There are a number of dilemmas that arise after the diagnosis of a terminal illness. There dimensions are multifaceted, and they encroach different areas that involve the patient, the caregiver, the health care services and the society at large (Chen-Scarabelli et. al, 2015). A patient diagnosed with an end stage disease may opt to take aggressive medications to prolong their life. From the clinicians perspective, these drugs may be expensive or have deleterious effects to the patients. However, the clinician is bound by the autonomy of the patient to agree to such decisions. A caregiver, on the other hand, may feel that some interventions are beneficial to the patient, while the latter may decline to undertake the interventions. These dilemmas usually emerge after the diagnosis of a patient with Alzheimers disease. Some dilemmas that are specific to the caregiver in AD situation include explaining to the family the meaning and the prognosis of the disease and having the patient accept the presence of the disease to allow the interventions that would improve the quality of their life.
AD is a financially demanding disease that leaves the family coffers in a bad shape. There are direct and indirect costs that are involved in the care and treatment of the disease. The WHO estimates that every US$ 1 increase in annual per capita income translates to a US$ 0.37 increase in the cost of caring for AD patients (Wimo et. al., 2013). It is the family that mainly incurs these direct and indirect costs, and its the obligation of the caregiver to advice is on the best methods to leverage on every available cent. One way through which the family can minimize cost is by sourcing cheap social work services. A social worker should thus make a compromise between providing the best care and charging a small fee. When the service charge does not suffice to pay for the caregiver services, there emerges a dilemma of whether to continue or discontinue the services. One of the solutions of approaching this dilemma is to minimize home visits while remotely keeping check on the patients. Technological devices like those suggested by Burstein et. al., (2014) can aid in the implementation of this strategy.
Both the patient and the family get confusion after the diagnosis of the disease. The patient requires a clear understanding of the disease while the family needs to know the implications of the same on its finances. The prodromes associated with AD are contributed by the patients arrogance of the disease. Anxiety and depression, in particular, develop as a result of the failure to adjust to the psychological changes happening in the body. The social worker thus needs to give an elaborate explanation of the disease including the measures that patients can take to alleviate the prodromes. The caregiver usually finds themselves in an awkward position if they do not have the necessary background on the disease. It is us upon the caregiver to bring on board the medical professionals who possess the knowledge of the disease. Another intervention to close the knowledge gap is the equipment of the caregiver with the information that the family and the patient may need concerning the disease. In a nutshell, the caregiver dealing with a patient diagnosed with a terminal disease should have adequate information and background about the ailment that will facilitate effective execution of their duties in a palliative setting.
Burstein, A. A., DaDalt, O., Kramer, B., D'Ambrosio, L., & Coughlin, J. (2014). Technology and the Caregiving Dilemma: A Comparative Look at Awareness, Attitudes, And The Role Of Technology. Alzheimer's & Dementia: The Journal of the Alzheimer's Association, 10(4), 571.
Chen-Scarabelli, C., Saravolatz, L., Hirsh, B., Agrawal, P., & Scarabelli, T. M. (2015). Dilemmas in end-stage heart failure. Journal of geriatric cardiology: JGC, 12(1), 57.
Wimo, A., Jonsson, L., Bond, J., Prince, M., Winblad, B., & International, A. D. (2013). The worldwide economic impact of dementia 2010. Alzheimer's & Dementia, 9(1), 1-11.
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