CASE PRESENTATION

By: Katelyn Poplin

Background of Resident
Resident is 85 years old
Has been at Grace Heights since 2013.
Advanced Directive: DNR and guardian which is her sister
Health has decline since coming into the facility.
Resident refuses to wear the cap and refuses her religion even though that is what she
has always been.

What were some value differences

between you and the client?
Wearing skirts all the time.
Holidays are different. They celebrate Kippur which is in September and in my culture
we do not celebrate this.
She does not like to take more medication than she has to even if it is for pain.

What events or life experiences have

shaped them into the person they
are?
The life experience for this lady to shape her into the person she is today is her family
pushed her to become a Jew and she is refusing it due to forcing. She will do
everything against her religion, such as painting her fingernails the darkest they can go
such as black. Her sister thinks she should read the bible daily and every chance she
gets, and the resident refuses to pick it up and it read it, she will hide it in a drawer or
even put it in her closet.

What is the staff recommendation

about diagnosis, Interventions or
treatment?
Diagnosis: Liver caner that has spread to her throat, head, and lungs, and other vital
organs. Swallowing issues
Interventions: Keep resident as comfortable as possible, she has Catawba Hospice
instead of Palliative care due to her cancer being very active.

Treatment: She is on thicken liquids and puree food, for her swallowing. She attends
exercise programs and has a Passive range of motion. She is not a candidate for
surgery due to her health and it could possibly harm her even more.

What does research say on their

diagnosis/problem/treatment?
Research says about the diagnosis: This National Cancer Institute booklet is about
cancer that starts in the liver. In 2013, about 23,000 men and 8,000 women in the United
States will be diagnosed with primary liver cancer. Most will be over 64 years old. It's
common for cancer to spread metastasize to the liver from the colon, lungs, breasts, or
other parts of the body.

Research says treatment, including surgery, chemotherapy, radiation therapy,

immunotherapy, and vaccine therapy. People with metastatic cancer in the liver have
different treatment options than those with primary liver cancer.

What changes do you recommend

for the agency or service?
I do not recommend any changes in the agency or the services. They are meeting the
need of the resident and her wishes. She has Catawba Hospice which is what the
guardian wanted and we have followed these wishes, and once she gets to the point
where she can move to the hospice house we will follow with that wish.