Question

A 70-year-old woman in a residential aged care facility has advanced dementia and is bedbound with multiple comorbidities. She develops a mild community-acquired pneumonia and is haemodynamically stable. Her daughter asks for aggressive treatment to prolong life. The patient's advance care plan documents comfort-focused care only. What is the MOST appropriate next step?

Accepted Answer

Discuss goals of care with the daughter, explain the existing advance care plan, and offer oral antibiotics and symptom control in the facility

Answer

Ignore the advance care plan and start intravenous broad-spectrum antibiotics and hospital transfer

Answer

Immediately cease all active treatment and provide opioids for palliation only

Answer

Transfer to hospital for ICU review to reassess prognosis

Answer

Ask the daughter to sign a new directive overruling the prior advance care plan

Practice question