PATIENT 5: Mr. M.M.J

The 54years old was seen on 16 June 2015. He is a case of CA esophagus. He lives in Malaka village in Mogoma ward. The clinic nearer to him is Malaka health post.

He is on HAART since 2010; he received chemotherapy and had a stunt insertion and gastroctomy tube in situ.

The palliative care clinic was attended by the oncologist, the community home based care nurse, dietician, 2 oncology nurses, and from the patient’s relatives the brother, sister and cousin attended. The patient has 4 brothers,, sister and 2 daughters. He stays with his 4 brothers, her sister and her daughter.

His physical, psychological and social wellness have been deteriorating since 2013, his spiritual wellness is increasing.

During the physical need assessment the patient reported blockage of the stunt and the oncologist explained the cause (the stunt moves and kinks causing the blockage) and the patient understood. Relatives explained that they don’t have enough knowledge on the disease and the oncologist explained the disease process and prognosis.

Lack of food was identified as a social problem. The patient explained that he takes Ensure and only 2 tins are provided for the whole month. The patient was referred to the social worker who will contact the social worker in the Malaka catchment area to assist the patient. The dietician will advice on the amount of ensure to feed the patient in day. Referral letters were given to the patient.

No spiritual problem was identified.

The patient suggested radiation and the oncologist explained that radiation will not help and he will consider it in the next 6 months.