Management of the Hopelessly Ill Patient: To Stop or Not to Start? Assessment and Decisions in the Perioperative Period
2001
A 75-year-old male was brought from a retirement home to the emergency de partment of a county hospital. He had been a heavy smoker ( 45 pack years) but had quit smoking 5 years earlier, after his cigarettes had caused some fire inci dents. These episodes, together with decreased concentration and memory and inability to take care of himself had obliged the family (two sons and a daugh ter) to admit him to the retirement home. In the past year he had become in creasingly demented and required continual supervision. Over the previous six months he also required assistance in performing usual activities such as feed ing, washing and changing clothes. He no longer recognized family members and he sat in a chair throughout the day without any communication with those around him.
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