Jack presents
to ED

| PART 1 |

Jack presents to ED

Jack’s daughter brings him to the Emergency Department

Jack is a 78 year old man who lives in his own home with his daughter Coral as his carer. Coral brings Jack to the Emergency Department because he is refusing to eat and drink, has reduced urine output, and is complaining of tiredness and dizziness. Coral provides Jack’s medical history and states he has “mild cognitive impairment due to dementia”, but he manages his activities of daily living with supervision, and mobilises with a walking frame.

On examination Jack looks cachectic and frail. He is alert but quiet and uncommunicative. The initial plan is for blood tests and supervised oral fluids, and to commence a fluid output chart. Coral disagrees with the plan. She says she is a nurse; she knows her father is severely dehydrated, and insists he requires urgent intra-venous fluids for the dehydration. She states: “I am Jack’s ‘power of attorney’ and I’m the person who makes decisions about his health care”.

Power of Attorney

Can a power of attorney make healthcare decisions on behalf of a patient to whom they are appointed?