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The patient considered for the evaluation is a 60-year old man, previously diagnosed with inclusive body myositis. The man’s condition has been deteriorating rapidly, prompting a nursing intervention. In order to accurately measure the patient’s condition and confirm the existing diagnosis, it is necessary to run a number tests and screenings. According to research, the most effective way to screen for IBM is a muscle biopsy, which shows the degeneration of muscles (“Diagnostic criteria for sIBM,” 2018). In addition to this screening method, it may be necessary to assess the level of muscular weakness present in the body (“Diagnostic criteria for sIBM,” 2018). Wrists and fingers, in particular, are most severely affected during IBM. In addition, it may be necessary to reference patient family history and perform an electromyography as well (“Diagnostic criteria for sIBM,” 2018). Once the presence and deterioration of inclusive body myositis has been confirmed, it is necessary to properly address the issue of patient care. Currently, the condition remains untreatable, permitting only accommodating measures and end-of-life considerations (Mavroudis et al., 2020). While research into potential methods of treatment exists, no attempts have been successful in addressing the disease (Naddaf et al., 2018). Therefore, it is necessary to make a decision regarding patient’s living conditions.
In considering end-of-life care, and helping patients with chronic conditions, the question of autonomy remains central. Medical professionals work to promote the wellness and decision-making of patients. However, ethically supporting the autonomy of patients also involves maintaining their ability to engage in daily activities, and feel in control of their life (Houska & Loučka, 2019). In the current deteriorating state, it is unlikely that the patient in question will be able to care for himself, or accomplish many of his daily tasks. Therefore, it is necessary to admit him to an inpatient setting, where he will be monitored and supported with consideration for his desires as an individual. This way, both the safety and autonomy of the patient can be respected.
References
Diagnostic criteria for sIBM. (2018). The Myositis Association.
Houska, A., & Loučka, M. (2019). Patients’ autonomy at the end of life: A critical review.Journal of Pain and Symptom Management, 57(4), 835-845.
Mavroudis, I., Petridis, F., & Kazis, D. (2020)Inclusion body myositis. Genetics, biomarkers and muscle biopsy.. International Journal of Neuroscience, 1-10.
Naddaf, E., Barohn, R. J., & Dimachkie, M. M. (2018). Inclusion body myositis: Update on pathogenesis and treatment. Neurotherapeutics, 15(4), 995-1005.
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