Utilization of the interdisciplinary process

As a nurse, you will be providing care for both older adults and their family or friends, particularly at end of life. Using the case example of Julia Morales below, create an end-of-life care plan for her. Identify the areas of holistic end-of-life care including utilization of the interdisciplinary process, end-of-life progression, and symptoms that may be encountered during end-of-life.

Julia Morales Monologue Script

My name is Julia Morales and I just turned 65 years old. My life has not been a traditional one. I have always believed in following your dreams and being true to yourself, that’s what my parents taught me. When I look back over my 65 years on this earth, I feel happy and proud of what I have accomplished, and I don’t need any pity. Of course, I was shattered when I learned I had lung cancer four years ago. But I fought a good fight. I followed all the recommendations my doctor had
for me. I did the radiation and all the chemotherapy. I even got complementary treatment from a naturopathic doctor. It’s just that we all know it’s not doing any good anymore. I’m ready to stop all the treatment and just let go. It hurts to breathe, it hurts to move. Everything hurts. But as I said, I don’t need any pity.

I’ve had a really great life. Would have liked to stick around a little longer, but I know it’s not to be. Still, I think my folks would be pretty proud to see what I’ve done. They got married young, right out of high school, and my Dad left Ohio to go off to war. He left Mom behind and fought in Europe for two years. My Dad was a strong person, he landed on the beach at Normandy and lived to tell about it. My mom worked hard in a factory while he was gone, and when he got back they had me,
their only child. They did so much for me. Whatever I was interested in, they encouraged me. We were a close family and took a lot of trips together, that’s how I got the traveling bug.

They wanted me to go to college to be a nurse or a teacher. I went because they saved money and
encouraged me. But I never really wanted to be a nurse or a teacher. I got a degree in business
instead and ran a small nursery. My folks were happy because I was happy. Then when I was about
50, I got tired of the business end of it, so I sold it to a young couple and continued to work for
them. I loved the place and the job. Still do. Just haven’t had the strength to work for the past six
months.

I had a few relationships in college and got married for a short time right after I graduated. Had my son,
Neil, he’s 42 already. But that didn’t last. We got divorced when Neil was little, I raised him on my
own. I still talk to my ex on occasion. He remarried, though I never did. I had a few relationships,
and always lots of friends. I met Lucy over 20 years ago when she moved in next door. We’ve been
together ever since. We’ve traveled all over in the past 20 years. She would never have gone without
me doing the planning, but she’s enjoyed it as much as I have. We’ve been to Japan, Italy, Ireland,
and all over the US. She has a bad knee and had surgery, she’s a little unstable and I worry about
that. We had to stop taking long trips.

I’ve been pretty healthy too, until this cancer. I smoked for about 10 years, after college. Then I quit.
We didn’t really know then that it was dangerous. Nobody knew. I was surprised when I got lung
cancer. At first, we thought I had pneumonia. But it never got better, and after the bronchoscopy,
they found lung cancer. I did the radiation treatment and the chemotherapy. For some of it I had to
be in the hospital a few days, which just about killed me. Never did like hospitals, ever. But the
treatment makes you so sick you want to die. And the bad thing is, it didn’t cure cancer. We tried
a few different treatments but no more. Nothing good came out of it. I just felt weak and sick, and
the cancer got worse.

I’m ready to stop all this. I just want to be here in this house that I love. I’m comfortable here. Lucy
is here, and she understands. She doesn’t like to see me so sick either. She does a good job taking
care of me, and we’re doing OK. My son Neil would like me to try more treatment, but even the
doctor says there’s not much more they can do, besides keep me comfortable. I’m tired, and I’m just
ready to let things happen naturally. Do you think that’s giving up?”