The patient's medical history includes hypertension, diabetes and CAD. While in hospital for the fall he developed pneumonia that led to respiratory failure and the need for a tracheostomy. He then developed c difficile colitis and ARF that required temporary renal replacement therapy. During his hospital stay he was transferred to the ICU multiple times, once for management of ileus where he required an NG tube, a second time for management of a pneumothorax, and the third time for bronchoscopy and ventilation.
In terms of mental health history, he reports a 30 year history of depression managed with trials of medications, psychotherapy and even ECT.
How would you assess this patient's capacity to make treatment decisions? How would you manage this patient?
"Depressed and sick with ‘nothing to live for’" by Alyson Kepple, Priya Gopalan, and Pierre N. Azzam (Current Psychiatry)