Reference no: EM133596568

Ms. G is a 87 year-old widowed orthodox Jewish woman who has been diagnosed with Alzheimer's dementia and Parkinson's disease 7 years ago. Currently, Ms. G's functional status is a FAST 7f and she requires total assistance with all her ADLs and iADLs. She is nonverbal and has been on artificial nutrition and hydration for the past 2 years. Ms. G has been living with her 53 year-old daughter (one of Ms. G's 10 children) who lives with her spouse. Ms. G's daughter also cares for her own grandchildren during the day Ms. G's children contribute to having a home health attendant care for Ms. G 24/7 at considerable expense, which is now going on 5 years. Ms. G was admitted to the hospital because she has been exhibiting concerning changes. According to her daughter, Ms. G is rarely awake and when she is, Ms. G is extremely agitated, pulling on her feeding tube and nasal canula. She has been having more difficulty breathing and increased incidents of throwing up, forcing the family to skip regular feedings. The family is very worried and very emotional and are very protective of Ms. G. They have mostly kept to themselves and asks everyone who tries to provide care if they are Jewish. They consult closely with their rabbi before speaking with the medical team. Eventually, Ms. G's respiratory status worsened, and she had to be placed in the ICU and intubated. The palliative team was consulted by the critical care team who verbalized concern that Ms. G was dying.

1. What additional information would you need to assess the client, including the family?

2. What federal or state laws or regulations are relevant to this case? For this assignment, use the state where you either reside or where your field placement is located. How would you address them? How do these affect the intervention that you have chosen for this case?

3. What are the palliative care issues presented in this case?

4. What interventions or decision would you recommend for this patient, (and family, if appropriate) based on the information included in the case and information that you would obtain? If information not included in the case is necessary to make a decision about treatment, discuss how the information you obtain would affect your recommendation for treatment.

5. What is the role of the social worker for this case? What is the role of the other members of the Palliative Care Team? Why?

6. What is in the evidence base about how individuals from this cultural group approach serious illness and end of life, including: a. Engaging in advance care planning b. Preferred communication style about diagnosis and prognosis c. Preferences regarding aggressive life-prolonging treatment

7. What are the ethical issues to consider in this case, including:

a. Relevant ethical values

b. Potential ethical dilemmas

8. What are the religious or spiritual issues that should be considered?