The comorbidities and complex symptoms

Running Head: PALLIATIVE CARE
PALLIATIVE CARE
Name of the Student
Name of the Author
Author Note

PALLIATIVE CARE1
Case Study 1:
Based on the case study provided the hospice care for the health compromised
individual, Betty identified palliative care as the preference for her health condition.
Pain in renal failure is due to renal bone disease. This causes increase in Betty’s anxiety
regarding prescribing as well as poor recognition. Codeine, strong opioids and morphine
should be avoided in renal failure. NSAIDs should also be limited to the use of the patient.
When the GFR falls below 20ml/min the solutions of buprenorphine and fentanyl solutions
should be used. She experiences neuropathic pain for which amitriptyline should be
administered at low dosage. She also expressed being nauseated at times. Low dosage of
haloperidol and levomepromazine are the anti-emetics that are used (Rak et al., 2016). The
palliative care is provided alongside with medication and the potential care at home is vital.
Hospice care for patients combating chronic kidney disease is complex and requires essential
planning. The care should essentially be holistic and the physical, social as well as the
psychological needs of the patient should be attended to. It should be noted that the health
deterioration is progressive in nature for chronic kidney disease. The comorbidities and
complex symptoms in relation to the chronic kidney disease also requires the palliative aid.
Hospice care for the renal patients had been inadequate in the recent past but
palliative care and nursing has helped in bringing a new approach to help the patients
improve their quality of life and be valued for in their final days (Foote et al., 2016). The
advanced care management would help Betty establish their priorities and preparing her
psychologically for death and establish subsequent control over their wants and wishes.
Advanced care planning management involves the process of interaction of the patient and
their health care providers and family members as well as the other individuals regarding the
preferred decision maker of the patient and the respective care required by the patient when
the patient is unable to take their own decisions. All the needs should be carefully

PALLIATIVE CARE2
documented and informed to the clinicians and the others to aid with the conditions of the
patient. The service will be taking place at her home. It is considered that the service helps
her husband and her daughter who visits her to cope up with the present situation. This care
demonstrates ‘cultural sensitivity’ to the patients which plays a crucial role in patient
satisfaction. Her family also provides high level of encouragement and unity for Betty. This
indeed helps in decreasing the levels of psychosocial morbidity. This is because lack of
support for the patient from their family negatively impacts their well-being (Kwok et al.,
2016; Foote et al., 2016).
Case Study 2
Care provided by the nurses to the patients is very much dependent on the cultural
perspective and the attitude of the healthcare personnel. As per the case study, Lan had
migrated to Australia with her parents Yi Ming and Mei when she was 18 years of age. After
migration Lan adopted an English name Amy and got married and had a son named Erick.
Thus they experience cultural differences among the workplace culture as well as in their
home. This is affecting the care that is provided to Amy and her family when her mother falls
short of English words whenever they are trying to communicate.
a) This is due to the fact that the delivery of quality primary care to the large
population is always challenging. Sometimes the patient who are seeking health
care leads to certain delays in obtaining the medical help for the reasons that are
more related with the culture, religious belief and social practice (Barrera et al.,
2013). As Amy and her mother belong to some other religion and culture the
healthcare system of Australia was very much different for them. On the other
side Erick was quite used to the system and faced no difference in the attitude of