Preparing for the Time of Death

Betty R. Ferrell, PhD, RN

May 02, 2014

Case Presentation

Ann S. was a 42-year-old woman who was well known to the oncology service in her community hospital. She had been diagnosed with breast cancer at 36 years of age and had been aggressively treated with surgery, chemotherapy, and radiation. Initially thought to be cured, Ann became a strong supporter of the cancer center's participation in the annual Survivorship Day and fundraising 5K run.

One year ago, Ann's disease recurred with extensive bone and brain metastases. Her symptoms have been well managed by the outpatient palliative care service, and 2 months ago Ann was referred to hospice. Hospice has been involved in managing her symptoms and supporting her spouse Tom and daughters, aged 17 and 20 years.

Three days ago. Ann developed seizures while at home with her youngest daughter and was transported to the hospital. It is estimated that she will die within the next 3-4 days, because she is no longer consuming food or fluids and is in renal failure. As a result of her many symptoms, Ann's family prefers that she remain in the hospital until her death.

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