YOUNG LEUK PT & VERY SICK - FAMILY - DYING Flashcards
22 f AML BM transplant. now is MOF. family thinks she is dying.
Discussions about her wishes in this situation.
Ensure u r clear on surrogates - representing her wishes
Burden of Rx against its potential benefit
Everyone would favour to continue Rx. Young pt. eventhough prognosis is bad.
Listen to their concerns
Explain the uncertainty of prognosis.
Focus discussion towards identifying Pt best interest.
HOW DO U FEEL THINGS HV BEEN GOING?
DO U THINK THIS IS DISTRESSING FOR PT?
WHAT DO U THINK PT WOULD WANT
R U FINDING ANY ONE THING PARTICULARLY UPSETTING
THINGS R VERY BAD BUT I THINK THR IS STILL A CHANCE.
MY EXPERIENCE - TOO EARLY TO DISCONTINUE.
SET SOME GOALS & TIME LINES TOGETHER
REMEMBER THAT WE CAN & WILL REASSESS REGULARLY.
IF NO IMPROVEMENT & DO NOT REACH THESE GOALS - ACCEPT THAT SHE IS NOT GOING TO GET OUT OF THIS.
