We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Clinical Crossroads | Clinician's Corner

An 86-Year-Old Woman With Cardiac Cachexia Contemplating the End of Her Life Review of Hospice Care

Jean S. Kutner, MD, MSPH, Discussant
JAMA. 2010;303(4):349-356. doi:10.1001/jama.2009.2015.
Text Size: A A A
Published online

Mrs H is an 86-year-old woman with progressive congestive heart failure and multiple chronic conditions who is experiencing worsening function and quality of life despite maximum medical therapies. She seeks advice regarding control over the circumstances of the end of her life, be it by suicide or under hospice care. Typical of US populations older than 65 years with multiple chronic health conditions and functional decline who are facing the end of life, Mrs H's concerns are particularly about quality of life, not being a burden on loved ones, and maintaining control. As she demonstrates, psychological, existential, and social factors, particularly fear of being a burden, are more common reasons for desiring hastened death than those related directly to physical symptoms. Hospice, which provides a multidisciplinary approach to care at the end of life, can assist Mrs H and her family in making decisions that are consistent with her goals.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?





You need to register in order to view this quiz.


Some tools below are only available to our subscribers or users with an online account.

7 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections