Re: Finding hope in dying
Failure to establish reasonable limits and failure to establish preferences for palliative care results in many patients dying a poor death in an unwanted manner. This is especially true for patients admitted to hospital where tests and treatments are readily available and there is a strong bias towards intervention.
Know your patient, establish/explore the impact of their illness on them and their family.
Ask lots of questions/FIFE--Feelings Ideas Function Expectations
Give / establish context / prognosis if clinically indicated at that time.
When appropriate* give bad news about CPR and ICU as non effective option
(Do not tailor opinion about options based upon preferences or unrealistic expectations or goals. Death remains an unavoidable outcome irrespective of treatment in many circumstances.)
*(If terminal illness present, terminal trajectory present, and you believe that no reasonable physician would RECOMMEND CPR or admission to an ICU.)
Offer palliative care as an option.
Compassionately negotiate demands for treatment should they arise.
Competing interests: No competing interests