This paper is a brief holistic health assessment for a 40-year-old male who is a friend of my family. For privacy and confidentiality reasons, he will be referred to as Eric. Rather than focus on specific health problems Eric might have, the holistic health assessment examines him from multiple dimensions from his health and family history to his physiological and psychological assessments, social history, and spiritual assessment, among others.
Health History
A decade ago, Eric visited the ER at his local hospital, complaining of difficulties passing urine. He explained to the attending ER physician that not only did he experience a burning sensation when urinating, but there were also some blood spots in the urine and regular bowel pains. Diagnostic tests, particularly urinalysis, and subsequent differential diagnosis, revealed the possibility of prostate cancer. Eric was, therefore, referred to an oncologist who confirmed the diagnosis. Eric had a benign prostate tumor (neoplasm). Apart from undergoing 3-month chemotherapy and hormone therapy treatments, his oncologist and physician also prescribed Docetaxel and Degarelix (Pignot et al., 2018). These treatments were aimed at treating his cancer with the best prognosis being putting cancer in remission.
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Looking into Eric's family history, immediate and extended, there was no one diagnosed with any cancer. Therefore, two years after the initial diagnosis, Eric's prostate cancer had yet to go into remission. Furthermore, his symptoms, as well as the quality of life degraded. For instance, Eric developed urinary incontinence a year after the cancer diagnosis. The outcome was involuntary urination that affected other aspects of his life. Things became worse, however, when Eric's benign tumor started to metastasize into a malignant neoplasm in his prostate glands. The recommended treatment action was a radical prostatectomy, which came with two more complications; erectile dysfunction and impotence.
Physiological Assessment
Eric developed three primary physiological conditions. First, every time he was relieving himself, he would experience a burning sensation. Secondly, his urinary incontinence made bladder control difficult, and he would urinate involuntarily but also find it difficult to stop the process. Lastly, the bowel pains turned from acute to chronic and affected his quality of life. However, after his radical prostatectomy, Eric's physiological problems increased. First, his erectile dysfunction meant he could not consummate his marriage. Secondly, the impotence meant that he would not have children, especially since no precautions were taken before the procedure, such as freezing his sperm.
Psychological Assessment
Eric's physiology was not the only affected part of his life. Since the diagnosis, Eric developed major depression that resulted in a psychiatric evaluation and admission in a mental health hospital. Apart from a regular course of anti-depressants, Eric joined a mental health support group at the facility. Interviews with friends and family revealed that Eric's behavior changed after his diagnosis (Albkri et al., 2018). He turned from a jovial outgoing person to a closed-off individual who spent most of his days alone.
Social Assessment
Prior to his diagnosis, Eric was an outgoing person. Apart from engaging in local baseball games, Eric also organized blood drives in the community to help stock up when supplies ran low at the local hospitals. Everything changed following the diagnosis, however, especially when he became closed off. Additionally, his wife of five years left due to his erectile dysfunction and the fact that she wanted kids borne from their marriage. Since then, Eric has never engaged in serious relationships and bounced off from one to another.
Spiritual Assessment
Eric was not a believer and could even be described as an atheist before his diagnosis. However, after learning about his cancer, he started to explore different religions. His purpose was not to find solace and guidance in a higher power but to seek answers for questions he had. Questions like why he was the only one in his family who developed prostate cancer and the impact it has had on his life. In less than three years, Eric jumped from Christianity to Muslim, Buddhism and even went to India on a spiritual journey. The journey eventually led him to seek alternative medicine as a cure for his cancer.
Developmental Assessment
Since his cancer diagnosis, Eric lost direction and the purpose of living. Only his constant pursuit of answers drove him. He also lost the ambition that was once his defining trait. The urinary incontinence and erectile dysfunction severely impacted Eric's self-image as a man. He broke off previous relationships, and apart from his family and other close friends, Eric had no social support.
Cultural Assessment
When Eric's cancer failed to go in remission and became malignant instead, Eric lost faith in modern medicine. Apart from becoming depressed, Eric stopped taking all medicine. After his spiritual trip to India, Eric turned to traditional healers and medicine as a solution for his conditions. He started to believe that the medication prescribed to him by both his oncologist and physician was responsible for his cancer becoming malignant.
