Affordable Healthcare: Todd and Reginald Case Study

Introduction

The verity that human life is priceless is indisputable. As a result, all spheres of human living ought to be inclined towards the protection and preservation of human life. The provision of quality and affordable healthcare is one gravitas attempt geared towards safeguarding human life (Patterson, 2017). It is crucial to note that the healthcare system is spread across an expansive scope, and healthcare providers occupy a core position within the system. Therefore, the attainment of quality and affordable patient healthcare demands pertinent evidence-informed practice approach by the healthcare providers when conceptualizing the work.

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Nevertheless, evidence-informed practice primarily denotes the use or reliance on germane scientific evidence for the provision of guidance as well as in the making of fundamental decisions (Christon, McLeod, & Jensen-Doss, 2015). Therefore, the conceptualizing of this work through an evidence infirmed approach does not incorporate the use of evidence that is based on intuition, tradition any other type of unproven technique. Also, the focal point of this paper applying evidence-informed practice approach is to erase any aspect of outdated and unsound practices and in place use a practical, grounded scientific assessment.

The Wates Family: Todd Case Study

Developmental and Cultural Factors Informing About the Preparation to Conduct End-Of-Life Preparation With Todd

A conversation involving the readiness to conduct an end-of-life preparation with Todd, who is still a young person is undeniably one of the most robust conversations to have as a caregiver. However, the fact that Todd's health might fail abruptly and unpredictably, it is exceptionally vital for medical, legal as well as alternative formal preparations to be instituted while Todd can make such critical decisions.

Besides, some of the critical factors to be considered in the preparation to conduct an end-of-life preparation with Todd are developmental and cultural factors. Todd is 28 years of age from an individual developmental perspective. At such a level of development, Todd is relatively capable of making most of the decision regarding his end-of-life preparation. Thus, as a young adult, an Advance Directive is one of the vital developmental factors that will inform about Todd an end-of-life preparation. The Advance Evidence is essentially a legal document that Todd will use to spell out his wishes concerning his future medical treatment and care (Kumar, Bhartiya, & Ichhpujani, 2017). More so, it will allow Todd to settle on the individual he believes suits to make critical medical decisions on his health conditions in the event Todd is rendered incapable of making critical decisions.

Also, a Living Will is another key developmental factor necessary to conduct end-of-life with Todd. The Living Will is a platform for Todd to document his wishes regarding the decision if whether he desires or does not want a medical treatment that will extend his life even though his current health situation appears irreversible and death is relatively foreseeable.

Even though Todd is in a critical health condition, he was actively working previously before his health condition worsened. He was able to attend a local community college where he managed to secure a Graphic Design Associate Degree. As a result, he secured employment with a web-based company that allows him to work from home. Hence, coming up with an end-of-life preparation for Todd demands the authority for an attorney for the appointment of a person responsible for making decisions regarding Todd's investments, bill payment, and other asset or legal issues (Garcia & McCarthy, 2018). Also, Todd's recent bank statements together with alternative financial documents about his investments, should be put in place that is accessible and safe if a told he had any.

From a cultural perspective, a chief informative factor on how to prepare to conduct an end-of-life preparation with Todd is his tribal affiliation. Sarah's yearning is the family to settle on the Nation's tribal land ultimately. Sarah's push for the decision is because she considers the existing correlation and ties between the family and its tribe. However, to the surprise of the family, the tribe is unwilling to allow them to settle on the Nation's tribal lands. Also, the medical services available within the tribal community is relatively irrelevant as far as Todd's dire health condition is concerned. Therefore, the cultural environment within the Nation's tribal lands that Sarah desires the family to live in is unconducive to both the family and Todd's health.

Moreover, the veracity that Todd is born of mixed parentage; native Americans and African Americans rubberstamps his growth and existence within a highly multicultural family. Coming up with an apt end-of-life preparation, therefore, will need to significant considerations for the highly differentiated cultural backgrounds that Todd is born. For instance, Todd mother might be against a move aimed at coming up with an end-of-life preparation be it he is a radical Christian. This is because Todd's mother might consider such a move to be ungodly and against Christian teachings and beliefs on the sacredness of human life.

An Engagement With Todd About the Preparation of Advanced Care Directives

Engaging Todd in a discussion about the preparation of an advanced care directive first and foremost demands proper understanding of the needs of his condition. Todd is presently suffering from hypercarbia and has a diminished lung capacity that needs supplemental oxygen. More so, at the beginning of the year, he suffered from an exacerbation of his CF. Due to Todd's condition, he needs to be put under a skilled nursing facility to receive rehabilitation services.

