Holistic Palliative Care Wellbeing Assessment

Te Whare Tapa Whā

Taha Tinana (Physical Wellbeing)

• 68 yo male (NHI: ZAC4821) with stage IV NSCLC and bone mets. Active issues: worsening R-sided rib pain, mild SOBOE, constipation, and cancer-related fatigue. Rx: morphine sulfate (m-Eslon®) 30 mg PO BID, morphine sulfate (RA-Morph®) 5 mg PO q2h PRN, paracetamol (Panadol®) 1,000 mg PO QID, docusate sodium + sennoside B (Laxsol®) 2 tabs PO NOCTE.
• ECOG 2; mobilises short distances indoors with a walking frame. Appetite reduced; tolerating small, frequent high-protein meals and oral nutritional supplements (Ensure®).

Taha Hinengaro (Mental and Emotional Wellbeing)

• Experiencing intermittent anticipatory grief and mild anxiety at night regarding disease progression and dyspnoea. Mood otherwise stable; denies pervasive low mood. Rx: lorazepam (Ativan®) 0.5 mg SL q6h PRN for acute anxiety/SOB.
• Engaged with Arohanui Hospice counsellor fortnightly. Uses guided breathing exercises and mindfulness audio tracks to manage nocturnal anxiety.

Taha Whānau (Family and Social Wellbeing)

• Lives with wife (Hine, primary carer) in Whanganui; two adult children live locally and visit daily to assist with heavy housework and transport. EPOA for personal care and welfare activated (daughter, Mere).
• Retired teacher; maintains social connection via weekly home visits from former colleagues and local marae kaumātua group. Strong connection to local hapū.

Taha Wairua (Spiritual Wellbeing)

• Finds deep peace and grounding through connection to his ancestral maunga and awa, and sitting outside in the garden. At peace with palliative diagnosis; priority is remaining at home with whānau.
• Supported by local kaumātua and Anglican Kaikarakia. Daily whānau karakia held each evening at 19:00.