Eric's Coping Mechanisms
Eric has exhibited both adaptive and maladaptive coping mechanisms. At first, Eric blamed his health problems on everyone, thus alienating them. He stopped attending social activities, especially blood drives and baseball games. After his admission to the mental health facility, Eric started to cope adaptively. Medication given helped to relieve his pain and depression. He started engaging in self-care activities, especially mental health, by meditating daily.
Eric also joined a support group for prostate cancer patients who meet twice a week to discuss and bond. The results were immediately noticeable, for he would return to his old self for a few days after the support group sessions. Further coping mechanisms can only be possible is Eric invests in his social capital, where he would not only rediscover his identity, purpose in life, and a sense of belonging to the community.
Teaching Plan
Currently, what Eric needs most is to rediscover the purpose of his life and find meaning. This is a psychological goal that is the foundation for other patient outcomes. The teaching plan, therefore, should first reorient his focus. It is not a bad thing to believe and even rely on alternative medicine to treat terminal illnesses (Keene et al., 2019). However, such beliefs are only acceptable until they start harming the patient's health outcomes. Therefore, part of the teaching plan would be to formalize Eric's education and exploration of his spirituality. The purpose of his spiritual journeys should not just be to find answers to life's disturbing questions. Eric should also be taught that spiritual explorations are also a method of self-discovery and finding deeper meaning and purpose in one's life, especially after a life-changing event, like a terminal condition diagnosis.
The second part of his education plan would be setting priorities. Eric should always prioritize his health and on achieving set outcomes. For instance, such prioritization would be essential in the decision to quit taking the medication that manages his cancer in favor of alternative treatments. Secondly, Eric's education should be comprehensive enough to identify that some of the alternative treatments cannot be mixed with his prescribed medication. Such knowledge would be essential in maintaining a positive prognosis, assuming Eric will be rational when taking alternative medicine. In the event that he might unknowingly experience the adverse effects of any treatment regimen, it is essential for Eric to keep a medical journal of all the medications, western or alternative, he takes, what their ingredients are, preparation methods, and dosage, among others.
Finding meaning and purpose in life cannot be achieved psychologically only. Besides, doing so would fall short of the requirement that the education plan should be holistic. Therefore, the key to re-establishing Eric's purpose and meaning in life is developing and sustaining his social capital (Panzarasa et al., 2020). Before his terminal diagnosis, Eric was both an avid baseball player and organizer for local blood drives. Efforts should, therefore, be made to restore such social activities. Achieving so would enable Eric to find social support, which could translate into a purpose in life. If it fails, Eric would still have a network of social support that is willing to ease the burden of daily care, physically, socially, mentally, psychologically, and spiritually.
Note that this teaching plan is not to be designed without input and direct participation from Eric and his primary care providers. Additionally, the plan should always be updated and made available to any authorized party in an electronic or hard copy format. Should any deficiencies be discovered, or Eric's state change, the plan needs to be changed or updated to reflect his current needs, medical or others.
References
Albkri, A., Girier, D., Mestre, A., Costa, P., Droupy, S., & Chevrot, A. (2018). Urinary incontinence, patient satisfaction, and decisional regret after prostate cancer treatment: a French national study. Urologia Internationalis, 100(1), 50-56.
Keene, M. R., Heslop, I. M., Sabesan, S. S., & Glass, B. D. (2019). Complementary and alternative medicine use in cancer: A systematic review. Complementary therapies in clinical practice, 35, 33-47.
Panzarasa, P., Griffiths, C. J., Sastry, N., & De Simoni, A. (2020). Social medical capital: how patients and caregivers can benefit from online social interactions. Journal of Medical Internet Research, 22(7), e16337.
Pignot, G., Maillet, D., Gross, E., Barthelemy, P., Beauval, J. B., Constans-Schlurmann, F., ... & Vincendeau, S. (2018). Systemic treatments for high-risk localized prostate cancer. Nature Reviews Urology, 15(8), 498-510.
