Resuscitation in palliative care – is it always a straightforward issue? A Case Report

Abstract Aim This article presents a case study of a 73-year old chronically bedridden woman from a stationary hospice, with pressure sores, a history of multiple sclerosis, hypothyroidism, and type 2 diabetes mellitus, who was admitted to the emergency department following cardiac arrest, with return of spontaneous circulation after successful cardiopulmonary resuscitation performed by the hospice physician. Methods Case study. Data concerning the patient were obtained from medical records and from an interview conducted during hospitalization at the Lady Sue Ryder Hospice of Warsaw in Zielona Góra. Treatment was carried out in accordance with current guidelines of relevant scientific societies. The patient provided written informed consent for the publication of this case report, and all personal data were anonymized. Discussion Palliative care in Poland provides medical, psychological, and social support for patients with advanced, life-limiting diseases. Services are delivered in inpatient units, outpatient clinics, and home setting. Admission criteria are quite strict (given limited bed availability), typically advanced oncological or non-oncological conditions with irreversible symptom progression. In this case, the patient, chronically bedridden with multiple comorbidities and pressure sores, was initially admitted to hospice care. Following interventions - including dual-chamber pacemaker implantation, neurological and endocrine treatment, and rehabilitation - her condition improved to the extent that she no longer met the criteria for inpatient hospice admission. As she remained hemodynamically stable, cognitively coherent, and able to participate in therapy, transfer to a long-term care facility with continued rehabilitation was considered the most appropriate course of action. Conclusion The case illustrates the complexity of decision-making in palliative and hospice care. Successful resuscitation and subsequent medical interventions enabled the continuation of long-term care with rehabilitation. The findings underscore the importance of holistic clinical assessment and flexible care pathways tailored to the patient’s evolving condition.