PALLIATIVE CARE

ASSIGNMENT 2 – PALLIATIVE CASE STUDY

PURPOSE
1. The purpose of Assignment 2 – Palliative Case Study is to allow students to integrate their
learning of palliative care, palliative support, and end-of-life assistance in a case-based
scenario
2. Through the questions presented, students will reflect on their roles in providing end-of-life
support and utilize skills of communication, compassion, and biological needs of dying to
navigate the end-of-life journey of Jane, a 42-year-old mother

ASSIGNMENT OBJECTIVES
1. Utilize the skills learned regarding palliative, hospice, end-of-life care and apply that learning
to a case involving Jane
2. Describe pain assessment modalities and integrate tools used in patient pain assessment in their
answers
3. Explore strategies to help a client manage biological changes that comes with actively dying
such as appetite, nausea, and vomiting

PLAGIARISM AND ACADEMIC HONESTY POLICY

1. Plagiarism is defined as “the practice of taking someone else’s work or ideas and passing them
off as your own without appropriate credit” (Oxford Dictionary, 2022)
2. All work presented in this assignment must of the student’s own work
3. Students must not copy other students (past or current students) work and pass that off as their
own assignment
4. Students are able to use the textbook and valid online resources to complete their assignments

MARKING CRITERIA
1. Students are to complete each question in full using acceptable grammar and punctuation
2. All assignments must be typed on a Word or Google document (font size and style is up to the
discretion of the instructor) and submitted via the D2L Brightspace environment as per the
instructor’s direction
3. Allocated marks are presented for each question and students must answer all the sections of
the question for full marks
4. Instructor’s can mark as per their discretion and can award partial marks where warranted
5. The total marks awarded for Assignment 2 – Palliative Case Study for Palliative Care is
25 marks
6. The passing mark for this assignment is 70%

PALLIATIVE CARE

Personal Support Worker Hybrid Program 2022

 ASSIGNMENT 2 – PALLIATIVE CASE STUDY
/25 Marks
ASSIGNMENT INSTRUCTIONS
1. Please read the entire assignment prior to beginning
2. Your task for this assignment is to read the following questions associated with the
case study and answer the corresponding questions below.
3. You may use your textbook and valid online resources to assist you in understanding
the definitions palliative care, hospice care, grieving process, end of life care, symptom
support or biological changes, compassionate communication, etc.
4. The mark for each question is indicated in the parenthesis next to each question

Case Study: Jane’s Story

 Jane is a 42-year-old woman who lives with her supportive husband John and their two
children.
 Jane’s two children, Jack (13 years) and Jaquie (7 years) are aware their mother has
cancer but have not been told the specific details of her condition.
 The family owns a local grocery store that is well taken care of by employees.
 Jane was diagnosed with lung cancer two years ago.
 She experiences nausea and vomiting from time to time.
 A public health nurse visits Jane twice a month to monitor her progress, administers
Morphine 4mg IV twice daily, and provides emotional support as needed.
 You are her primary caregiver in her home and visit her 3 days a week to look after
her personal care needs and light housekeeping.
 While visiting Jane, the nurse notices that she appears to be in considerable discomfort
though she denies any pain and you are aware of this too.
 On questioning John, the nurse learns that Jane has been found crying and holding her
chest but refuses to seek medical attention. The nurse has documented this, so you are
aware.

Please answer the following questions in short answer form regarding the case study above:

