Last moments of life: Can telemedicine play a role?

Palliat Support Care. 2013 Feb 7:1-3 Low JA, Beins G, Lee KK, Koh E. Department of Geriatric Medicine and Palliative Care, Khoo Teck Puat Hospital, Singapore.

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.

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