Category: Advance Care Planning

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  • 93. Case: Mr. Rattan Wants to Stay

    Mr. Rattan has been a resident at Ocean Wind, a retirement community offering a range of options for accommodation, for the last ten years since his partner died.  Currently he has a studio apartment in the assisted living wing, which provides assistance with ADLs. Mr. Rattan has been diagnosed with dementia.  In the last few…

    View Case Study: 93. Case: Mr. Rattan Wants to Stay

  • 92. Case: End of Life with Dementia

    Mr. Shah lives in a continuing care facility. A nurse recently commented; “My patient, Mr. Shah, has an advance directive that he wrote last year and that requests medical assistance in dying when he is no longer able to recognize his wife. His dementia has worsened quickly and recently he’s asked who his wife is…

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  • 85. Case: Adam’s Story

    Adam Snowdon, a 16 year-old Sydney boy, was diagnosed with ALS (Amyotrophic Lateral Sclerosis) 18 months ago.  The disease has progressed rapidly over the past three months and over this period Adam has quickly begun losing the ability to use his right arm to the point now where it is no longer effectively functional.  He…

    View Case Study: 85. Case: Adam’s Story

  • 29. Case: Complicated Caring

    Mr. Sundown is a 78-year old African Nova Scotian who is a patient in an internal medicine clinical unit at the Halifax Infirmary. He has a variety of serious medical conditions including diabetes, coronary artery disease, and advanced COPD. He is experiencing progressive respiratory failure on the basis of a difficult-to-treat pneumonia. Mr. Sundown has…

    View Case Study: 29. Case: Complicated Caring

  • 28. Case: Mind the Gap!

    Mrs. Hardriver is admitted through ER to a general surgery unit for emergency surgical management of an acute small bowel obstruction secondary to her advanced colorectal cancer. After surgery, Palliative Care is consulted and they agree to admit Mrs. Hardriver to their service. As there is no palliative care bed available at the time of…

    View Case Study: 28. Case: Mind the Gap!

  • 27. Case: Withdrawal of Life-Sustaining Treatment

    Mr. Windown, age 82, is admitted to a cardiology clinical unit with unstable angina. In addition to his coronary artery disease, Mr. Windown suffers from disabling generalized osteoarthritis, chronic and progressive obstructive lung disease, and diabetes with associated compromise of his vision and kidney function. The coronary angiography reveals significant blockages of Mr. Windown’s coronary…

    View Case Study: 27. Case: Withdrawal of Life-Sustaining Treatment

  • 25. Case: A Difference of Opinion?

    Mary is a 90-year old woman who has been in hospital several weeks. She has a COPD exacerbation, increasing difficulty swallowing, and pneumonia. She has said repeatedly she is tired of being in hospital and tired of fighting to breathe. She doesn’t want a feeding tube or her IV but wants to be allowed to…

    View Case Study: 25. Case: A Difference of Opinion?

  • 24. Case: Changing Care and Care-Giving

    Kevin Henderson is an 83-year old man who is hospitalized in an internal medicine clinical unit at the local hospital. Kevin has a variety of serious medical conditions including severe Alzheimer’s disease, diabetes, coronary artery disease and advanced chronic obstructive lung disease. He is slowly recovering from a difficult-to-treat pneumonia, which required treatment with intravenous…

    View Case Study: 24. Case: Changing Care and Care-Giving

  • 23. Case: Reaching the Limits

    Mr. Stanley, a divorced 55-year old journalist with a history of epilepsy, was admitted to the medical ICU after an unwitnessed (presumably prolonged) episode of status epilepticus at home. Investigations, including an MRI study, revealed that he had sustained watershed cortical infarcts and a diagnosis of severe anoxic encephalopathy was made. Mr. Stanley did not…

    View Case Study: 23. Case: Reaching the Limits

  • 20. Case: To Treat or Not to Treat

    Stan Miller, a retired widower, sustains severe burns covering 80% of his body surface in a house fire secondary to a propane gas leak. He is initially assessed in the ED of the local hospital where he is sedated and intubated without any pre-resuscitation discussion about the seriousness of his thermal injuries and his care…

    View Case Study: 20. Case: To Treat or Not to Treat

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