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Teachable Moment
July 2015

Patient Preferences and End-of-Life CareA Teachable Moment

Author Affiliations
  • 1The Dartmouth Institute for Health Policy and Clinical Practice, Lebanon, New Hampshire
  • 2Geisel School of Medicine at Dartmouth, Lebanon, New Hampshire
JAMA Intern Med. 2015;175(7):1087-1088. doi:10.1001/jamainternmed.2015.1283

Late one evening, our team was paged to the emergency department to admit a 90-year-old man with a history of atrial fibrillation, ischemic cardiomyopathy, and metastatic prostate cancer experiencing 2 days of fevers and intermittent hypoxia. He had been discharged to a skilled nursing facility (SNF) from our hospital 6 days earlier following a 19-day admission for atrial fibrillation with rapid ventricular response and acutely decompensated heart failure. That stay had been prolonged due to suspected aspiration pneumonia, delirium, and physical deconditioning.

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