John McGregor (Mac) is admitted to a hospice for two weeks respite care. Mac is an 86-year-old gentleman with a history of Chronic Obstructive Pulmonary Disease and Alzheimer's. You are doing rounds and come in to check if everything is alright and if there is anything that you can do. As you walk in, his wife of 66 years, Dorothy, is sitting beside his bed doing a crossword. She asks Mac "What's another word for vile?" to which Mac responds "You!". You glance at Dorothy. She is visibly shaken. Mac looks up at you and tells you to "fuck off and don't come back". You respond with "Okay, I’ll give you your space. Call out if you need anything" and walk towards the door. Dorothy meets you at the doorway and walks out with you. A few feet down the corridor Dorothy says "I am so sorry. Until my husband got sick with this Alzheimer's he would never speak like that and he would never, never use a profanity in front of a woman". She adds "I wish he could just die; this is not my husband." She pauses for a moment and adds “He’s ready to die. The next time he gets another chest infection he probably will.” You ask Dorothy if she would like to talk. She says “Yes please. I am having difficulty coping with all of this; I’m barely hanging on.”
Part 1: Assessment (1000 words)
• Discuss the legal and ethical issues and decision-making for Mac’s end-of-life care.
• Determine the means of creating a holistic care plan for Mac in collaboration with his wife Dorothy.
• What self-care strategies do you recommend for Dorothy?
Use Gibbs reflective cycle as a framework to reflect on an experience you have had with death or dying and how this has shaped your nursing care
Sample Solution