Introduction

After the diagnosis of a progressive neurological condition like Amyotrophic Lateral Sclerosis (ALS), the first responsibility for multidisciplinary teams, family, and caregivers is to think about palliative care (Goutman et al., 2022). The goal of this paper is to critique relevant elements of the CPG and case study whilst upholding the National Palliative Care Standards of NMBA. 

Critique of CPG for case study

The end has come for Tylor Morton, a 40-year-old man who suffered from a number of terrible illnesses. His "Amyotrophic lateral sclerosis" began with discomfort and weakness in his left hand and has progressed via dyspnea, dysphagia, dependence on other people due to loss of movement, and a constant worsening of his physical state (ACU, 2021). Meanwhile, tensions with his wife and family have added another layer of difficulty to Tylor's life. Tylor's decline may be seen in the form of respiratory degradation requiring "non-invasive ventilation," gastrointestinal infections requiring a PEG tube, and constant pain requiring medicine (ACU. 2021). Furthermore, she was not prepared to talk to Tylor's mom or other relatives about his terminal illness. Catherine, Tylor's wife, wasn't blind to the fact that she thinks her husband would never recover from his current state of immobility and return to work (ACU, 2021).

Since Tylor's disabled condition has progressed to a terminal stage, "end of life care" has been selected as the appropriate clinical practice guideline (CPG) to ensure that he receives the highest possible quality of life and the kind of compassionate, family-centered care that will allow him to maintain some semblance of normalcy in the days leading up to his death (ACU Practice guideline, 2021). Clinical guidelines for the treatment of terminally ill patients are best understood as the process of intervening and caring for a patient in their last moments. Guidelines in this CPG address topics such as "options for the treatment of this patient in the last stage," "decision-making," "continue supporting the patient and his family," and "medical, therapeutic, preventative, supportive, and preventive service for the last moment during the last few days of life" (Brizzi et al., 2019).

The diagnosis of Tylor's motor neuron disease (MND) and amyotrophic lateral sclerosis (ALS), which causes paralysis of the arms and legs, speech and breathing difficulties, swallowing difficulties, and advanced muscular problems that can eventually lead to permanent paralysis, is the first and most important step in providing care for him as he nears the end of his life. MND and ALS are progressive neurodegenerative diseases that affect nerve cells in the brain and spinal cord. As described in this case study, Tylor suffered from a similar ailment one that was exacerbated since his wife did not give him the benefit of the doubt (Palliative Care Australia, 2018). In order to provide care for terminally ill patients while adhering to CPG guidelines, RNs may need to take into account some of the NPC Standards. Standard 2 of the palliative care guideline is "developing care planning," Standard 3 is "care for carers," Standard 4 is "providing care," Standard 6 is a "grief report," Standard 8 is "quality improvement," and Standard 9 is "staff qualification and training" in order to provide Tylor with care for his motor neuron disease (Australian Commission on Safety and Quality in Health Care, 2020).  See appendix A

According to this case study, in order to understand Tylor's current condition with ALS, one would need to look at previous records such as his medical history and the reports collected from the palliative team along with the medical officer, also reports from both Tylor's relatives. Additionally, one would need to speak with Tylor's medical officer. . First and foremost, as a certified nurse, it is your responsibility to notify Tylor's loved ones, from his mother to his wife, about his terminal situation and to emphasize the value of providing care centered on the needs of the whole family. Considering his current state of anguish, family pressure and further strain pose immediate dangers to Tylor's life. The pain, anxiety, hunger, weakness, and discomfort levels of Tylor were measured using the SAS tool "Modified Karnofsky Score," "problem severity score," as stated in this case study (Barbetta et al., 2019). Catherine, though, clearly wasn't worried about any of these medical findings. The medical and palliative care teams have only a prognosis and diagnosis of Tylor's illness, and his wife and family are still at odds on how to proceed.