Thursday, September 22, 2011
Where is the AD?
A 77 year old woman comes to the hospital after suffering a stroke. She is paralyzed on the left side of her body and cannot speak, though she can squeeze a hand and follow an object. It is not clear yet how much movement and speech, if any, can be recovered with therapy. Over the last couple of years the woman was suffering progressively worsening memory loss, confusion, pain, and vision loss. Her family says that the woman signed an advance directive stipulating that she would want only comfort care in this situation, but they cannot find it. What should the care team do?
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The health care team should definitely try to assist the family in locating the advanced directive. If the paper work is unable to be found the patient should have indicated a proxy or a substitute that would be able to speak on the patients behalf. According to the rules of the advanced directive the patient needs to tell the person that they appointed them their proxy.
ReplyDeleteHowever, since the family cannot find the paperwork and the women is 77 there could be suspicion that the family is trying to get the woman's health insurance money.
Jeff Danyew Heather Atherton and Megan Lewis were also involved in this decision.
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