What kind of stress jake is experiencing

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Reference no: EM133343629

Case Study: Jake Charles is a 70-year-old male with metastatic prostate cancer. He is a retired teacher that the Palliative Care home care team and the Case Manager has been looking after him at home for the last two months. Jake was diagnosed with inoperable prostate cancer three years ago and has been treated with ablative hormone therapy. Six months ago, Jake started to have pain in his hips. His oncologist ordered a CT scan and found he had metastases in his ribs, pelvis, and lumbar spine. Jake and his wife Sally had a meeting with the team at the cancer center and decided not to go ahead with any further cancer treatment. The couple's only daughter Susan disagrees with Jake and his wife wish of no further treatment. The Palliative Care team has been involved since. Sally called the Case Manager yesterday and asked for a home visit. Jake has been having more pain this week is anxious and has been spending most of his time on the couch. Jake in the past week has poor appetite and has loss 10 lbs. in the last month. He cannot get around without assistance and is very fatigued. His only daughter, Susan is a 45-year-old nurse, has not been involved in taking care of her father and spend most of her time with her friends. She blames her mother for her father's worsening condition.

Medical Regiment & History:

Jake's past medical history includes hypertension and reflux. He is taking Prednisone 5 mg PO BID, Leuprorelin Depot 22.5mg IM every 3 months, hydrochlorothiazide 25 mg daily and pantoprazole 40 mg daily.

For pain, Jake takes Morphine slow release 100 mg q12h. The pain with the current treatment plan is not effective and Jake complains of increasing pain. The proposed recommendations are 0.5mg/ml Q 4 hours for breakthrough pain. Susan visited her father for the first time in two months and after seeing her father believes, since he no longer takes chemo, Jake would benefit from Hospice care. She is advising her parents to set up a POLST. Sally is devastated and believes with the right pain management Jake will be comfortable and regain his appetite again.

Questions:

1-as a new Palliative Case Manager to the team, what would be your recommendations on Symptoms Management?

2/ What kind of stress Jake is experiencing?

3/ Do you think the GAS can be apply to Jake's decompensation? Explain in detail if or if not with citations

4/What would be your recommendations on coping mechanisms for Jake's family?

5/ Can you identify any defense mechanisms in the scenarios. If so explain and which family member. Please use EBP to substantiate your responses.

6/What would be the recommendations on a treatment plan for the client and family.

7/What is the differences between hospice and palliative care. Based on your knowledge of the matter which one would Jake benefit from and why?

8/What is a POLST?

a/Explain the various forms of advance directives

b/Is Susan correct in recommending a POLST for her father? Give a full explanation if you agree or disagree.

9/From the scenario set up a SBAR

10/ What is End of life Care? Explain fully and what are the goals?

Reference no: EM133343629

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