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Care for the Hopelessly III

Lawrence H. Bernstein, MD
JAMA. 1988;259(17):2546. doi:10.1001/jama.1988.03720170022023.
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To the Editor.  —I am writing in response to the article in the Jan 15 issue on care for the hopelessly ill.1 I am struck by the small number of patients who were treated at home. I would hope a comprehensive supportive care team would, in addition to the excellent service that is well described in the article, view home care as an adjunct and enhancement of medical care. If, indeed, nutritional support has been withheld and the patient is a candidate for "do not resuscitate" status, there are several advantages offered by home care.The elusive "quality of life" factor is always hard to delineate in a comatose patient, so, by default, we usually apply this phrase to the family. If the family agrees and has the resources—personal, social, and financial—home care can enhance the care and caring for the family unit. Families often respond by saying, "Grandma


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