-of-life care with patients and their families. Explain how you would approach a family who wants “everything” done for a patient with only a limited time to live. Then, explain when it is appropriate to involve hospice and how to approach patients and/or families who refuse hospice services. Finally, explain potential outcomes of the patient in the case study you selected and how you would facilitate the discussion of end-of-life care with this patient’s family. Read a selection of your colleagues’ responses. Respond on or before Day 6 to at least two of your colleagues on two different days who selected different case studies than you. Based on the site of care, suggest strategies for establishing the role of advanced practice nurses in end-of-life discussions with patients. Click on the Reply button below to reveal the textbox for entering your message. Then click on the Submit button to post your message.

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