Module 14

CASE STUDY: Caregiver Role Strain: Ms. Sandra A.

Sandra, a 47-year-old divorced woman, received a diagnosis ofstage 3 ovarian cancer 4 years ago, for which she had a total hysterectomy,bilateral salpingo- oophorectomy, omentectomy, lymphadenectomy, and tumordebulking followed by chemotherapy, consisting of cisplatin (Platinol),paclitaxel (Taxol), and doxorubicin (Adriamycin). She did well for 2 years andthen moved back to her hometown near her family and underwent three more roundsof second-line chemotherapy. She accepted a less stressful job, bought a house,renewed old friendships, and became more involved with her two sisters andtheir families.

Sandra developed several complications, including metastasis tothe lungs. Then she could no longer work, drive, or care for herself. She hadbeen told by her oncologist that there was nothing else that could be done andthat she should consider entering a hospice. She met her attorney and preparedan advance directive and completed her will. She decided to have hospice careat home and, with the help of her family, set up her first floor as a livingand sleeping area. She was cared for by family members around the clock forapproximately 3 days.

Sandra observed that she was tiring everyone out so much thatthey could not really enjoy each other’s company. At this time, she contactedthe Visiting Nurse Association (VNA) to seek assistance. Her plan was to try toenjoy her family and friend’s visits. After assessment, the VNA nurseprioritized her problems to include fatigue and caregiver role strain. Other potentialproblem areas that may need to be incorporated into the care plan includeanticipatory grieving and impaired comfort.

Reflective Questions

1. What are some of the stresses on Sandra’s middle-aged sistersand their families?

2. What resources are available to manage these stresses andsupport the sisters while caring for their dying sister Sandra?

3. Describe Sandra’s feelings about dependency and loss ofautonomy because she is unable to do her own activities of daily living anylonger.

(This case study is for answer those questions using APA style 6th edition and support your answer in references from the past 5 years. Also place the references in APA style at the end of the document).

This is a case study, just for answer 3 questions; it will be probably done in one or two pages. This is not a final paper document.