ABSTRACT
These should be hours for necessities, Not for delights; times to repair our nature With comforting repose, and not for us To waste these times. King Henry VII, V, i. Case history
Jim is a 20-year-old postgraduate student with advanced lymphoma that is resistant to further chemotherapy. He is dying and has only weeks to live. He is in hospital because he has asked to die in the unit where his lymphoma was treated. His parents are distressed by his pain and his sisters are at school, unable to visit as frequently as they would wish.
Jim is becoming withdrawn, and says little to the nurses or his family. A staff nurse on the haematology unit asks the palliative care team social worker to see him.
After two visits Jim confides to the social worker that he feels angry. He thinks that the doctors have let him down. He explains that he feels sad about the fact that he will be unable to complete his postgraduate diploma, and wishes that he could see more of his family without burdening them.
The social worker obtains Jim’s permission to discuss these feelings of anger and isolation with his family and with a clinical psychologist in order to find ways of alleviating the situation. The psychologist is able to discuss Jim’s wish to be at home without causing his family anxiety.
The social worker, family, GP and community nurses devise a package of home care for Jim and his family. This package of care is discussed with Jim, who feels much happier that he can remain at home. His pain is controlled and he spends another four weeks at home. During this time his university grants him his diploma on the basis of the work that he has completed. Jim dies at home with his family present, and the family are supported by the social worker through their bereavement.
