End-of-life and Palliative Care
You have just hung a new fluid bag and antibiotics for Will when his family arrives for the morning. His wife sits at his bedside and holds his hand and starts crying. One of his daughters approaches you for an update. You provide it and ask how they are doing and if they would like to speak with the social worker. The daughter informs you that it is very hard to see her dad like this especially when he was at home with them just three days ago. She mainly expressed concerns about Will being in pain and suffering. The other daughter joins her sister and says, “We don’t want to keep our dad alive like this if he never going to be able to breathe on his own. We don’t want him to suffer”
You explain that William’s CT head indicates that he is still bleeding within his brain and his response to stimuli has decreased. The respiratory therapist does not believe that William will be able to breathe on his own. William’s vitals continue to become unstable and he is febrile as he is going into septic shock. His creatine, C-protein, leukocytes, lactate are all elevating with decreased urine output via the Foley, which may indicate the multi-organ effects of his sepsis.
William’s wife then speaks up from the side of the bed and says that she does not want him to suffer and knows her husband would not want to live with a tube and all these machines. She says, “I just want him to be comfortable.” As you leave the room, she opens a small book and starts to chant in a language you are not familiar with. One daughter shakes her head and states, “My parents are Baha’i and prayers are often chanted during difficult times. But, what are prayers going to do now!”