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We agreed that CPR would be inappropriate as well as other life-prolongingtreatments. We thought our patient was dying and we promised to keep them comfortable. The patient’s spouse told us clearly that they had discussed their wishes for no resuscitation. We were asked how much time was left.
Instead, it’s about shifting the focus from curative treatments to comfort and quality of life. Hospice care can be provided concurrently with curative or life-prolongingtreatments in pediatric patients, an approach known as palliative care. Choosing pediatric hospice care is an intensely personal decision.
Ie, is dying in 2 months from untreated cancer alongside suboptimally treated OUD an acceptable alternative to dying in 1 year from properly treated cancer alongside suboptimally treated OUD (for a patient who wants cancer treatment)? Patients with SUD often require multiple engagements with different treatments before achieving remission.
While it is true that in order to qualify for Hospice Services, a patient must be certified with a terminal illness that may end life within six months, it is by no means inferior care. The focus of Hospice Care is not curative, meaning no traditional lifeprolongingtreatment such as chemo or surgery are continued.
It’s at this point where she’s talking about highly aggressive life-prolongingtreatment. How can this be, somebody who’s so deeply invested and embedded in hospice and palliative care, caregiver for her mother? What happened here?
This type of request is often made by those wishing to avoid life-prolongingtreatments such as ventilation or artificial nutrition when there is no hope for recovery. In some cases, the advance directive will indicate that palliative care should be used without limitation until death occurs.
She made me promise that no lifeprolongingtreatments would be given to her, as she did not want her existence extended. She really didn’t mind how she went, as long as she died quickly, was her answer. I promised to abide by her wishes, and that we would always try to make her more comfortable.
Many residents dying with untreated symptoms, often after multiple high hospitalizations, lifeprolongingtreatments, and very little specialty palliative care. Alex: We talked about how it’s such a tough place to integrate palliative care with high staff turnover. Alex: What hope is there?
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