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

 

Sandra, a 47-year-old divorced woman, received a diagnosis of stage 3 ovarian cancer 4 years
ago, for which she had a total hysterectomy, bilateral salpingo- oophorectomy, omentectomy,
lymphadenectomy, and tumor debulking followed by chemotherapy, consisting of cisplatin
(Platinol), paclitaxel (Taxol), and doxorubicin (Adriamycin). She did well for 2 years and then
moved back to her hometown near her family and underwent three more rounds of secondline chemotherapy. She accepted a less stressful job, bought a house, renewed old friendships,
and became more involved with her two sisters and their families.
Sandra developed several complications, including metastasis to the lungs. Then she could no
longer work, drive, or care for herself. She had been told by her oncologist that there was
nothing else that could be done and that she should consider entering a hospice. She met her
attorney and prepared an advance directive and completed her will. She decided to have
hospice care at home and, with the help of her family, set up her first floor as a living and
sleeping area. She was cared for by family members around the clock for approximately 3 days.
Sandra observed that she was tiring everyone out so much that they could not really enjoy each
other’s company. At this time, she contacted the Visiting Nurse Association (VNA) to seek
assistance. Her plan was to try to enjoy her family and friend’s visits. After assessment, the VNA
nurse prioritized her problems to include fatigue and caregiver role strain. Other potential
problem areas that may need to be incorporated into the care plan include anticipatory grieving
and impaired comfort.
Reflective Questions
1. What are some of the stresses on Sandra’s middle-aged sisters and their families?
2. What resources are available to manage these stresses and support the sisters while
caring for their dying sister Sandra?
3. Describe Sandra’s feelings about dependency and loss of autonomy because she is
unable to do her own activities of daily living any longer

 

Sample Solution

Environmentalists promote the decrease of the greenhouse effect by aiming for a transition and limiting the region’s reliance on gas and oil. In many new cites, LED bulbs are being used to replace the existing lighting system. These technological advancements will play a crucial role in increasing energy efficiency and reducing dependency on sources that emit emissions. However, it was obviously not free. Just like electronics, it needs to be charged, so needing a charger for every bus alone will cost a lot, as well you’ll need to purchase and install them which would roughly be around $70 million. But that’s only the chargers, each bus would cost from $950,000 to $12,500,000 ($200,000 to $500,000 more than a diesel bus). Although this a is an expensive amount, electricity cost less than fuel as they have fewer parts compared to diesel buses. It is also expected to be more reliable and can even save money in the long run. It’s estimated if the whole fleet were changed to electric buses, it would save around $50 million to $70 million in fuel annually.

Despite all of this, the government would need to be involved to make investments; this would mean buying electric buses and building charging stations, so the transit agencies will make the fares cheaper. An estimated 300 million tonnes of plastic garbage are generated globally each year. This is very similar to the weight of the entire human race. Almost half of all plastic produced are used once and then discarded. The food and beverage business are a big offender in the usage of single-use plastic, which is bad for the environment and earth itself. According to a survey, only the daily use of food packaging accounts for around 78.1% of domestic plastic trash. In order to limit the consumption of single-use plastics and prevent the hazards related to food packaging, start-ups are attempting to develop and produce biodegradable food packaging. A food wrap made of natural silk protein and resembling plastic has been developed by a company named Mori. The food is kept fresh when it is delivered to retailers by replacing any thin plastic film or packaging. Since it is 100% natural compared to plastic, its biodegradable.

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