Assignment: Scenario Analysis- Julia Morales and Lucy Grey
Scenario Overview
Patient: Julia Morales
Diagnosis: Lung cancer, stage 4
This scenario is part of the Julia Morales and Lucy Grey Unfolding Case. The scenario can be used as a standalone scenario or as part 1 of the case.
The Unfolding Case
Julia Morales, age 65, and Lucy Grey, age 73, are partners who have been together for more than 25 years. They are retired and have spent the past several years traveling together. Julia has lung cancer, which has been treated with chemotherapy and radiation, and now she wishes to stop treatment. Lucy is supportive and feels she will be able to care for Julia in their home. Lucy's past medical history includes a knee replacement. Their support system includes Julia's son, Neil.
The simulation scenarios begin with the home health nurse evaluating Julia after she has decided to stop treatment for her lung cancer. Her partner Lucy wishes to care for her in their home. In the second scenario, the end of Julia's life is near and she is surrounded by her loved ones and the hospice nurses. Julia dies during this scenario. The learners are introduced to supportive measures for both the patient and the family during this process. The final scenario concentrates on Lucy and the difficulties she has adjusting to her new life after Julia is gone. The objectives focus on the students' assessment of Lucy's grieving process, how well she is coping, and the physical changes that she has experienced over the past few months.
Brief Summary of Present Scenario
This scenario involves a visit by the home health agency nurse. The students are expected to do a physical and functional assessment of Julia and her nursing care needs. Julia inquires about hospice services, but her son Neil urges her to try one more round of chemotherapy. Lucy is supportive of Julia's decision and tries to comfort Neil. The students should assess Lucy's caregiver preparedness, and articulate what hospice care means for the patient and family. The assessment tools recommended for this scenario include the Katz Index of Independence in Activities of Daily Living (ADL), and Informal Caregivers of Older Adults at Home: Let's PREPARE!
Learning Objectives
Upon completion of the scenario, the student should be able to:
1) Provide care for the terminally ill older adult and her family in the home setting
2) Perform physical and functional assessments of the older adult, using standardized tools, to include:
• Katz Index of Independence in Activities of Daily Living (ADL)
3) Assess caregiver preparedness using the Informal Caregivers of Older Adults at Home: Let's PREPARE! assessment tool
4) Identify purpose of hospice care and services provided
5) Explain advance directives and durable power of attorney.
6) Relate the importance of providing individualized care unique to each individual and family.
Task
1) What priority problem(s) did you identify for Julia Morales and Lucy Grey?
2) What teaching measures and what other members of the health care team should be included in the home health nurse visit for Julia Morales and Lucy Grey?
3) What potential barriers might Julia Morales and Lucy Grey encounter that would hinder active participation in Julia's care?
4) What appropriate assessments were made to help you decide what interventions Julia Morales and Lucy Grey needed?
5) What appropriate strategies could be implemented to empower Julia Morales and Lucy Grey in the management of Julia's care?
6) What potential problems does Julia Morales face if the symptoms of her disease progression are not recognized and if actions are not initiated in a timely manner?
7) What is the role of the home health/hospice interprofessional team, and what is the importance of teamwork and collaboration in the case of Julia Morales and Lucy Grey?
8) What potential environmental/safety hazards need to be assessed in the home care setting?
Concluding Questions
1) Reflecting on Julia Morales and Lucy Grey's case, were there any actions you would do differently?
2) How would you apply the knowledge and skills that you obtained in the case of Julia Morales and Lucy Grey to an actual patient care situation?
Format your assignment according to the following formatting requirements:
(1) The answer should be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides.
(2) The response also includes a cover page containing the title of the assignment, the student's name, the course title, and the date. The cover page is not included in the required page length.
(3) Also include a reference page. The Citations and references should follow APA format. The reference page is not included in the required page length.