Case study 3. Tom’s Story

Case study 1. Betty’s story

Betty is a 70-year- old woman married to Alan, also 79. Betty and Alan have a

close family network; their daughter Cheryl, has two young boys and they see

each other regularly.

Two years ago Betty was diagnosed with Stage 3 Chronic Kidney Disease (CKD)

following routine tests organised by her GP. Betty has multiple co-morbidities

including: Type 2 Diabetes, IHD, PVD, HT and a STEMI 2 years ago.

Her kidney disease has been fairly stable since diagnosis. Betty has been well

managed by her GP in conjunction with the multidisciplinary team at the kidney

clinic. The renal dietician has been providing nutritional information and

support to Betty and Alan, advising them on the impact of certain foods on her

renal function.

For the past month or so, Betty has been experiencing new symptoms. She is

lethargic, slightly short of breath, nauseated at times and her legs are

oedematous. Betty is concerned about these new symptoms and is seeing her

team at the Kidney clinic tomorrow to discuss this.

Please see the video relating to Betty on this link to PCC4U: (Links to an external site.) (Links to an external site.)

What treatment/management option Betty has identified as her preference?

Outline what this would involve.

What key factors need to be considered to enable Betty to have the End of Life Care she would prefer?

Case Study 2. Amy’s Story

Lan migrated to Australia with her parents Yi Ming and Mei when she was 18 years of age. Lan adopted the English name Amy soon after arriving in Australia.

Amy married in her early 20’s, had a son Erik and divorced from her husband when Erik was six years of age. Amy took on the responsibility of raising Erik with the assistance of Ying Ming and Mei. Amy is now 59 years of age and works full time in a fruit-canning factory. She has good friends from her workplace, neighbourhood and community. Amy speaks both English and her traditional language. Amy lives with her son Erik and her mother Mei, who is now in her 80’s with limited English. Erik speaks English, with minimal ability to speak Amy’s traditional language.

Recently Erik has noticed that his mother has trouble finding words and sometimes repeats herself during a conversation. He has also noticed she doesn’t seem to be able to concentrate for long and has missed paying bills two months in a row, which is very unlike her. Erik has asked about her about it, but she continues to shrug it off, saying she has been feeling stressed from work.

Please watch the video about Amy via this link from PCC4U: (Links to an external site.) (Links to an external site.)

Discuss how staff attitudes about Amy, Mei and Erik’s cultural practices would:

  1. a) Affect care provided to Amy and her family
  2. b) Impact on Amy and her family’s psychological well-being

Case study 3. Tom’s Story

Tom is a 55 year old Aboriginal man with advanced lung cancer and multiple

metastases. He collapses at home, his family call the ambulance and he is

admitted to the ward, extremely breathless. His disease is now end stage. Tom’s

wife Cec and their son Jimmy are with him in the ward.

Please watch the video about Tom via this link from PCC4U: (Links to an external site.)

What are the key needs and concerns likely to be for Tom and his family as they face Tom’s imminent death in the hospital? Please provide evidence for your answer.(You may use dot points here)

Jimmy states “Dad knows he’s not going to make it back to country to die”. Based on this scene, what are some of the reasons that Tom may want to return to the country to die?

Based on your learning from this activity, what specific strategies do you plan to incorporate as a health care professional?

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