What should happen when a physician agrees with the family members and the nursing staff does not?
What should happen when a physician agrees with the family members and the nursing staff does not?
Marion is a 92-year-old patient who weighs 78 pounds. She has had poor eating habits for at least 20 years and refused all attempts by her two daughters to improve her nutrition. In addition, Marion had been a heavy smoker all her life and suffered frequent respiratory problems. During the past two years she has become quite forgetful, has suffered a broken hip as a result of a fall out of bed, and has been treated for pneumonia. Her daughters, who have their own family responsibilities and cannot bring their mother to live with them, have found an excellent nursing home near them. In spite of Marion’s protests, she enters the nursing home. However, she quickly adjusts to her new home and likes the care and the attention that she receives.
During her third week in the nursing home, Marion develops a cough, high temperature, and respiratory problems. She is hospitalized with a diagnosis of pneumonia. Marion immediately becomes disoriented and attempts to remove her intravenous and oxygen tubing. Since she tried to climb out of bed, her daughters must remain at her side. The attending physician tells the daughters that in addition to treatment for pneumonia, Marion will also need to have a pacemaker inserted to regulate her heartbeat. Marion would then be unable to return to the nursing home since the facility is not equipped to care for someone recovering from surgery.
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