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Where is the best place for Ella? Essay

Ella is an elderly lady with breast cancer, she is now in the last stages of the cancer an soon her life will be over. The social worker in this case must be able to determine the best care possible for this lady. Ella has a background of trusting only in natural remedies for ailments along with her husband John who is of Native American descent, and trust only in traditional methods for healing. When looking at only John and Ella’s viewpoints of health, the answer would be easy on how to care for this lady. However John and Ella have three children along with their spouses and four grandchildren, who all have their own ideas of how Ella should be cared for. Ella’s father also has to be considered for his thoughts on her care. Even though modern medicine would prolong her life, Ella should be able to be where she wants to be when she dies.

She would be happier and more comfortable in her last days if she were allowed to do what she wants to do, also she is not trusting of modern medicines and should not be forced to take them. Now for this report, the social worker should go over the pros and cons of what Ella wants along with the pros and cons of what her family wants. Ella should be able to be where she wants to be when she dies. People are happier and more at ease when they are in a familiar setting. It is well known that a person cannot be comfortable or rest very easily within a hospital setting. She is also not trusting of modern medicines and should not be forced to take them, all of her life she has been taught by her family to only trust in natural remedies for ailments.

Her husband who is of Native American descent only trusts in traditional medicines so he too is not comfortable with her spending her last days in a place where she will have to take modern medicines. The most important reason Ella should be able to be where she wants to be when she dies is because she would be more comfortable and happy in her last days if she were allowed to do what she wants to do. Being at home Ella would be in a familiar environment with family and friends to surround her and help her also to give her encouragement and support.

Ella’s husband would also be more comfortable and relaxed with her being at home for him to help care for her. Ella could get help through hospice and palliative care. Being in a hospital or nursing home environment could possibly cause Ella to go into a depressive state, she could become combative, noncompliant, and because of this her death could possibly come faster for the simple fact that she is being made to do something she does not want to do. “Home can be the very best or the very worst place to die. The advantages of home care include:

Feeling secure
Flexible routines
Reduced medical intervention
The patient remains part of the family
Control (professionals become the visitors)” (Kaye, n.d.)

Ella’s family and friends believe that Ella would be better off in a hospital or nursing home environment. They think that 24 hour care would be better for her. Their arguments are that 24 hour care would be the best for Ella, they say that someone would always be watching over her and could alert the Doctors to any changes right away. They also say that isolation and physical suffering can be extreme if patients at home are neglected, if physical symptom control is inadequate, and if family caregivers (or neighbors and friends) cannot obtain adequate assistance and support. (Kaye, n.d.) The author of this report has suggested to the family that they should honor what the patient wishes, this could possibly prolong her life if she is allowed to stay where she is most comfortable.

“The prime factor in deciding where a terminally ill patient should be cared for is the patient’s own wishes. Some patients feel that a hospital is no place for a person who is seriously ill. Other patients feel more secure in an in-patient setting. Some may fear “becoming a burden to their family” if they choose to stay at home. It is important to listen carefully to the patient. While every effort should be made to comply, the patient’s wishes have to be considered in light of practical issues such as the availability of professional and volunteer support, and the attitudes and abilities of family members.” (Kaye, n.d.) This reporter gave information to the family on Hospice home health care.

Hospice home health care

“Hospice home health care encompasses the assistance of physicians, nurses, personal care assistants, counselors, therapists, chaplains, social workers, and trained volunteers. Note, each home health caregiver plays a unique and important role in the patient’s care. Specifically, each home health caregiver provides care in his or her area of expertise. In essence, home health hospice targets as many facets possible in terms of the patient’s care. After all, each home health caregiver wants to relieve and/or minimize pain as much as possible so that the patient can be comfortable. Moreover, home health hospice care managers provide the patient, as well as the family, with a care plan that lists the specific duties, work days, and hours of the each home health caregiver; this also includes contact information. In other words, continuity is ensured via the constant communication.” (Advantage, 2011)

Home health hospice is affordable

“Hospice home health care has yet another added benefit for terminally ill patients. In particular, this type of care generally costs significantly less than inpatient care in a hospital, nursing home, or other, similar type of facility. The chief reason that home health hospice is much more inexpensive is because patients only pay for specific care needed. What’s more, hospice home health care may employ volunteers who may provide many services at little or no costs; things such as telephone support, visits, and assistance with meals, housekeeping, or errands. Therefore, should you or a loved one have the need for hospice home health care, please reach out to find more information. You may contact your physician, social worker, or discharge planner. Any one of these individuals should be able to recommend local hospice care providers and/or facilities.” (Advantage, 2011) And then offered to give a referral for Hospice home health care.


In conclusion although modern medicines would prolong her life, Ella should be able to be where she wants to be when she dies, for two main reasons. First, she is not trusting of modern medicines and should not be forced to receive them. But most importantly, she would be more comfortable and happy in her last days if she were about to do what she wants to do. In contrast should she be made to spend her last days in the nursing home are hospital, her life would be that of suffering, and hurt because of thoughts of disappointment in her family.


Advantage, H. (2011). Hospic Advantage. Retrieved from Hospic Advantage: http://www.hospiceadvantage.net/home-health-caregiver.html Kaye, P. (n.d.). Hospice Education Institution. Retrieved from Hospice World: https://www.hospiceworld.org/book/home-care.htm

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