Patients - Gundersen Health System

Honoring wishes at time of death:
68 year old male with CHF, COPD,
Respiratory Failure
• ACP Session: 6/23/08; Understood his condition as having heart disease and diabetes.
Also understands that he is at risk for kidney failure. His disease burden included
dizziness, fear of falling, swelling in his legs, shortness of breath and dependence on
oxygen. Quality of life dramatically changed by his limited declining status. Hope for
improvement of sores on his legs but knows he cannot cure his lung disease. Statement
of Treatment preferences – full code; also, if he suffered a serious complication with low
probability of survival or he survived a serious event and had significant cognitive or
functional deficits he would want to stop all efforts to keep him alive and focus on
comfort. ACP note and HCD documents were in the EMR.
• Date of death: 7/27/08; EMR Death D/C summary and course of care during
hospitalization – In ICU on BiPAP for respiratory failure. Deterioration in mental status.
• Per MD note in summary, “In Accordance with his well stated previous wishes and
wishes of his family, aggressive medical treatments were discontinued and the
patient was made comfort cares only. The patient was kept comfortable with PRN
morphine. The patient died peacefully on 7/27 with family present.”