Mr Jagger was admitted to the emergency department because of severe pain that was not manageable, so his wife was worried, and he was admitted to the emergency ward. The condition of Mr Jagger was not good, and the medical professional treated them with some medications and allowed him to return home. The advanced care that can be provided to Mr Jagger at home is pain management strategies and the involvement of a multidisciplinary team. Various pain management strategies include taking pain medicines. Cancer pain can be managed through the intake of medicines prescribed by medical professionals. Sometimes few Psychological approaches can also be followed, for example, Cognitive behavioural therapy (CBT). This therapy mainly aims to identify various negative thoughts and behaviour (Poort et al., 2020). CBT supports changing the behaviour of the patient and making people aware of the pain. The psychologist will assist in developing better-coping skills. The perception of pain is present in the brain of humans; therefore, it affects physical pain by expressing the pain in terms of thoughts and behaviour (Addison et al., 2021). CBT supports providing the pain in different ways, such as it will help in changing the thoughts, emotions and coping strategies to put the patient in comfort. It also assists in alteration in the physical response in the brain. Stress is caused by pain, and it affects the chemicals of the brain. The neurotransmitters such as norepinephrine and serotonin are affected by stress caused by the pain. Chronic pain can be managed through medications and through massage. CBT helps in providing the tactics to control the pain. Some of the adjuvant analgesics drugs can be provided that help control the pain. Some of the non-opioids and opioids are used in relieving the pain. Targeted therapies can be provided by medical professionals, such as anti-angiogenesis drugs. In the home, the room environment should be made very comfortable so the patient can feel energetic and can not feel boring. Emotional issues can be handled carefully through communicating with the patients so that patients do not feel alone and incomplete. The patient can be provided with healthy food to avoid malnourished symptoms. A dietician can be consulted in order to to have healthy and better food such as lean meats and chicken (Wall et al., 2021). Low-fat dairy products can be taken so that better health can be maintained. Complex carbohydrates need to be avoided for a patient who has colon cancer. Few of the fruits such as oranges, pear and blackberries can be consumed. For the overall health of bowel cancer patients, fibre, vitamin-rich plant-based products are mostly consumed. Pain relievers and chronic pain medicines are effective in the management of pain. The strongest pain relievers are opioids, but sometimes there is a risk of addiction; these can be taken under the supervision of doctors (Sumitani et al., 2022). Massage and relaxation are some techniques that help reduce pain. Involvement in activities such as taking part in some activities of interest will help in coping with the pain.
Some of the strategies can be followed to support the families and care providers. The first strategy that can be followed is to educate the family about colon cancer so that they can be psychologically prepared for the end of the life of the patients. Bowel cancer awareness can be spread between the family member and its associated risks (Lee et al., 2022). The family members must be educated concerning the behaviour change and changes in body the body that can induce death. Emotional needs are important for the family members; they can be provided by various emotional support by involving them in a lot of practical tasks (Logan & Anazodo 2019). The caregivers and family members are made aware of various circumstances and different stages of cancer. The Bowel can spread through the liver and spread in various organs such as the brain and lungs. Bowel cancer has stages such as stage zero, stage one, stage two, stage three and stage four, stage four is deadly, and the person usually dies in this case. In the given case study, Mr Jagger is suffering through stage four of bowel cancer. The family must be educated about different stages of cancer and the deadliest stage. They must also be educated about bowel cancer surgery and the reversal process.
Family-centred and Cultural competency is another strategy that can support the family members or care providers to the patients who need palliative care or who are near to the end of life. IN this kind of strategy, the family members need emotional support or need more communication so that they can express their concerns and beliefs. Communication is a vital part of cultural competency that helps identify the gaps and identify the emotions of the patient’s family members (Mallette et al., 2018). People must be made comfortable and must be aware of the cancers and palliative care. Communication improves emotional support and makes them accomplish positive thoughts. Cultural competency helps provide accurate medical information of the patient to the family members. It also supports in eliminating misunderstandings between the care providers and the medical professionals. This will help in building trust between the family members. Cultural competency enhances the communication that supports the family members in various ways (Soni & Tscherning, 2021). It also plays a great role in achieving various perceptions concerning the different kinds of health services and emotional support. Family-centred and cultural competency will help in understanding the behaviour of family members. Family communication when the patient is near the end of life will support in recognizing the actual cause of death and actual reason. Effective interaction with the family members can help in maintaining the emotional support of the family members. This will assist in making family members aware of the condition and the stage of cancer during which end of life can take place at any time. The stress can be improved through communication and adapting to the circumstances when there are patients near to end of life. People must be aware of health literacy to gain some kind of care and emotional support (Derry et al., 2019).
