Case Study Eleven
Amanda L. Miller
Nursing of the Gerontological Client (N309)
April 19, 2012

Case Study Eleven
1. 	“The goal of hospice is to help patients live their last days as alert and pain-free as possible” (Hospice Care). 
2.	For referrals on Hospice care, Jane can use her local resources. These resources include her doctor or hospital discharge planner. You can also check your local telephone book.  Using the American Cancer Society, Agency on Aging, United way, Visiting Nurse Association, or your place of worship will have referrals and help guide you in your hospice decisions (Hospice Care). 
3. 	The interdisciplinary group for Hospice care include the doctor, Registered Nurse, Social worker, and Pastoral or counselor. Each member of this team provide care are there to assess the patient as well as the caregiver and family (Mauk. 2010. p. 758). 
4.	Medicare benefits periods are determined by the doctor and hospice medical director to determine if the patient has less than 6 months to life. There is a re-certification at the beginning of each period, this means 2 periods of 90 days each. Then, an unlimited number of 60-day periods (Hospice Care). 
5.	The most common symptom found in patients at the end-of-life, is the symptom of pain. The most important thing hospice care can do for a patient is relieve them from pain (Hospice Care). 
6.	The nurse can assure Jane that she will be free of pain. The nurse should address that it is a fear that she can have, and should express, but the nurse will be able to relieve her pain. 
7.	As a nurse, I would let the family know that it is first and foremost Jane’s decision for hospice care. It is important for them to know that Jane is not giving up, she is just relieving her pain. She doesn’t want to go through any more treatment, and its important to support her and be with her during this time. 
8.	It is important that the physicians and social worker determine Jane’s capability to make her own decisions. Is she mentally capable to make her own decisions on her end-of-life care? Her children will need to be counseled during their grieving process, as well as Jane as she comes to her decision. 

References
Hospice Care. (n.d.) Retrieved from http://www.cancer.org/treatment 
/findingandpayingfortreatment/choosingyourtreatmentteam/hospicecare/index.
Mauk, K. L. (2010). Gerontological nursing: Competencies for care. (2nd ed). Saudbury, MA: 
Jones and Bartlett.