You are the CNS, Nurse Educator or Social Worker on this unit. Mr. Jones is a 74-year-old patient with advanced Alzheimer’s disease who is dependent for all of his activities of daily living and requires assistance with eating and drinking. He has been a resident at your institution for the past 3 years and his wife of 52 years is his health care proxy. She visits him daily and assists with his meals. Mr. Jones is having increased difficulty swallowing and Mrs. Jones has requested that the staff stop feeding Mr. Jones, because “that is what he would have wanted”. The primary care provider has suggested the placement of a feeding tube for nutrition, but Mrs. Jones has declined the offer of a feeding tube. There are no Advanced Directives and Mrs. Joes has been acting as Mr. Jones health care proxy since he became incapacitated. Mr. and Mrs. Jones have 3 children; two of the children are in agreement but the third does not agree with the decision and has become very upset. When visiting this family member becomes very vocal and argues that if Mr. Jones does not receive a feeding tube then the staff is “killing him”. When visiting, this family member attempts to feed Mr. Jones who often begins coughing and the staff is fearful that he will aspirate or choke. You have scheduled a family meeting for tomorrow afternoon and the staff has asked for preliminary meeting to prepare for the family meeting. You have gathered the staff in the conference room and they express their concern and are upset about the Jones’ family situation. They are seeking your counsel about the situation. Consider the following questions for the Case Study. Who are the ″stakeholders?″ List those who have an interest in the outcome of this case
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