Patient 1: Miss M.R

A 40years old female seen 6 March 2015 in the palliative care clinic with a diagnosis of Cancer of the cervix with a large residual disease on the rectum.

The patient resides in Majwaneng in Botswana next to Majwaneng clinic. She came to the clinic accompanied by her sister and her son. The palliative care team members available during the sessions were 2 oncology nurses, 2 dieticians, the oncologist, the physiotherapist, and a community home based care nurse

Miss M.R is on HAART since 2012, she was given palliative chemotherapy (Cisplatin INJ), she did Total Abdominal hysterectomy (TAH) IN 2011 and received radiotherapy in May 2014. (Pelvis 50Gy, rectal mass 10Gy and Brachy 7Gy).

Both of her parents are deceased. She has 3 sisters and brothers and a son. She lives with her older sister who has 6 children.

On assessment her physical wellness has been decreasing from 2012 where it was rated 90% to 2015 where it’s rated 40%. Her psychological support is fair as well and her spiritual and social wellnesses are good.

During the physical assessment we identified pain and constipation as the main problems she complained of. She mentioned that the pain improves when on chemotherapy and the team members (oncologist and oncology nurses) agreed to continue chemo unless there are adverse effects or pain doesn’t become better. Morphine tablet 10mg BD PO and lactulose 10mg Noct PO were prescribed

The son was very emotional because of her mother’s condition and was booked to see the social worker for counseling on 10 April 2015. No social problem was identified. Spiritually she is a Christian and affiliated to a church which is distant from where she resides, so she was advised to find a church nearer to her home.