RT Book, Section
A1 Usatine, Richard P.
A1 Smith, Mindy A.
A1 Chumley, Heidi S.
A1 Mayeaux, E.J.
SR Print(0)
ID 57670324
T1 Chapter 5. End of Life
T2 The Color Atlas of Family Medicine, 2e
YR 2013
FD 2013
PB The McGraw-Hill Companies
PP New York, NY
SN 978-0-07-176964-8
LK accessmedicine.mhmedical.com/content.aspx?aid=57670324
RD 2024/04/18
AB An  89-year-old  frail  woman  presents  with  Alzheimer  dementia,  hypothyroidism,  depression,  congestive  heart  failure,  and  macular  degeneration.  Her  functional  status  was  gradually  declining.  It  was  difficult  for  her  family  to  provide  24-hour  care  and  she  was  admitted  to  a  nursing  facility.  Her  dementia  worsened  over  a  period  of  2  years  in  the  nursing  facility  and  she  became  incontinent  of  urine  and  feces  while  developing  limitations  in  speech  and  ambulation.  She  could  not  sit  up  without  assistance  and  lost  her  ability  to  smile  and  hold  her  head  up  independently.  The  facility  was  very  supportive  and  a  hospice  consult  was  initiated.  Figure  5-1  shows  Dr.  Gokula  along  with  the  hospice  nurse  visiting  the  patient  for  admission  to  hospice  care.