Terminal and chronic illness case study
Discuss about the Case study of Terminal and Chronic Illness.
A terminal illness is a disease whereby there is no hope of recovery for the sick person. The issue of terminal illness and how to tackle them has been a difficult topic over the years. The suffering the patients undergoes during this period is unbearable. As such, in many countries, they have implemented different policies to deal with this matter. Some have allowed euthanasia to be carried out, but only under the consent of the patient. Other nations do not advocate for ending of life (known as assisted suicide in medical terms) no matter how the pain is intolerable (Battin, Rhodes, & Silvers, 2015). A terminal disease mainly has been described to have five phases. The first phase occurs before diagnosis, whereby a person senses and recognizes some symptoms and signs and, thereby realizing they could have contracted a disease or an illness. The second phase is the acute period whereby diagnosis is made, and the patient is explained vividly his/her condition. Then, the chronic phase whereby the patient receives medical treatment. The recovery phase follows where the patient accepts his/her status and is prepared to handle the stigma that comes with the social, financial, physical, mental, and religious effects of their illness (Bovero et al., 2016). This paper discusses a case study concerning terminal and chronic illness (cancer), the pastoral role that I played in the incidence, and the pastoral strategies employed.
The case study involves a 15-year-old boy (John- not real name) who was diagnosed with metastatic osteosarcoma. Osteosarcoma is a malignant bone cancer with a high chance of spreading to the lungs (Mialou et al., 2005). Primarily, osteosarcoma affects adolescents from age 12-18 years. However, there are always variations as in some instances it can occur in children or adults, though in rare cases. The cure rate of the non-metastatic osteosarcoma is usually higher (70%) compared to the metastatic one- less than 20% at the time of diagnosis (Picci, 2007). Treatment usually involves surgery and chemotherapy based on the recent clinical research trials.
After John was diagnosed with metastatic osteosarcoma, he was immediately placed under treatment. However, he did not respond so well to conventional medication and therapy. Therefore, he was taken through a therapeutic randomized clinical trial for almost a full year. The standard treatment that he was given involved; postsurgical chemotherapy, limb salvage surgery, and up-front chemotherapy (Chou Geller, & Gorlick, 2008). He did not respond so well to these therapies as well and, especially the up-front treatment. And so, he was taken through another program through randomized trials where he received additional experimental chemotherapy.
Analysis of the encounter such as the family system transition
John is remaining only with his mother as he lost his father at a tender age through prostatic cancer. However, together with his mother, they have a very close relationship, and she encourages him every day through prayer and positive words. John has been participating actively in all the treatment conference, and in most cases, he has been tolerating the treatment. Within the last three months of treatment, however, he struggled too much both emotionally and physically as the procedure was taking over him (Lee et al., 2015). The end-of-therapy scan revealed that the tumor still existed in the bone as well as lungs. During this period, John together with her mother went through the most challenging moments of their life. John was expressing unexplainable pain (Wolfe et al., 2010) and the thought of him dying and leaving his mother alone brought tears to his eyes every time. His mother, on the other hand, was uncontrollable due to fear of losing his son after losing her husband through an almost similar incidence. So, the mother feels an urge to progress his son’s life through a trial of unproven experimental therapy. However, John feels he has been through enough and, therefore, he does not want this intervention proposed by his mother. He explained to the physician in charge of his treatment that he should not administer the proposed drug but leave him to die according to how he wants, chooses, or on his terms (Maryland, 2017). The mother, on the other hand, believes that John has no right to make any decision, but it barely rests on her. Therefore, she asked the physician to treat her or otherwise she would take her son to another doctor who would be willing to treat her. John’s mother attends the church that I Pastor, and as such, I was able to know everything happening in her life. Also, being the Pastor, I was obliged to offer Pastoral advice and encouragement through prayers and positive words from time to time.
The John case study involves various aspects of the family system such as a history of loss, relationships, and transitions from one stage to another. The incidence typically involved few participants such as John’s mother, John, physician, as well as the immediate family. Being the person supposed to offer pastoral care, it was my duty to identify the problems that arose, the needs of the participants, and hence provide the necessary help. It’s important to note the close relationship John had with his mother and, how his death would affect her both emotionally and physically (Tsai et al., 2016). Since she had lost her husband before, the pain could be unbearable and, so she required emotional and spiritual support. It was my duty to give her all the necessary help she required through prayers and frequent visitation. John as well needed all the support he could get through this hard time and, therefore, moral support was vital to show him that all hope is not lost (Surbone et al., 2010). During this period, it was a transition era for them especially for John’s mother, since she had lost her husband and now she was at another point of losing her son. The physician also was in a state of dilemma as he did not know whether to listen to John or the mother. However, he was bound to act through the legal principles of physicians.
