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Last moments of life: Can telemedicine play a role?

Published online by Cambridge University Press:  07 February 2013

James A Low*
Affiliation:
Department of Geriatric Medicine and Palliative Care, Khoo Teck Puat Hospital, Singapore
Gillian Beins
Affiliation:
St Joseph's Nursing Home, Singapore
Kok Keng Lee
Affiliation:
Department of Geriatric Medicine and Palliative Care, Khoo Teck Puat Hospital, Singapore
Ethel Koh
Affiliation:
Department of Geriatric Medicine and Palliative Care, Khoo Teck Puat Hospital, Singapore
*
Address correspondence and reprints requests to: James Alvin Low, Department of Geriatric Medicine, Khoo Teck Puat Hospital, 90 Yishun Central, Singapore768828. E-mail: [email protected]

Abstract

Background:

We describe the experience of managing the dying moments of a nursing home patient via telemedicine.

Case presentation:

Ms. C was a 92-year-old frail woman with multiple medical problems, living in a nursing home. She spent her final days in the nursing home, choosing not to be transferred to an acute hospital should she turn ill. On the last day of her life, she complained of acute-onset breathlessness and agreed to a teleconsultation with the hospital physicians involved in acute care.

Case management:

During the telemedicine consultations (tele-consultation) process, Ms. C's condition deteriorated rapidly as she entered the dying phase of life. She died peacefully soon after, in the presence of the nurse, the pastoral care worker, and the physician who was conducting the tele-consultation session 30 km away. The family was not present at the patient's bedside when she died. They were, however, relieved to know and were appreciative of the fact that a physician had been “present” during the patient's death.

Conclusions:

Telemedicine could act as an effective communication tool in end-of-life care, between the patient and carers, up to the last moment of life.

Type
Case Report
Copyright
Copyright © Cambridge University Press 2013 

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References

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