Palliative Care for Patients With Physical Disabilities

Betty R. Ferrell, PhD, RN

Disclosures

April 13, 2017

Hopeful and Optimistic

Marilyn is a 52-year-old Chinese woman with a complex medical history. At age 29, she became paraplegic when she experienced a spinal cord injury during a fall from a high wire as a performer in a circus acrobatic act. Marilyn has had a difficult course, enduring endless struggles with the financial complexities of receiving care as a disabled person.

Over the past two decades, Marilyn has had many problems associated with her paraplegia, including urinary tract and wound infections, deep vein thrombosis, and pneumonia. Despite these issues, she has also achieved greater success in rehabilitation than expected, and has excelled in her career goals to become a disability counselor. She has remained hopeful and optimistic despite her difficult course of care.

Marilyn was recently diagnosed with stage IV breast cancer. She has had many conflicts with the oncology team in the initial diagnostic period and when considering treatment options. Today in the oncology clinic, she refused to discuss completing an advance directive and has delayed initiating treatment.

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