[Solved]: Mr

Mr. Roy immigrated from Hungary 50 years ago. He is able to speak only limited English. He lives with his wife in a farmhouse on a 100-acre homestead, which his children continue to manage with him. Mr. Roy has a Grade 8 education. He has no pension but has some earnings from the farm. He worries for his wife’s well-being if he is no longer able to contribute on the farm. He is a non-smoker and does not consume alcohol. He is Catholic by faith and attends church “on his good days.” His family is supportive and is often telling him “it will pass” or “you’ll get better soon dad.” They encourage him to follow what the doctors want to do. Mr. Roy has followed a healthy diet since starting dialysis to avoid any problems but lately has not had an appetite and has lost 15 lbs in the past few months. He has had two infections of his access site in the past 6 months; one of the episodes he does not remember. “I lost my mind for a bit,” he tells you. Mr. Roy is finding the drive to dialysis increasingly tiring and now has to rely on neighbours for assistance as he no longer drives on his own. He longs to enjoy his life at home more and ruminates about the idea of not being on dialysis anymore. This thought causes him anxiety as he worries about his faith. He tells you, “It’s suicide to stop in eyes of the church.” He asks what you think about this. No one has ever talked to him about treatment options or stopping dialysis. : Questions: What are the contextual features impacting the scenario? What would be involved in informed consent to stop dialysis? What would a palliative approach to care involve in this scenario? What conversations need to occur? What is the role of the nurse?