‘Peaceful End-of-Life Theory’ by Cornelia M. Ruland and Shirley M. Moore CASE STUDY Becky is a 66-year-old woman who was diagnosed with stage IV…

Question Answered step-by-step “Peaceful End-of-Life Theory” by Cornelia M. Ruland and Shirley M. Moore CASE STUDY Becky is a 66-year-old woman who was diagnosed with stage IV congestive heart failure (CHF). She is recently widowed (approximately 6 months ago) and the mother of four devoted young adult children and the grandmother of two. Her youngest daughter (Sue) lives with her mother and is a student at a local University. Sue has taken leave from the University to care for her mother. Becky has completed her advance directives, and is adamant that she not receive extraordinary measures to sustain her life. This has been a difficult issue for her children, as they cannot fathom the loss of another parent. Sue is the durable power of attorney (DPOA) and states she will call 911 in the event her mother stops breathing, even though her mother has a Do Not Resuscitate (DNR) order. The physician has ordered home hospice care. The daughter greets the social worker and nurse at the door and insists the word hospice is not mentioned to her mother, as it would “kill” her. During the hospice admission, it became clear that Becky understands she is dying and sees how much her children are grieving over the thought of losing another parent. After several weeks on the hospice program, Becky continues to report discomfort, high pain levels, shortness of breath, and difficulty in communicating with her children about her wishes. She is not ready to say good-bye to her children or grandchildren and is afraid to die. Despite prescribed medication and team-focused care (social worker, nurse, nursing assistant, and clergy), Becky continues to rate her pain level at severe (8 to 10) and talks about her suffering, fear of death, and concern over what will happen to her family when she is gone. During a team meeting, it was decided to ask Becky to describe three different kinds of pain (physical, emotional, and spiritual). Becky had a physical pain rating of 3 to 4, and both emotional and spiritual pains were rated as severe (8 to 10). The adult children continue to ask about treatments that are more aggressive; however, they also state that they also state that they do not like to see her suffer.CRITICAL THINKING ACTIVITIES The end of life is filled with complex physiological, psychological, spiritual, and family relationship problems that affect the patient’s comfort and ability to achieve peaceful end of life. In addition, unresolved issues in family relationships can lead to complicated grieving for family members before and after the death. Suffering outside of physical discomfort is not readily understood, but the relief of suffering is a fundamental goal of end-of-life care and is necessary to achieve comfort and a peaceful end of life.  Explore the Peaceful End-of-Life Theory in relation to your practice. How does it assist you in identifying and addressing issues related to suffering (e.g., emotional, spiritual, and psychological) in a case from your clinical practice? In the case of Becky? Use the concepts of “closeness to significant others” and “experience of dignity and respect” from the Peaceful End-of-Life Theory to assist you in developing a nursing practice strategy to address the relationship issues for Becky and her family.Describe how the concepts of the Peaceful End of-Life Theory apply to patients with diagnoses other than congestive heart failure, such as Alzheimer’s disease, amyotrophic lateral sclerosis (ALS), or chronic obstructive pulmonary disease (COPD). Does the theory help you identify issues and develop, implement, and evaluate appropriate nursing interventions? What limitations of the theory did you find in these considerations? Identify signs of anticipatory grieving that exist for Becky and her family, and then describe use of the Peaceful End-of-Life Theory to address these issues and how to achieve a peaceful end of life. Health Science Science Nursing NURSING 122 Share QuestionEmailCopy link Comments (0)

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