Description: For the case provided, read the information and answer the associated questions as a
group.
Mrs. B. is 97 years old, and was admitted to your LTC facility 6 years ago. Shortly after
becoming a resident, she suffered a cardiac arrest and was found to be unresponsive by the staff;
CPR was initiated for a total of 20 minutes prior to return of spontaneous circulation. She has an
advanced directive stating that she agrees to transfer to an acute care facility, but other options,
such as CPR and intubation, were not explicitly addressed in this document. She has no formal
Power of Attorney.
Initially, Mrs. B. had lived at your facility watching TV for most of the day. She was wheelchair
bound and required assistance with most activities of daily living (ADLs). Her husband lives at
your facility with her and is quite frail with moderate dementia. Mrs. B. is frequently visited by
her large extended family, which comprises 4 children and 5 grandchildren. She is known to
have cancer throughout much of her body, moderate dementia, a very bad heart, and type-2
diabetes.
After her cardiac arrest and a short stay in the Hospital ICU, Mrs. B. is brought back to your
facility able to breathe on her own, but with a moderate -severe brain injury caused by lack of
oxygen after her cardiac arrest; this has left her unable to communicate in any meaningful way
with others. She is receiving thickened fluids as her source of nutrition and hydration but is only
able to consume about half of the calories that would be needed to keep her at her current weight.
Unfortunately, her health begins to decline further shortly after returning.
The team decides to hold a family conference with the residents children and proposes a plan of
treatment that would focus on comfort care only, excluding CPR if needed again. The patients
eldest daughter does not agree and states that her mother is a fighter and wanted to live to be 100
years old so that she could receive a letter from the Queen. The daughter asks that her mother be
transferred back to the acute care hospital to receive the care of experts
1 of 3
HLTH9224
SPRING 2020
and so that she could be seen by a surgeon for surgery and chemotherapy for her cancer.
The treating physician discusses the case with the intensivist on call at the hospital over the
telephone. The intensivist agrees that the prognosis is extremely poor and likely the resident
would not benefit from further invasive treatment. The intensivist at Hospital holds a family
conference with the family and team at the LTC home over the telephone. He identifies himself
as an expert in the field. The older daughter reiterates their requests to the intensivist.
Part 3
Recommendations for Actions (1 page maximum)
Provide your evaluations and recommendations with rationale. Recommendations should be
supported by findings from the analysis..
Description For the case provided, read the information and answer .pdf
1. Description: For the case provided, read the information and answer the associated questions as a
group.
Mrs. B. is 97 years old, and was admitted to your LTC facility 6 years ago. Shortly after
becoming a resident, she suffered a cardiac arrest and was found to be unresponsive by the staff;
CPR was initiated for a total of 20 minutes prior to return of spontaneous circulation. She has an
advanced directive stating that she agrees to transfer to an acute care facility, but other options,
such as CPR and intubation, were not explicitly addressed in this document. She has no formal
Power of Attorney.
Initially, Mrs. B. had lived at your facility watching TV for most of the day. She was wheelchair
bound and required assistance with most activities of daily living (ADLs). Her husband lives at
your facility with her and is quite frail with moderate dementia. Mrs. B. is frequently visited by
her large extended family, which comprises 4 children and 5 grandchildren. She is known to
have cancer throughout much of her body, moderate dementia, a very bad heart, and type-2
diabetes.
After her cardiac arrest and a short stay in the Hospital ICU, Mrs. B. is brought back to your
facility able to breathe on her own, but with a moderate -severe brain injury caused by lack of
oxygen after her cardiac arrest; this has left her unable to communicate in any meaningful way
with others. She is receiving thickened fluids as her source of nutrition and hydration but is only
able to consume about half of the calories that would be needed to keep her at her current weight.
Unfortunately, her health begins to decline further shortly after returning.
The team decides to hold a family conference with the residents children and proposes a plan of
treatment that would focus on comfort care only, excluding CPR if needed again. The patients
eldest daughter does not agree and states that her mother is a fighter and wanted to live to be 100
years old so that she could receive a letter from the Queen. The daughter asks that her mother be
transferred back to the acute care hospital to receive the care of experts
1 of 3
HLTH9224
SPRING 2020
and so that she could be seen by a surgeon for surgery and chemotherapy for her cancer.
The treating physician discusses the case with the intensivist on call at the hospital over the
telephone. The intensivist agrees that the prognosis is extremely poor and likely the resident
would not benefit from further invasive treatment. The intensivist at Hospital holds a family
conference with the family and team at the LTC home over the telephone. He identifies himself
as an expert in the field. The older daughter reiterates their requests to the intensivist.
Part 3
2. Recommendations for Actions (1 page maximum)
Provide your evaluations and recommendations with rationale. Recommendations should be
supported by findings from the analysis.
