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In Sickness and in Health

The 88-year-old man had a massive stroke after undergoing heart surgery with resulting complications. Nearing end of life, he was non-responsive and on a ventilator at a local hospital. Across the Valley, his wife of more than 50 years was awaiting surgery at another hospital within the same system. She was unaware of the severity of her husband’s condition.

The couple’s two sons were understandably distressed and in some disagreement. One son said their father would not want to be kept alive by artificial means if there was no hope of recovery. The other son wanted their father sustained on life support until their mother had a chance to see him and be involved in decision-making.

Enter Drs. Amy Ha and Nisal Samarasekera of Hospice of the Valley. They provide palliative care consultations for the hospital system caring for the couple. Thanks to teamwork,  the elderly couple was reunited and the family was supported at a time of loss.

Ha consulted on the case. “I was talking to the nurses and doctors who were caring for him and said: ‘This is not good patient care. He’s not doing well. The wife needs to see him,’’ Ha said. “We all put our brains together. We thought, it’s a sister hospital, so why not transfer him over, knowing he will be withdrawn from life support once his wife says good-bye. Everyone was in agreement. All the stars aligned.”

Transferring a patient who is so close to death is challenging, medically and administratively. A nurse volunteered to go with the patient and stayed with him for several hours at the emergency room until a bed became available.

The baton was passed to Samarasekera. Arrangements were made to bring the wife to see her husband.

“He was unresponsive except when she came down,” said Samarasekera. “He opened his eyes and there was a little connection there.”

The wife agreed to stop artificial life support. After the ventilator was removed, two days passed, and the wife continued to visit her husband. He was moved to HOV’s Thunderbird palliative care unit. She was discharged from the hospital, and saw her husband one more time before he died.

“This case is about teamwork—where every member of the team is just as important in trying to take care of the family and patient,” said Ha. “It’s also about going above and beyond—getting the patient transferred over, the nurse volunteering her time, our work getting the family all on the same page. It was a first for me.”