CASE #1
Myrtle is a 92 year old resident of the Clearwater Nursing Home where she was placed a year ago due to dementia. She has also been diagnosed with cancer and her family has been told that she has less than six months to live. She has been placed in hospice care to help control her pain and make her as comfortable as possible until her death. Myrtle is a very happy person on most days and carries her baby doll around as if it is a real child. You can usually find her in her rocker in her room talking to her baby and watching television. Myrtle cannot feed herself, is incontinent, and cannot walk unassisted. She cannot talk coherently and rarely recognizes anyone.
She has 3 daughters and a son who visit her regularly. Her son is in total denial about his mother's impending death and the 3 daughters are in various stages of acceptance. Her middle daughter appears to be the most realistic about her mother's health. The children have not made any funeral arrangements and they are suspicious of hospice service providers due to a bad experience with their father.
What things do you see needing to be addressed with this family and how would you approach them in regard to those issues? What concerns do you have about the patient, if any?
