A 86-year-old woman with advanced COPD (FEV1 28% predicted), heart failure (NYHA IV), and moderate frailty (CFS 6) is discussed at a multidisciplinary...

Question

A 86-year-old woman with advanced COPD (FEV1 28% predicted), heart failure (NYHA IV), and moderate frailty (CFS 6) is discussed at a multidisciplinary team meeting. She has been admitted three times in the past 6 months with exacerbations and has expressed a wish not to be readmitted to hospital. She has capacity. What is the MOST appropriate next step in her care planning?

Accepted Answer

Arrange an advance care planning discussion to explore her values, preferences, and wishes for future care including a Recommended Summary Plan for Emergency Care and Treatment (ReSPECT)

Answer

Initiate a Do Not Attempt Cardiopulmonary Resuscitation (DNACPR) order without discussing it with her

Answer

Refer for lung transplant assessment

Answer

Discharge from secondary care as she does not want hospital admissions

Answer

Start palliative sedation to manage her symptoms

uk-dgm MCQ (SBA): Advance Care Planning and ReSPECT