Decision Making at the End of Life: Joint #patientpref and #hpm Tweetchat

By Meredith MacMartinFred was a sick guy. He had been diagnosed with COPD years ago, and more recently developed heart failure, and although he and his wife Nancy tried to stick with his medication regimen and monitor his salt intake, his shortness of breath had been making it harder and harder to even get around the house. He followed regularly with his primary care doctor, and talked about what he would want in terms of medical care if and when he got sicker. His wife knew that he didn ’t want to go to the hospital if it could be avoided, and that he definitely did not want to end up in an ICU on a ventilator, or getting CPR. In addition to having those conversations with his wife and PCP, he had even had an portable DNR form completed. Fred, his family, and his physician did ev erything they could to prepare for the eventuality of his disease worsening.One morning, Fred ’s shortness of breath got worse. This happened from time to time, and usually resolved with use of his rescue inhalers; Fred used his albuterol as often as he could through the morning and into the afternoon. By late in the day, his breathing was markedly worse, to the point that he was so short of breath he couldn’t get up off the couch and could hardly talk. Nancy had been asking him all day if she needed to call his doctor and had waved her off, but now, with Fred gasping for air, Nancy knew she had to act. She called 911, over Fred’s objections. EMS arrived, and after a rapid assess ment realiz...
Source: Pallimed: A Hospice and Palliative Medicine Blog - Category: Palliative Care Source Type: blogs