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BACKGROUND
L.S. is a 70-year-old with advanced chronic obstructive pulmonary disease. He is intubated and
unconscious in the intensive care unit with pneumonia complicated further by acute renal failure.
His advance directive, completed seven years ago when he was highly functional, indicates that
he wants life-sustaining treatments. He has not updated his advance directive since that time.
Members of the medical team are concerned that he has little chance of surviving this hospital
stay, and if he were to survive, he is at high risk of significant cognitive deficits that would require
long-term skilled nursing care. The patient's wife is listed as his healthcare agent in his advance
directive. She asks how she should proceed with decision-making as she struggles to balance
what she thinks would be in her husband's best interest and what he has indicated in his advance
directive. She consults her two adult children regarding their ideas.
QUESTION
What should Ms. S. do if she disagrees with both her children's ideas related to her husband's
advanced directives? What should she do to prepare for the time when she will no longer be able
to make her own healthcare decisions? Have you had past experiences with a family member or
friend or heard of another situation where a decision had to be made about death and dying?
In your peer response provide an alternative course of action for Ms. S and discuss why this might
be an appropriate action.

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BACKGROUND LS is a 70yearold with advanced chronic obstr.pdf

  • 1. BACKGROUND L.S. is a 70-year-old with advanced chronic obstructive pulmonary disease. He is intubated and unconscious in the intensive care unit with pneumonia complicated further by acute renal failure. His advance directive, completed seven years ago when he was highly functional, indicates that he wants life-sustaining treatments. He has not updated his advance directive since that time. Members of the medical team are concerned that he has little chance of surviving this hospital stay, and if he were to survive, he is at high risk of significant cognitive deficits that would require long-term skilled nursing care. The patient's wife is listed as his healthcare agent in his advance directive. She asks how she should proceed with decision-making as she struggles to balance what she thinks would be in her husband's best interest and what he has indicated in his advance directive. She consults her two adult children regarding their ideas. QUESTION What should Ms. S. do if she disagrees with both her children's ideas related to her husband's advanced directives? What should she do to prepare for the time when she will no longer be able to make her own healthcare decisions? Have you had past experiences with a family member or friend or heard of another situation where a decision had to be made about death and dying? In your peer response provide an alternative course of action for Ms. S and discuss why this might be an appropriate action.