Sandra, a 47-year-old divorced woman, received a diagnosis of stage 3 ovarian cancer 4 years ago, for which she had a total hysterectomy, bilateral salpingo- oophorectomy, omentectomy, lymphadenectomy, and tumor debulking followed by chemotherapy, consisting of cisplatin (Platinol), paclitaxel (Taxol), and doxorubicin (Adriamycin). She did well for 2 years and then moved back to her hometown near her family and underwent three more rounds of second-line chemotherapy. She accepted a less stressful job, bought a house, renewed old friendships, and became more involved with her two sisters and their families.
Sandra developed several complications, including metastasis to the lungs. Then she could no longer work, drive, or care for herself. She had been told by her oncologist that there was nothing else that could be done and that she should consider entering a hospice. She met her attorney and prepared an advance directive and completed her will. She decided to have hospice care at home and, with the help of her family, set up her first floor as a living and sleeping area. She was cared for by family members around the clock for approximately 3 days.
Sandra observed that she was tiring everyone out so much that they could not really enjoy each other’s company. At this time, she contacted the Visiting Nurse Association (VNA) to seek assistance. Her plan was to try to enjoy her family and friend’s visits. After assessment, the VNA nurse prioritized her problems to include fatigue and caregiver role strain. Other potential problem areas that may need to be incorporated into the care plan include anticipatory grieving and impaired comfort.
- What are some of the stresses on Sandra’s middle-aged sisters and their families?
- What resources are available to manage these stresses and support the sisters while caring for their dying sister Sandra?
- Describe Sandra’s feelings about dependency and loss of autonomy because she is unable to do her own activities of daily living any longer.
have instated a Communist regime, was widely spread and, as Folch-Serra argues ‘systematically enforced through schools and textbooks, the pulpit, the Fascist institutions and the media’ (p. 228). There was heavy censorship of news that could have challenged this image, which Folch-Serra shows was ‘illustrated by the Spanish media’s disregard of the Nobel prizes awarded to Juan Ramón Jiménez for literature in 1956 and Severo Ochoa for science in 1959’ (p. 229). This leads on to the contradictory nature of Franco’s treatment of the Republicans since, as well as spreading defamatory comments about their nature, there was also, as Folch-Serra explains, a ‘suppression of information about their fate and whereabouts’ (p. 229) which drew from a ‘deliberate policy of oblivion and silence’ (p. 229). By winning the Civil War, Franco also won the fortune of being able to rewrite history and, as Folch-Serra confirms, he was able to ‘concoct a uniform image of the defeated as one and the same’ (p. 227). Amongst other forms of propaganda, education allowed Franco to disseminate his version of events as truth, which can be seen through school textbooks which Xavier Laudo elaborates on how they ‘spoke of the desertion of Republican soldiers’ as well as presenting Republican Spain as the ‘enemy within’ (p. 442) who were ‘responsible for the erosion of the nation’s Christian faith’ (p. 442). Assmann further shows how this ‘one sided version of history’ (p. 64) not only ‘protected’ (p. 65) and legitimised Franco, but also ‘prolonged the enemy stereotype of the murdered communists and democrats’ (p. 65). Thus, it can be seen that Franco manipulated the memory of the Civil War during his dictatorship and how his policies towards the Republicans after the war allowed him to promote his narrative as the truth and legitimise his position. This collective amnesia that Franco wanted to induce, discredited and erased his opponent from history. However, Assmann adds that this ‘silence did not dissolve the memory of the traumatic past’ (p. 66) and did not fully discredit his opponents, as individual memories of the events were ‘materially preserved in the earth and in families’ (p. 66). Memory also featured heavily in Franco’s propaganda, with many references made to returning Spain to the greatness it had once experienced. Franco’s message regarding the Republicans was spread through education and Laudo explains that so was the image of the Civil War as a ‘crusade’ (p. 438) such as during the Middle Ages. Zheng Wang describes how school textbooks can be used as ‘instruments for glorifying the nation, consolidating its national identity and justifying particular forms of social and political systems ‘ and how the rewriting of school textbooks can be used to ‘legitimise the new regime’ (p. 45). This is evident on the front cover of El Libro de España, which features a boat sailing across the globe, against the backdrop of the Spanish flag. This reminds the viewer of the Spanish Empire, as Laudo confirms, ‘stressing the cross-Atlantic colonialist adventures in the Americas’ (p. 443), and the power and glory that this brought, ‘promoting a spirit of patriotism’ (p.443). Through this, Laudo explains that Franco was able to propagate his ‘vision of Spain’s history, its Hispanic mission for imperial glory’ (p. 453). Religious references were frequently seen in Franco’s propaganda, and comparisons were made to the Catholic monarchs and the unity and greatness Spain experienced under them. Miriam >GET ANSWER