Alana is entering the end-of-life stage.

Case study

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Alana is entering the end-of-life stage. She often has difficulty breathing. She likes Mai to stroke her arm and apply massage oil. One morning she whispers to Mai that she doesn’t have the energy to see her friends and extended family anymore. She asks if Mai can tell them that she loves them, but she can’t see them anymore.

As Mai is helping her out of bed, Alana says, ‘I don’t think I can have a shower today’. Mai tells her that is all right and that she can bathe her in her room instead. Just as Mai is reassuring her, Alana groans with pain. She clutches her chest and starts to cry. Mai knows she is allowed to watch Alana self-medicate so she makes sure the pain-relief tablet is taken.

Alana’s family is aware that Alana is entering the end of her life and Alana’s husband would like Alana to die at home surrounded by her family members. Alana expresses that she is more comfortable in the hospice and would prefer to remain there.

1. When a person accessing services makes a decision that impacts the families, carers and/or significant other, what course of action should the support worker follow?

2.  How can the support worker assist the person accessing services to choose the location of their end-of-life care?

3. What might a support worker observe and document about pain for a person and how should this be reported?

4. Identify two strategies that Mai implements to manage Alana’s pain and provide comfort.

5. When explaining that the doctor has ordered morphine as a pain-relief measure for Alana, her family become very upset and do not want this intervention. What should a support worker do in this instance?