End-of-Life Care Transitions and Palliative Care
Unit outcomes addressed in this Assignment:
- Identify best practice in strategies facilitating autonomy and patient self -determination in the aging population.
- Examine ethical and legal challenges related to end of life and palliative care in the aging population.
- Examine the advanced practice nurse role working in primary care in transitions across health care settings of aging patients.
Course outcome addressed in this Assignment:
MN584-05: Form a collaborative relationship with the patient, family, and other health care providers.
Case Study: Mrs. Georgia D’Angelo
Mrs. Georgia D’Angela is 76 years old. She has been married to her husband Marcus for 58 years. Marcus is 80 years old. The D’Angelo’s live in a well-kept, middle class home. The D’Angelo’s have three grown children: two sons and one daughter. All of the children are married and only their daughter lives close to them. The two sons each live more than 3 and a half hours away. The D’Angelo’s are very close to their children and talk with the children every day. Four months ago, Mrs. D’Angelo noticed her skin was “yellowish” in color and upon calling her primary care provider, she was told to go immediately to the emergency room for evaluation. After having a CT scan of the abdomen and laboratory studies, Mrs. D’Angelo was told she had pancreatic cancer and that she should immediately have a Whipple Procedure. This news was devastating to the D’Angelo’s and their family and friends. Mrs. D’Angelo called a friend who is a nurse and asked who she might go to for a second opinion. A second opinion was obtained and the second opinion reaffirmed the diagnosis of pancreatic cancer however the recommendation was to have chemotherapy prior to the Whipple Procedure. Mrs. D’Angelo began the chemotherapy and has suffered severe issues secondary to the chemotherapy and her quality of life is greatly impacted with a huge decrease in her functional status and activities of daily living. As of today, Mrs. D’Angelo has not discussed her fear of dying with you as the primary care provider or with her family. She has an excellent attitude about “fighting this horrible disease.”
Based on this case study, imagine you are the nurse practitioner providing primary care for Mrs. D’Angelo. Please prepare a 10–12 slide PowerPoint presentation. The title slide and reference slides are not included in the slide count. You should have 5 peer-reviewed scholarly references no more than 5 years old to support this Assignment. Please address each of the following grading criterion. Include the Grading Criterion as a subheading in your paper in APA 6th edition format.
- Discuss the advanced practice nurse role facilitating end-of-life care and advance directives for Mrs. D’Angelo.
- Compare and contrast the types of advance directives and discuss the relevance of advance directives to this case study.
- Describe how you would approach the topic/issue of advance directives with Mrs. D’Angelo.
- Identify 2 ethical principles and 2 legal challenges related to end of life and palliative care for Mrs. D’Angelo that could be an issue if advance directives are not addressed at this time.
- Describe communication strategies you will use as the nurse practitioner to effectively engage and collaborate with other members of the intra professional healthcare team and Mrs. D’Angelo’s family