| [ Summary ] |
This case offers a report on end-of-life decision-making support for a patient in her sixties diagnosed with terminal pancreatic cancer after being on dialysis for twelve years. After the patient was diagnosed as being unlikely to survive another full year, she experienced a state of despondency to the extent that she no longer felt that even dialysis was necessary. However, when nurses provided support that acknowledged her feelings, the patient gradually began to communicate her wishes. By respecting the patient's opinions while moving the dialogue forward, nurses provided support that enabled the patient to prepare a living will (advance healthcare directive). This document occasioned conflict between the patient and her family ; however, the process of promoting repeated dialogue facilitated by medical personnel, with the aim of achieving consensus between the patient and her family while respecting the patient's wishes and considering the patient's quality of life (QOL), was found to be important. |