Additionally, Todd needs to receive the best clinical services as part of his advanced care directive. Among the best clinical services for Todd is making sure that his upper airway is clear and patent from any form of obstructions. As a result, Todd needs to be put under ventilator support as well as supplemental oxygenation (Cook, Langford, & Ruocco, 2017). Also, alternative clinical practices such as mechanical ventilation and endotracheal intubation may be offered to Todd when other lesser invasive methods fail.

Nevertheless, because engaging a patient on a discussion centered on an end-of-life preparation is time-consuming as well as difficult across all training levels, I will uphold professionality, competency, and expertise in my discussion with Todd. I relatively expect Todd to be uncomfortable with such a topic of discussion, but due to its fundamentality as far as his health is a concern, I will have no option but to prompt him in the debate. Therefore, to achieve apposite facilitation of the discussion, I will pay critical attention to winning Todd's trust that essentially is the principal care physician.

Besides, since Todd is at home, engaging him in a discussion about preparing advanced care directives will entail an outpatient discussion setting. This is because advanced care directives discussions are complicated, especially within academic medical settings since most patients feel uncomfortable to talk about end-of-life issues. However, the outpatient advanced care directive discussion will make Todd feel much comfortable, thus facilitating a better discussion in reaching a pivotal end-of-life preparation decision (Cook, Langford, & Ruocco, 2017).

Todd's family occupies a unique position in his life. It is therefore very critical for Todd's family cultural narratives be included in the work. Any attempt to exclude the family's cultural narratives into the work might jeopardize the family's position as well as Todd's health. Thus, incorporating the family's cultural narrative will involve giving an ear to their cultural demands and opinions. However, owing to the verity that Todd is at the core of the situation at hand in its entirety, the power to make the final decision will be in the hands of Todd. For instance, the family's cultural narrative might try to discuss Todd's last resting place. Such a discussion will be left upon Todd to make the final decision about his suitable resting place.

Also, another family's cultural narrative might be coming up with the proper way of granting Todd a better send-off. Such a decision will also be left upon Tod to make the final decision. Summarily, incorporating the family's cultural narratives into the work will entail giving them room to raise their ideas and opinion but leaving Todd with the veto powers regarding the acceptance or rejection of the family's cultural narrative ideas.

Anticipated Personal Biases, Values and Beliefs and Their Management

As a medical practitioner, I anticipate coming across several biases, values, and beliefs when speaking to a 28-year-old about dying. For instance, I anticipate having difficulty with the belief of abandonment by God by a 28-year-old. This is because at 28 years of age, it is still too young for a person to die, and as a result, the 28-year-old will feel abandoned by God and left to suffer. On values, I anticipate having trouble with my spirituality value. This is because as an individual who is highly spiritual and believing in God's healing power, I will get a hard time to prepare Todd for his imminent death yet I firmly believe spiritual intervention can heal him.

Correspondingly, I anticipate having difficulty with overconfidence bias. This bias is likely to arise from my false sense of self-belief and skill of quickly helping Todd in an end-of-life preparation. Therefore, to manage the bias in my work with Toddy and family, I will drop any aspect of the illusion of control, the effect of desirability and timing optimism that essentially give room for the occurrence of overconfidence bias (Wentlandt et al., 2011).

Part Two: Reginald Case Study

Justification of Reginald's Health Condition

After careful consideration of the information provided, and drawing upon evidence-based-practice, I firmly believe Reginal is more likely experiencing dementia. This is because Reginald's daughter books an appointment for her dad after realizing that he is very forgetful. Reginald is having so many difficulties recalling days of the week; he forgets to settle several of his overdue bill notices, he fails to remember why he entered a room and easily gets lost while driving to the grocery store which is a place he has regularly been driving (Patterson, 2017). Reginald also forgets a boiling pot on the stove while cooking pasta. All these are clear signs and symptoms of individuals who have dementia since they exhibit difficulty in recalling of information freshly learned.

Besides, individuals who have dementia show changes in mood or personality. This is precisely what Reginald is facing, and it is evident when Reginald is easily irritated by his daughter speaking about his memory. Also, Reginald is currently 73 years old that makes him not any younger but old. Dementia primarily affects elderly persons; therefore, the probability of Reginald suffering from the condition is high based on his present age.

Recommendatory Services and Resources for Reginald

It is critical to note that diagnosing dementia is a challenging process. This is because its diagnosis demands apt recognition of the pattern of function and skill loss to establish what an individual is still capable of accomplishing. More so, most dementia is incurable and can only be managed. I will, therefore, recommend Reginald nondrug approaches such as therapies. For instance, I will recommend him for occupational therapy services that will significantly help to make Reginald's...