• E-mail
• Print
• RSS

Complex case: Advance directives and the Surrogate Health Care Act

Case Management Weekly, February 5, 2008

Want to receive articles like this one in your inbox? Subscribe to Case Management Weekly!

As case managers, we are often faced with medically complex patient admissions, especially those concerning end-of-life care and decisions. One of the most challenging parts of case managers' responsibilities is helping families deal with a loved one with a terminal illness or catastrophic injury, particularly when the loved one has not signed an advance directive or designated a healthcare proxy.

Karen is a 34-year-old, single woman with no dependents. While driving home, she careens into the guardrail of a busy expressway. Karen is transported to the nearest short-term acute care (STAC) hospital, where she is found to have a Glasgow Coma Scale (GCS) score of 8, which indicates a severe head injury classification. A CT scan of the head reveals a large right-sided intracranial hemorrhage. She is airlifted to the closest teaching hospital and immediately taken to the OR, where she undergoes a grueling 14-hour surgery.

After the operation, Karen develops more complications and requires additional surgery. After stabilization at the STAC hospital, Karen is transferred to a long-term acute care (LTAC) hospital for continuing care of her injuries. Karen has never written an advance directive or appointed a healthcare proxy, so her wishes for life support and other life-sustaining measures are not known.

Source: To read more about this complex case, take a look at the February 2008 issue of Case Management Monthly.

Want to receive articles like this one in your inbox? Subscribe to Case Management Weekly!

• Comment
• E-mail to a Colleague
• Print
• RSS
• Archive

Comments