Instructions: Read the following case study and answer the reflective questions. Please provide  rationales for your answers. Make sure to provide citations/references for your answers in APA  format. 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

1. Some of the stresses on Sandra’s middle-aged sisters and their families include the emotional burden of seeing their sister suffering from a terminal illness, the responsibility of providing round-the-clock care for Sandra, and the potential strain on their own relationships, work, and personal lives due to the demands of caregiving. They may also experience financial strain if they have to take time off work or hire additional help. Additionally, they may feel overwhelmed by the uncertainty of the future and the impending loss of their sister.

2. There are several resources available to manage these stresses and support Sandra’s sisters while caring for their dying sister. Firstly, they can seek support from healthcare professionals, such as nurses and social workers, who can provide guidance, information, and emotional support. They may also benefit from joining support groups or online forums for caregivers of terminally ill patients, where they can connect with others going through similar experiences and share their feelings and concerns.

In terms of practical support, they can explore options such as respite care, where they can take breaks from caregiving for short periods while trained professionals take over. This can help to alleviate caregiver burnout and provide a much-needed rest. They can also consider reaching out to friends and family members for help with tasks like meal preparation, child care, or household chores.

Financial assistance may also be available through government programs, non-profit organizations, or charitable foundations. It would be beneficial for Sandra’s sisters to research and inquire about these resources to ease any financial strain they may be facing.

3. Sandra’s feelings about dependency and loss of autonomy are likely to be complex and may evolve over time as her illness progresses. Initially, she may feel frustrated and resentful about needing assistance with activities of daily living that she was once able to do independently. She may also experience a sense of loss and grief for her previous way of life.

Over time, Sandra may need to come to terms with her dependency and shift her focus towards accepting and adapting to her new circumstances. This can involve finding new ways to maintain a sense of control and independence, such as engaging in activities that she is still able to participate in or exploring assistive devices and technology that can increase her autonomy.

It is important for Sandra’s healthcare providers and support network to validate her feelings and provide emotional support throughout this process. Encouraging open communication and offering opportunities for Sandra to express her desires and preferences can help her feel empowered and maintain a sense of dignity as she navigates her care journey.