Question

Ashley is an 82-year-old patient recently diagnosed with stage IV lung cancer and admitted through the ED for difficulty breathing. As you prepare the DNR and health care surrogate documents, you note that Ashley does not have children, spouse, or family members listed.

a. How should you proceed with the assessment?
b. What are special considerations for older adults who are LGBTQ?

Answer 1

For an elderly patient like Ashley with no listed family, healthcare providers should assess whether a living will or advance directives exist and support the patient in appointing a healthcare proxy. Special considerations for LGBTQ older adults involve sensitive communication, privacy respect, and ensuring legal and financial protections.

Step-by-step explanation:

When preparing the DNR and health care surrogate documents for an elderly patient like Ashley with stage IV lung cancer, it is crucial to assess whether the patient has a living will or any advance directives already in place. If Ashley is mentally competent and can communicate her wishes, she should be encouraged to designate a health care proxy or surrogate who will make medical decisions on her behalf and discuss the extent of treatments she desires at the end of life.

Special considerations for LGBTQ older adults include the need for sensitive communication and awareness of potential for a smaller support system. It is important to respect their privacy and wishes regarding disclosure of their sexual and relationship identity, and to ensure their legal and financial protections are addressed, especially if they lack recognition from a legal partner.