Ms. Long has been admitted to a skilled nursing home after four months in the hospital, and has been assigned a public guardian since she is no longer able to make life decisions on her own. The guardian is faced with the problem of deciding whether maintaining/sustaining life-giving care or palliative/hospice care is appropriate for their charge. With the medical team, and a personal assessment, the apparent choice would be palliative or hospice care. Comfort care at this stage becomes the basic concern. The palliative care plan should be the consideration for the do-not-resuscitate (DNR) provision. The guardian should also consider the alternatives of artificial nutrition and hydration, as well as cardiopulmonary resuscitation and the option …show more content…
From USLegal.com: “The term terminally ill in the context of this case study and generally in all health care refers to a person who is suffering from a serious illness and whose life is not expected to go beyond 24 months at the maximum.”
It is important to note that severe dementia is a terminal illness, that is increasing in occurrence. According to the World Health Organization, “ 47.5 million people have dementia and there are 7.7 million new cases every year’’ (WHO media center 2016). Severe dementia is recognized as a leading cause of death in the USA. In a study of 323 nursing home residents, 85.8% developed an eating problem, while 39.1 % experienced pain in the last few months of life. Eating problems are among the most frequent complications suffered by patients with advanced dementia and is associated with the last few months of life. These factors along and her severe diabetes, history of stroke, diminished kidney function indicated that Ms. Long can be considered terminally ill. Distressing symptoms such as pain, pressure ulcers experienced by Ms. Long indicates increased closure to end of