Put your knowledge and skills to the test with a case of a 76 year old man, who was admitted to hospital after a fall and reports feeling depressed and tired, and wants all life sustaining therapies withdrawn and tells his family and healthcare team that he "has had enough, i'm done" and to "just let me go".
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)
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)
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