May’s Story
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Chinese herbal medication
Extra strength acetaminophen (3-4 times per week)
Extra strength acetaminophen (3-4 times per week)
Background
May is a 38 year old woman who was sponsored by her husband from China about 12 years ago and soon got married and had children. They have 3 children Kevin (11 years old), Dianne (9 years old) and Bobby (4 years old); who attend private school. She speaks Mandarin and her verbal and written English is limited. Her husband David is a COO at a computer software engineering company and he speaks and writes English fluently.
Diagnosis
May was diagnosed a few years ago with ALS and is now developing increasing symptoms requiring more care. Her husband is abrupt in some of the communication with his wife and children and always feels tired. He is working fulltime and is now taking on more responsibilities with the children.
Concerns
May is afraid of how the symptoms will develop and is really upset about her diagnosis. She feels like she is losing control physically and mentally, and cries often when she alone. May wants to be a good wife, mother and take care of the family, but is not able to fulfill these roles. She is starting to get a pressure sore on her coccyx from sitting for long periods. She is having harder time with swallowing and occasionally panics that she cannot breathe. Pain is also starting to be an issue, as it gets worse the more she stays in one position because her limbs and joints get stiff. She is now experiencing urinary retention and may require a foley catheter. May has been seeing a traditional Chinese medicine practitioner who does acupuncture and supplies traditional Chinese medicine to cure her disease.
Formal / Informal Supports
May does not have family in Canada at this time. The couple have been working on sponsoring her young sister and parents over from China; however there have been some difficulties. May had been quite involved with the Chinese community and participated in many volunteer activities at the church she attends. She is receiving on hour a day of home support under Long Term Care in the morning to assist her with bathing and dressing and the daily per diem is high so David is wondering if private care would be less expensive.
Follow-up Visit
ALS Centre team has been following May and after a recent appointment they called the health unit and indicated that for a variety of reasons, May is now approaching end stage ALS. They stated May now has a prognosis of approximately 6 months. May’s husband was unable to attend the appointment and therefore an in-depth conversation did not take place.
Reflection
01
What are your priorities for your next visit and what concerns might you identify in advance?
02
What would be your plan for follow-up?
03
What could you anticipate for the future of this client?