Category: Case Studies
Articles about two or more studies to explore a given topic.
How to Use the START/STOPP Criteria for Medication Reconciliation and Deprescribing in Hospice Care: 10 Case Studies
If you are caring for a terminally ill patient in hospice, you know how challenging it can be to manage their medications. You want to make sure they are getting the best possible care, but you also want to avoid unnecessary or harmful drugs that may worsen their quality of life or cause adverse effects.
That’s where medication reconciliation and deprescribing come in. Medication reconciliation is the process of reviewing and updating the patient’s medication list to ensure accuracy and completeness. Deprescribing is the process of reducing or stopping medications that are no longer needed, effective, or appropriate for the patient’s condition and goals of care.
Why Saying Goodbye to Your Dying Loved One Matters
Losing a loved one to a terminal illness is an incredibly challenging experience. It's a journey filled with emotions, uncertainties, and the need for profound empathy. One crucial aspect of this journey is saying goodbye to your dying loved one and permitting them to pass peacefully. In this article, we'll explore the significance of these acts, which bring comfort to the terminally ill and aid in the grieving process for those left behind. We'll also share three case studies to illustrate the importance of these actions.
Four Case Studies About External Oxygen on Hospice
It is common for family members and caregivers who are not trained in end-of-life topics to be concerned about their loved one's oxygen concentration (SpO2 and sometimes also abbreviated SPaO2) reading from a pulse oximeter. Suppose their loved one refuses external oxygen or takes off the external oxygen. In that case, this often causes distress to the family and caregivers because they are focused on the numbers vs. the patients themselves. Hospice is about patient-centered care, and I would like to present four case studies to demonstrate how hospice manages this situation with compassion.
Early Detection of Serotonin Syndrome in Dementia Patients: Three Case Studies
Serotonin syndrome is a potentially life-threatening condition caused by an excess of serotonin in the body. Detecting this condition early is crucial, but it can be particularly challenging when dealing with dementia patients due to communication barriers and the complexity of their symptoms. In this article, we will present three case studies that highlight the early detection and successful management of serotonin syndrome in patients with different types of dementia: Alzheimer's disease, vascular dementia, and Lewy Body Dementia.
Unlocking the Power of Validation Therapy in Compassionate End-of-Life Care
In the realm of hospice care, where empathy and compassion are paramount, a remarkable approach called Validation Therapy has emerged as a beacon of hope and comfort for individuals facing dementia and cognitive disorders in their final journey. As an experienced hospice registered nurse case manager, I've witnessed the transformative impact of Validation Therapy on patients, allowing them to find solace, regain their self-worth, and experience a sense of dignity during their end-of-life phase.
Ethical Dilemmas in Hospice
As a hospice RN case manager, I have seen many ethical dilemmas arise in end-of-life situations. Hospice care is unique because it focuses on providing comfort care to patients no longer seeking curative treatment for their illnesses. As a result, the ethical concerns in hospice care differ from those in other healthcare settings. This article will explore some ethical dilemmas that can arise in hospice care and how they can be addressed.
Before I review several case studies gathered from the sources in the resource section below, please allow me to share a current one of mine that is ongoing as this article is being published.
Rally as part of the dying process
Dying is an inevitable facet of life, a natural progression that touches us all. This journey towards the end of life can unfold in diverse ways—peaceful and graceful or turbulent and fraught with stress. Amid this journey, there exists a phase known as the "rally." It occurs just before the final moments of a person's life. This rally phase often shrouds itself in misunderstanding and misconceptions. It's imperative to unravel what it truly signifies.
The D.O.G.I. at the window case study
As nurses, when we see an acute change of condition, part of what we should be doing in our assessment is determining if there are reversible or treatable elements that are causing the change. In RN school, Dr. Dagen taught the students about using the D.O.G. mnemonic to help us remember that if a patient has an acute change of condition to check whether there were new medications the patient is taking, their O2 saturation level and their glucose level.
I would further add that as a hospice nurse dealing with mainly geriatric patients that if there is an altered level of consciousness (LOC)/personality change, to also consider the patient may have an infection. For any of you dealing with geriatric patients add “I” for infection, hence “D.O.G.I.” While this mnemonic is typically used for acute changes of level of consciousness, the thought process behind it can be used for other acute change of patient condition as well.
Fall Reduction – Reducing Falls in Personal Care Homes and Private Homes
Falls among the elderly can have severe consequences, including hip fractures, which can be life-threatening. As an experienced hospice registered nurse case manager, I understand the importance of fall prevention, especially in private homes, personal care homes, and assisted living facilities. This article aims to provide practical tips for reducing falls in these settings by following the nursing process: assessment, diagnosis, planning, implementation, and evaluation.
General Inpatient (GIP) Level of Care for Hospice Explained
GIP, or General Inpatient Hospice, is an often misunderstood aspect of hospice care. Both hospital staff and families sometimes have misconceptions about GIP. Families may assume it's readily available upon request, while hospital professionals may believe it allows patients to remain in the hospital indefinitely, even when death is weeks away. This article will clarify the basics of GIP for hospice, including eligibility requirements, doctor's orders, care plans, documentation, and education. We'll conclude with two real-life cases to illustrate these points.