96 year old refuse treatment

Specialties CCU

Published

I have worked in a general ICU 13 years. I currently work in hospice. So if a patient is 96 almost 97 years old, Having a cardiac event, increased SOB, edema of the feet, legs, and ankles, and has made up her mind to refuse treatment. I do agree with her.

She has been continent and starting lasix would change that for sure. ANd then she will be low on K+ so we will have to start K+ to add to her already insane number of meds. Why can't we just keep her comfortable and the least expensive route possibe? Not change her routine and keep her peaceful?

Lots of people have differing opinions. What do you think? Since she is completely alert and oriented, can't we follow her wishes? Why does everyone want to medicalize mortality here? Its a war with some people!

Specializes in burn ICU, SICU, ER, Trauma Rapid Response.

You open yourself up to charges of battery if you provide interventions that a competent patient has refused. Certainly if I were in that lady's shoes I would call the police if any doctor or nurse did anything to me I had refused.

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Specializes in BNAT instructor, ICU, Hospice,triage.

As a cardiac care nurse, is it going to be hard to keep her breathing easy and comfortable without the lasix?

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Specializes in CVOR, CVICU/CTICU, CCRN-CMC-CSC.
As a cardiac care nurse, is it going to be hard to keep her breathing easy and comfortable without the lasix?

One of the palliative care patients (A+Ox3, no DPOA) I took care of was given the option of Lasix as well as a Foley for comfort care. She elected for the Lasix+Foley option, and left this earth on her own terms without having to be toileted Q 30 min.

I firmly believe that the patient should be able to direct his or her own palliative care if mentally capable of doing so, and shame on the families who fail to consider the patients' final wishes to die in peace and comfort. That is all.

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Specializes in Cardiac/Telemetry.

The lasix+foley that camillusrn brings up is a good option. I know that morphine can also help with the SOB/air hunger feelings but I am unsure if morphine (for those purposes) is usually reserved for comfort care and/or DNR patients. What's the code status on this patient?

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Specializes in BNAT instructor, ICU, Hospice,triage.

DNR, no measures to give artificial feeding, no hospitalizations

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