Question

A 78-year-old man with moderate dementia and congestive heart failure is admitted with aspiration pneumonia. He has had several admissions in the past year and is now bedbound. His family asks about code status. What is the most appropriate approach consistent with Canadian end-of-life care principles and CanMEDS Communicator role?

Accepted Answer

Engage the patient (if possible) and family in a goals-of-care discussion, exploring values and prognosis before making shared decisions about resuscitation status

Answer

Unilaterally write a Do Not Resuscitate order without discussion

Answer

Avoid discussing prognosis to maintain hope

Answer

Tell the family that full code is mandatory for all patients

Answer

Delegate the conversation entirely to nursing staff

Practice question