Her son brings an 86-year-old woman with Alzheimer's disease to the emergency department with a worsening cough and exhaustion; she is diagnosed with pneumonia. The doctor describes the diagnosis and treatment plan, which includes hospitalization for intravenous antibiotics. The patient responds: "I'd rather go. I feel more at ease at home." She requests that she be released with oral antibiotics. The doctor says that intravenous antibiotics are preferable and that the dangers of infection increasing include sepsis and death. The patient understands the dangers and states, "I will return to the hospital if I feel worse; I simply don't enjoy staying in the hospital." The patient is widowed and lives with her son, who insists that she stay in the hospital for treatment. He reports that his mother has been increasingly forgetful and has gotten lost several times while walking in the neighborhood. On mental status examination, the patient is alert and oriented. Mini-Mental State Examination score is 24, indicating mild cognitive impairment. Which of the following is the most appropriate next step in the managment of this patient?

Question

Her son brings an 86-year-old woman with Alzheimer's disease to the emergency department with a worsening cough and exhaustion; she is diagnosed with pneumonia. The doctor describes the diagnosis and treatment plan, which includes hospitalization for intravenous antibiotics. The patient responds: "I'd rather go. I feel more at ease at home." She requests that she be released with oral antibiotics. The doctor says that intravenous antibiotics are preferable and that the dangers of infection increasing include sepsis and death. The patient understands the dangers and states, "I will return to the hospital if I feel worse; I simply don't enjoy staying in the hospital." The patient is widowed and lives with her son, who insists that she stay in the hospital for treatment.  He reports that his mother has been increasingly forgetful and has gotten lost several times while walking in the neighborhood.  On mental status examination, the patient is alert and oriented.  Mini-Mental State Examination score is 24, indicating mild cognitive impairment.  Which of the following is the most appropriate next step in the managment of this patient?

Quizplus · Accepted Answer

Eductional Objective: The ability to refuse treatment necessitates the ability to articulate a preference, comprehend relevant medical facts, consider the potential repercussions of treatment alternatives, and provide an explanation for the decision. Patients with moderate Alzheimer's disease frequently maintain decision-making skills.

Her Son Brings an 86-Year-Old Woman with Alzheimer's Disease to the Emergency