Personal Support Worker Hybrid Program 2022

 1. (5 marks) Why do you think Jane is reluctant to seek medical attention and acknowledge
her pain?
-Jane may want to shield her family, particularly her children, from the realities of her illness
and its potential progression. She may feel that acknowledging her pain and seeking medical
attention could disrupt the stability of their family life.
-Jane may fear that seeking medical attention will lead to receiving bad news about her
condition, which could be emotionally distressing for her and her family.
- She may hold beliefs that discourage seeking medical help or prioritize stoicism in the face
of pain.
- Negative experiences with the healthcare system, such as feeling dismissed or not taken
seriously, may contribute to Jane's reluctance to seek medical attention.
2. (5 marks) How would you assess the severity of Janes pain? What methods would you
use?
To assess the severity of Jane's pain, I would first use the Symptom Framework for Personal
Support Workers adapted for pain. If Jane denies pain, I would then switch to the Pain
Assessment Checklist for Seniors with Limited Ability to Communicate (PACSLAC-11). This
tool helps identify pain-related behaviors in individuals who have difficulty expressing
themselves verbally. By using these validated assessment tools, I can gather information about
Jane's pain experience and tailor interventions accordingly.
3. (5 marks) What non-pharmacological strategies would you implement to help relieve
some of Jane’s pain?
To help relieve Jane's pain using non-pharmacological strategies, I would implement the
following approaches:
-Creating a Relaxing Pace for Daily Activities
-Planning Activities for Optimal Medication Effectiveness: Scheduling activities during times
when Jane's pain medication is most effective can maximize its pain-relieving benefits and
minimize discomfort.
-Positioning for Comfort: Ensuring Jane is positioned comfortably during rest or activity can
alleviate pressure points and reduce musculoskeletal pain.
-Supporting the neck
-Repositioning for Comfort

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 -Protecting Skin Before Turning: Taking precautions to protect Jane's skin, such as using
cushions or padding, before repositioning her can help prevent skin breakdown and minimize
discomfort.
-Elevating Swollen Lower Limbs
-Turning in Stages Through the Night
-Distracting for Comfort: Engaging Jane in enjoyable activities or providing distractions, such
as reading a book or listening to music, can temporarily divert her attention away from pain
and promote relaxation.
-Stimulating for Comfort: Using warm flannels, cool cloths, or gentle massages with creamy
lotions can stimulate Jane's senses and provide tactile comfort, helping her focus on sensations
other than pain.
4. (5 marks) What strategies can you use to help Jane increase her intake (of food or water)?
To help Jane increase her intake of food and water, I would implement the following strategies:
-Ensure Favorite Drinks Are Accessible: I would make sure that Jane's favorite drinks are
within reach, such as placing them on the bedside table, to encourage her to drink more
frequently. If necessary, I would offer reminders and encourage her to take sips regularly
throughout the day.
-Encourage Hydrating Choices: I would encourage Jane to avoid dehydrating beverages like
coffee, black or green tea, and alcohol, and instead suggest hydrating alternatives such as water,
herbal teas, or diluted fruit juices.
-Provide Excellent Mouth Care: I would prioritize providing excellent mouth care to minimize
dryness in Jane's mouth, lips, and tongue.
-Offer Fluids in Modified Forms: If Jane has difficulty swallowing, I would consider offering
liquids in modified forms, such as thickened soups or clear fluids in solid form like flavored
gelatin or Popsicles, to make them easier to swallow and reduce the risk of aspiration.
-Review Fluid Intake Needs: As Jane's condition progresses and her intake of fluids naturally
decreases, I would regularly review her fluid intake needs with the healthcare team.

5. (5 marks) What could possibly be the reason for Jane’s nausea and vomiting?
Some medications used to manage pain or other symptoms associated with cancer treatment,
such as opioids can themselves cause nausea and vomiting as side effects.

Personal Support Worker Hybrid Program 2022

 Lung cancer itself can cause symptoms such as nausea and vomiting due to factors such as
tumor size, obstruction of the gastrointestinal tract, or the release of certain hormones or
chemicals by the tumor.
If the cancer has spread (metastasized) to other organs or tissues, particularly those involved in
digestion or metabolism, it could lead to gastrointestinal symptoms like nausea and vomiting.

SUBMISSION INSTRUCTIONS
1. Once your assignment is complete, please upload your assignment into the D2L
Brightspace platform in the appropriate submission fields for this course
2. THE DUE DATE IS DETERMINED BY YOUR INSTRUCTOR (please reach out
to your instructor for the exact date and time of all assignment deadlines)

Personal Support Worker Hybrid Program 2022