There are several ways to provide coordinated, integrated palliative care to Mr and Mrs Jagger’s Wishers. Multidisciplinary teams of medical professionals will help in providing care to the patient and his wife. Palliative care is used for the proper treatment process, and it usually depends on the illness and supports the critical patients. Pain management can be managed through cooperative doctors and medical professionals. This will also support in acknowledging the pain. Relaxation techniques, music and massage, can be useful in managing the pain, and it will allow the patient to take less medication. If the pain can be managed well, the quality of life can be improved (dos Santos Felix et al., 2019). When the patient feels less pain, the patient will become more active and will have more energy. This will assist in minimizing the risk of complications. Palliative care involves various experiences such as depression, physical pain and hopelessness. Palliative care can be of various forms, including emotional, social, and spiritual support to the patient. Loved ones or family members provide extra support to the person who has cancer. Most of the time, the caregivers have been observed to have feelings of stress, depression, and anxiety (dos Santos Felix et al., 2019). Palliative care helps in providing the balance to maintain the quality of life. Emotional support can be provided to the patients by listening to them and being present near them. The physical presence, such as sitting calmly and holding the hands of patients, can be very soothing for patients as well for the family members. A psychologist can help the patients or help the patient’s wife make sense of their lives, and they will also support and encourage them on various religious and spiritual discussions. Better communication can be done through family members to help the patient and family members suffering from anxiety. Patient-centred care mainly focuses on establishing the relationship between patients and family members, and the patient needs support in managing their own care, and they ensure the satisfaction of the needs of the patients. Improved patient satisfaction will help in encouraging the patients concerning their desires (dos Santos Felix et al., 2019). Coordinated care can be provided to the wife and the patient by sharing knowledge of the bowel cancer, establishing accountability, assisting them with transitions of care and developing proactive plans (Tookey et al., 2018). The care coordination can be carried out with the help of health information technology, medication technology and through the patient-centred medical home. Patient-centred care is vital because this will help get the patient’s clear situation, and therefore, the patient can be referred to primary care. Integrated care provides different care pathways to meet patients’ requirements (Jalal et al., 2021). Behavioural health services can be provided so that the patients can live without stress and anxiety. Cancer patients can be treated through emotional attachment, such as the involvement of the wife in daily activities with Mr Jagger.
References
Addison, S., Shirima, D., Aboagye-Mensah, E. B., Dunovan, S. G., Pascal, E. Y., Lustberg, M. B., & Nolan, T. S., (2021). Effects of tandem cognitive behavioral therapy and healthy lifestyle interventions on health-related outcomes in cancer survivors: A systematic review. Journal of Cancer Survivorship, 1-24. https://link.springer.com/article/10.1007/s11764-021-01094-8
Derry, H. M., Reid, M. C., & Prigerson, H. G., (2019). Advanced cancer patients’ understanding of prognostic information: applying insights from psychological research. Cancer medicine, 8(9), 4081-4088. https://onlinelibrary.wiley.com/doi/full/10.1002/cam4.2331
dos Santos Felix, M. M., Ferreira, M. B. G., da Cruz, L. F., & Barbosa, M. H., (2019). Relaxation therapy with guided imagery for postoperative pain management: an integrative review. Pain Management Nursing, 20(1), 3-9. https://www.sciencedirect.com/science/article/abs/pii/S1524904217303442
Jalal, E., Nabishah, M., Safiah, N. I., Fuad, I., Haslinda, K., & Najibah, A. R., (2021). The Use of Breast Cancer Survivor Patients as Part of Patient-Centred Education in the Training of Breast Cancer Care Nurses. IIUM Medical Journal Malaysia, 20(1). https://onlinelibrary.wiley.com/doi/abs/10.1111/ecc.12792
Lee, S. M., Versace, V. L., & Obamiro, K., (2022). Public Awareness of Bowel Cancer Risk Factors, Symptoms and Screening in Tasmania, Australia: A Cross-Sectional Study. International Journal of Environmental Research and Public Health, 19(3), 1497. https://www.mdpi.com/1660-4601/19/3/1497
Logan, S., & Anazodo, A., (2019). The psychological importance of fertility preservation counseling and support for cancer patients. Acta Obstetricia et Gynecologica Scandinavica, 98(5), 583-597. https://obgyn.onlinelibrary.wiley.com/doi/full/10.1111/aogs.13562
Mallette, J. K., Futris, T. G., & Schramm, D. G., (2018). Fostering a culture of family?centred care: Child welfare professionals’ beliefs about fathers, family instability, and the value of relationship education. Child & Family Social Work, 23(3), 354-363. https://onlinelibrary.wiley.com/doi/abs/10.1111/cfs.12422
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