NURS6711 Palliative Care Practice


Case study

Let’s consider Wilf, a 78 year old man who lives with his wife, Mavis (76), in your local area. They are a very devoted couple and Mavis has been Will’s principle carer for many years but is beginning to struggle with caring for her husband. She has been having problems with hypertension recently and has been told to “slow down”. Wilf has become increasingly dependent on Mavis and has stopped doing a lot of the things that had previously given him great joy in life (except smoking!!). He was a keen gardener and loved playing lawn bowls with his mates but his health has declined to the point where it is very difficult to now do these things. 

Wilf and Mavis have two children -David and Jenny, both of whom are married and have children, giving Wilf and Mavis a total of six grandchildren. They are a very close, supportive family and all live nearby each other. The following is Will’s relevant medical history for you to consider: 

• Mild COPD
• Osteoarthritis
• Hypertension
• Chronic Heart Failure
• Mild Cognitive Impairment secondary to vascular dementia 
Will’s children talk to their Mum about what has been happening and the strain that it has been putting on her. Mavis wants to keep looking after Wilf but admits that she is suffering at the same time. She tells her children that she is terrified of losing Wilf and she has started to notice that he is becoming more forgetful and getting angry with Mavis more often. She also tells them that he is getting really frustrated because he can’t do the things he wants and is getting out of breath really quickly nowadays but won’t give up the cigarettes. The children are finding all this information a bit confronting but really want to help their parents
1. What are the short and long term goals for Wilf from your perspective? Are there any specific goals relevant to your discipline / profession?
2. What do you need to consider to support Mavis?
3. What conversations need to be held with David and jenny, and who is the person most appropriate to do this?
4. How can you manage the competing interests of maintaining Wilfs safety while respecting and facilitating his right to exercise his personal autonomy / decision making?
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