Category: Quality of Life

  • 44. Case: Whose Business Is It?

    Brent Wathorn, 78, has been living at Halfway Lake Manor for about 6 years. His main complaint has been that he is lonely and has had difficulty connecting with the other residents. This has been a source of distress for staff at times, as they would like him to feel more ‘at home.’ Norma Carkner,…

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  • 37. Case: A Question of Resources

    Joyce Skinner is a 38-year old woman with non-curative leukemia. She is the single mother of two children, ages 11 and 8, and her ex-husband is ‘out of the (parental) picture’. Since her leukemia diagnosis, Joyce has approached her progressive hematological cancer in an assertive manner, seeing it as her responsibility to fight to stay…

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  • 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…

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  • 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…

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  • 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…

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  • 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…

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  • 21. Case: Balancing Concerns

    “Where’s the door to my bathroom? Can’t a man get some privacy?” “Uh oh, that’s Elias again. We’d better make sure he’s alright.” “How many times are we going to have to go through this with him? Maybe we should just put the bathroom door on again.” “The only problem is that on his ‘bad’…

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  • 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…

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  • 17. Case: Too Much to Expect?

    92-year old Ellie MacPherson has recently moved to a long-term care facility. She had found that the increasing difficulty she was experiencing due to arthritis with getting dressed, making her meals and getting out of the house meant that she could no longer live on her own. Ellie brought a number of her favourite clothes…

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  • 14. Case: I Want to Go Home!

    A widower (age 88) lives alone, but has family living nearby. Recently he had a stroke and regained consciousness after being admitted to hospital. He was deemed to have cognitive capacity. His adult children approached the physician in charge of his case along with the unit’s Nurse Manager and requested that the patient be placed…

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