Write an critical analysis on the given scenario ( end of life care ) about communication ,decision making and involvement of the family
Trigger 3 (Patient cenario)
The community nursing team have been caring for Robert ( has dementia) for the past 3 and half years.
Marcus ( his youngest son ) has taken a sabbatical from his career and moved into his parents’ house to help care for his father . He now carries out most of his father’s personal care . Private carer visit twice a day to assist him. Judith continues to help her husband but she has become physically drained and psychologically withdrawn in the last 6 months , she hasn’t attended her church or have friends visit during this time . Michael and his family visit regularly but haven’t been for over 4 weeks now as the children find it distressing to see their grandfather .
The community nurses have been asked to do an urgent home visit by the GP after Marcus phoned worried about his father’s deteriorating condition over the last 2 days .
Over the past few months Robert has experienced profound weight loss showing bone protrusions at key pressure points. He has also developed grade one pressure wounds on his left buttock, left shoulder, elbow and ear.
When the nurses arrive it appears that Robert’s condition has deteriorated . his breathing is laboured ; he is coughing on what appears to be respiratory secretions and is crying out on any movement. He is currently receiving 25mg of fentanyl via a transdermal patch. This was last changed by Marcus 2 days ago. There is no other analgesic medication prescribed. Robert has stop taking any oral fluids for 48 hours. He is sleeping over 20 hours a day and makes no physical effort to move in the bed. His lips are dry and cracked and his incontinence pads have been dry when checked. Robert fears that his father would not recover from his current situation, but has kept this to himself, as he doesn’t want to upset his mother any further .