Mdm Mariam, aged 73, is semi-dependent on activities of living and is ambulant with intact cognition

Mdm Mariam, aged 73, is semi-dependent on activities of living and is ambulant with intact cognition. Mdm Mariam stays with her 78-year-old husband in a 3-bedroom HDB flat with a lift landing. They have 2 sons and 1 daughter, all are married, and none stays with them.

Mdm Mariam was diagnosed with colon cancer secondary to lung 1 year ago.  During her recent admission, she developed complications (Malignant Pleural Effusion) and was nursed in ICU, requiring medical sedation and intubation.  Two weeks later, Mdm Mariam’s condition improved slightly although at the slow progress. She regained consciousness and was extubated. She informed the physician that she was not keen on re-intubation for future episodes of respiratory failure due to discomfort and pain. Mdm Mariam understood her risk of sudden cardiac death in view of her poor ejection fraction (EF) and underlying lung condition.

During the ACP session, the patient re-iterated that she does not want re-intubation in the presence of her 2 sons because of discomfort and pain. Her sons wanted more time to discuss ACP preference with other family members as their sister is currently overseas.

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