Integrated Palliative Care Strategies for End-Stage COPD in Australia

NURS3105: Complex Care: Palliative Approaches

Assessment 2: Palliative Care Case Analysis

Task Overview For this assessment, you will produce an 1800-word case analysis in response to three short-answer prompts. The prompts are based on the provided case study of Mr. Miller and are designed to assess your understanding of key principles in contemporary palliative care. Each response should be 600 words and must refer explicitly to the case study. Your analysis must be supported by high-quality evidence, including Australian healthcare policies, clinical guidelines, and peer-reviewed academic literature.

This assessment allows you to demonstrate your clinical reasoning and understanding of:

• The role of the multidisciplinary team (MDT) in managing complex, non-malignant, end-of-life trajectories.
• The application of specific nursing strategies to support older carers facing significant strain.
• The challenges and enablers of providing coordinated, integrated palliative care in the Australian community setting.

Case Study: Mr. Miller’s Journey

Mr. David Miller is a 78-year-old man diagnosed with end-stage Chronic Obstructive Pulmonary Disease (COPD). He lives at home in a regional town with his wife, Helen, who is 75 and has osteoarthritis, which limits her mobility. They have two adult children who live interstate and visit every few months.

Mr. Miller has been admitted to the local regional hospital following an acute exacerbation of his COPD, presenting with severe dyspnoea (breathlessness), fatigue, and anxiety. His prognosis is now considered poor, with a life expectancy of weeks to a few months. The focus of his care has officially shifted from active disease management to a palliative approach.

During his admission, the team has managed to stabilise his acute symptoms with oxygen, bronchodilators, and low-dose opioids for his breathlessness. However, Mr. Miller remains very weak. He has expressed a strong and consistent wish to return home and die there. Helen is committed to caring for him but is visibly anxious about managing his breathlessness and her ability to cope physically and emotionally. The family is concerned about the availability of 24/7 support in their regional area.

Short Answer Prompts

With Mr. Miller’s case study in mind, respond to each of the following prompts. Your responses should demonstrate a deep engagement with the case details and a critical understanding of comprehensive, person-centred palliative care.

Prompt 1 (600 words): Examine the role of the multidisciplinary team (MDT) in planning for a safe and dignified transition to home for Mr. Miller. In your answer, discuss the specific contributions of at least three different healthcare professionals in addressing his complex physical and psychosocial needs.

Prompt 2 (600 words): Critically analyse two evidence-based nursing strategies that could be implemented to support Helen in her role as Mr. Miller’s primary carer. Your evaluation should consider the unique challenges faced by an elderly carer with their own health concerns.

Prompt 3 (600 words): Discuss the key challenges and enablers in providing integrated, person-centred palliative care for Mr. Miller within his regional community setting. Consider how the healthcare team can ensure care is coordinated effectively between the hospital, general practitioner (GP), and community palliative care services.

Assessment Guidelines

• Style: You are required to write in a formal academic style. Answer each prompt separately under its own heading. Do not write a single essay.
• Research and Referencing: Your work must be supported by credible, peer-reviewed evidence from 2019-2025. You must cite all sources using the APA 7th Edition referencing style, including in-text citations and a final reference list.
• Submission: Submit your assignment as a single Word document via the online learning portal.

References (APA 7th Edition)

1. Aoun, S. M., O’Connor, M., & Rumbold, B. (2021). The ‘good caregiver’ at the end of life: A concept analysis. Palliative Medicine, 35(2), 346–359. https://doi.org/10.1177/0269216320970634
2. Bradford, N. K., Smith, A. C., & Caffery, L. J. (2022). The role of telehealth in supporting palliative care patients and their families in regional and remote Australia: A narrative review. Australian Journal of Rural Health, 30(4), 456–468. https://doi.org/10.1111/ajr.12871
3. Johnston, C., cleanington, A., De-la-Haye, S., & Yorke, J. (2022). Integrated respiratory and palliative care services for patients with advanced COPD: A systematic review. Palliative and Supportive Care, 20(4), 519–531. https://doi.org/10.1017/S147895152100078X