Pre-readings
What is a palliative approach to care?
Focuses on improving QOL for patients and families living with serious illness
Name one sign that Dan's MS has progressed
Fatigue, dysphagia, increased dependence, aspiration pneumonia, SOB
Which CNO role focuses on working effectively with the interprofessional team?
Collaborator
Using research evidence to guide care represents which Way of Knowing?
Empirical
What was Dan's primary goal in Part A?
Maintaining independence and remaining at home
True or False: Palliative care should only begin when curative treatment has stopped
False
Name one non-pharmacological intervention that could improve Dan's QOL
PT, OT, energy conservation, exercise, CBT
Which role includes helping patients navigate the healthcare system?
Coordinator
Understanding what matters most to Dan as a father and teacher represents which Way of Knowing?
Personal
What became Dan's priority in Part B?
QOL and reducing Sarah's burden
The core concept of the 6S-model and focuses on preserving the patient's identity despite illness and dying
Self-image
What are local supports for caregivers?
MS Society, CMHA, Community Support Connections
Listening to Sarah's concerns while building trust demonstrates which role?
Communicator
Balancing Dan's wishes with Sarah's caregiver burden represents which Way of Knowing?
Ethical
What event suggested Dan's swallowing had worsened?
Aspiration pneumonia/hospitalization
Dan initially believed palliative care meant "giving up". Which common misconception does this represent?
Palliative care is only for end of life
Dan wants to remain home despite increasing needs. Name one alternative that could be explored before traditional LTC
Enhanced home care, respite, assisted living, specialized supportive housing, hospice residence (when appropriate)
Recognizing Dan's worsening swallowing and initiating further assessment demonstrates which role?
Clinician
Recognizing the impact of long waitlists and advocating for equitable access represents which Way of Knowing?
Emancipatory
Sarah asks, "How do we know staying home is no longer the best option?" What issue is she expressing?
Caregiver burden, safety, ethical tension, transition planning
This concept in the 6S-model reflects the patient's need to be an active participant in care decisions and have their values respected
Self-Determination
What is the most recommended pharmacological intervention for neuropathic pain in MS?
Anticonvulsants
Name 3 CNO roles the nurse demonstrates when coordinating a family meeting to discuss Dan's goals of care and explain how each role in demonstrated
Communicator - facilitates therapeutic conversations with Dan and Sarah
Collaborator - works with the interprofessional team
Coordinator - organizes services and transportation
Advocate - ensures Dan's wishes are respected
Clinician - uses assessment findings to guide recommendations
Educator - explains disease progression and care options
Tailoring communication to meet Dan's unique needs represents which Way of Knowing?
Aesthetic
Name 3 priorities for Dan's nursing care at the end of Part B
Symptom management, family support, community resources, care coordination, advance care planning, QOL, advocacy