Need some feedback

[meluhn]

I just started in HH a few months ago and I am loving it. I just started case managing a case in which the pt is a 62 yo, lives alone in a 2nd story walk-up apartment and just had the whipple procedure done for pancreatic ca. He will be going for chemo when his incision heals. I plan on talking to the oncologist and my manager about this but isn't that going to be kind of rough getting home after tx? I know the prognosis for pancreatic ca is not good but does this procedure improve it dramatically? I am wondering if I should be concerned about his living situation. Should I get SW involved? Try to nudge him towards moving someplace more accessible in his compromised position? I dont know how much family support he has if any.

[KateRN1]

This sounds like an excellent referral for social work. From a nursing standpoint, I'd talk to him about how his energy levels are likely to plummet, his nutrition is likely going to be an issue (might get a dietician in if you have one available), and how he is planning to manage with ADL/IADLs. I wouldn't start in with telling him he needs to move, rather help him to realize that it may be in his best interest to move somewhere that there aren't any stairs. Does he live alone? Any family that assist? Friends? Neighbors? Is he going for chemo/radiation afterwards? What are the plans for his treatment? You might also want to gently bring up the idea of hospice, for when the time is appropriate.

[caliotter3]

Ditto what Kate said. Also be prepared for denial at first. He may not be mentally prepared for being gently reminded that things might change for him. It most likely has not sunk in yet, if this has been discussed at all. I definitely would get the SW involved.