A 90-year-old woman with a CFS of 8 is in a nursing home. She has end-stage Alzheimer's dementia and is bedbound. She develops a fever of 38.4°C with ...

Question

A 90-year-old woman with a CFS of 8 is in a nursing home. She has end-stage Alzheimer's dementia and is bedbound. She develops a fever of 38.4°C with a productive cough. She has a ReSPECT form stating comfort measures only, no hospital transfer, and no CPR. Her oxygen saturation is 88% on air. What is the MOST appropriate management?

Accepted Answer

Provide comfort measures in the care home: antipyretics, oral or subcutaneous antibiotics if likely to improve comfort, mouth care, repositioning, and consideration of subcutaneous fluids

Answer

Commence intravenous antibiotics via a syringe driver

Answer

Transfer to hospital for a chest X-ray and IV antibiotics

Answer

Withhold all treatment and allow natural death without any symptom management

Answer

Start non-invasive ventilation in the care home

uk-dgm MCQ (SBA): Comfort Care in End-Stage Dementia