Theological factors related to the case study
Spirituality plays a significant role in helping the terminally ill patients. More often than not it helps improve the emotional state of the individual. Religious or spiritual nourishment is crucial for chronically and terminally ill patients as it enhances their health by improving their mental health. These people all they need at such a time as this is hope (Gum & Snyder, 2002). Hope that tomorrow will be better or better still, there is hope of getting well. In this case, involving John, the theological factors that stood out are; prayer, scripture, meditation, spirituality, faith, hope, caring, and love. John’s mother is a member of my church and, therefore, we were able to click as we shared the same religion and spiritual ideologies and principles. In such an instance where the involved parties were all suffering, it calls for wisdom so that you can offer the essential comfort needed. As such, I encouraged John’s mother to stand firm in faith and hope that God was in control. God knows everything about our situations and He is faithful to carry us through every turmoil. John, on the other hand, needed to hear more of hope (Johnson, 2007) and being given a listening ear every time.
The pastoral role in dealing with terminally ill patients and those suffering from a chronic disease is critical in determining the effect of the outcome. For instance, in most cases, a terminally ill patient usually dies after few months. For chronic illness, the person can only stay alive for about three months since the disease is not curable. Therefore, as a pastor in charge, I had to come up with strategies that would help ease the tension and pain in the case scenario. The first strategy is to major in scriptures as you give them hope. The Bible is the best book that offers hope, encourages, and strengthen the weak and broken-hearted. So, the best thing was to encourage John’s mother and John himself to keep reading the Bible every day. The scripture gives direction even regarding issues to do with the end of life. For instance, some terminally ill patients prefer to end their lives on their terms to avoid the unending pain as well as protect their loved ones from trauma and draining them financially. In this case study, John as well had decided not to take further medication but choose according to his terms how to die. The Bible, however, is against any form of assisted death, suicide, euthanasia, or mercy killing. As such, John has no spiritual obligation to decide on how to end his life since the Bible is against any form of self-determination in matters of human existence.
Pastoral strategies employed
Prayer and meditation are tools that when employed can have a positive effect. It is believed that individuals who hold to certain religious beliefs, cope better in such instances as compared to their counterpart (Vasudevan, 2003). They can accept the situation readily as they still hope for a cure through the faith they possess. However, it is vital for the person offering pastoral care not to give these individuals false hope. For instance, if they are hoping and trusting that God will cure them, and then the cure seems impossible and the patient die eventually, there is a high chance of such people to become distressed and lose their faith. Therefore, my role was to let them know that God is sovereign and, therefore, they ought to be prepared for whichever outcome, but they should remain faithful to prayer and God.
People who are undergoing difficult times are in need of individuals who can show them love and care. Showing love and caring for such people is the basis of Christian principles (Balboni et al., 2007). Therefore, I would visit John’s mother and John in the hospital to offer them the love that they needed more. Also, I was able to mobilize other members of the church and community and encouraged them to visit the family as well as pray for them. It is crucial to offer in kind of assistance to these people, may it be, emotional, spiritual, physical, or social support.
Chronic and terminal illness results in unimaginable pain and leaves a lot of suffering to the family members. John’s case was not different and led to much pain between him and the mother. It is easy for the patient to lose hope and faith due to their condition just as John was about to do. However, the pastoral care is very crucial in ensuring such people hold on to hope and they don’t lose their faith (Kaut, 2002). It is crucial for every person to undergo medical check-up early enough from time to time. In most instances, people suffering from the chronic and terminal illness, they realize when it’s too late and at an advanced stage that treatment becomes ineffective (Rabow & Dibble, 2005). If I encounter such a scenario again, I would still encourage the parties involved to seek better treatment as they hold to hope still since technology has improved the field of medicine. It is also vital for people to hold on to spiritual principles so that they may avoid making decisions that are not right concerning ending of life assisted by the physicians (Campbell, 2017).
Conclusion
Terminal and chronic illness generate a crisis for the parties involved and the family at large. It disrupts in a significant way the family equilibrium leaving a depression, pain, and suffering. John’s case was a devastating situation especially to the mother as she was about to lose her son. It wasn’t easy for John either as he experienced a lot of pain and the medication he was taking was not working until he was giving up. However, the pastoral role such as showing love, encouraging, and offering support through prayer (spiritual), moral, and physical support, goes a long way in giving new hope to this people. In the future, it is essential for people to undergo a medical check-up to screen for such terminal diseases such as cancer and HIV/AIDS
References
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