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In 1988, Cruzan’s parents requested that her feeding tube be removed, arguing that she would not want to continue in this state. On the one hand, this was unfortunate, as it meant Nancy Cruzan could not be disconnected from the feeding tube immediately. For example, I had another patient in the ICU who she was on a ventilator.
This idea that for critically ill patients in the ICU, geriatric conditions like disability, frailty, multimorbidity, and dementia should be viewed through a wider lens of what patients are like before and after the ICU event was transformative for our two guests today. He, his Twitter feed though is brilliant. Eric: Yeah.
Because, if anybody hasn’t seen it, you’ve got a great Twitter feed that gives tons of pearls on palliative care and a lot on communication. Speaking of pearls, should we move to Shunichi’s Twitter feed? Alex: Shunichi, your Twitter feed is like haiku. What motivated you to dive into this? Don’t use that.
And whether tube feeding should be on there, that’s never an emergency decision. I can on one hand count the patients I’ve cared for who didn’t want mechanical ventilation. But yeah, full treatment. But I just want to, Scott, I guess we just disagree on this.
I think one of the residents you asked how would they broach a subject, and he said wording like, “Unfortunately, he still needs a ventilator.” ” You talk about this too, even in your own training, where even around CPR, the training is like he might need a ventilator if he couldn’t protect his airway.
However if you want to take a deeper dive, check out his website “ The Ink Vessel ” or his amazing twitter feed which has a lot of his work in it. And yet, when the reality of breathing difficulties, BIPAP, the talks of tracheostomy and ventilators set in, what had seemed so clear on that piece of paper, no longer seemed so clear.
Alex 00:54 And Jasmine Santoyo-Olsson, who’s a social behavioral scientist and a fellow in the T32 Research Fellowship at the UCSF Division of Geriatrics. So intubation, cpr, feeding tubes. Eric 19:31 So it was interventions like feeding tubes, mechanical ventilation, dialysis at the very end of life.
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