Nicole Buckley, a 53-year-old Wurundjeri woman with complex medical needs including Dandy-Walker syndrome, intellectual disability, and metastatic breast cancer, died of her malignancy at Sunshine Hospital. She was admitted on 11 June 2024 with shallow breathing, lethargy, coughing, and decreased functioning. Clinical assessment revealed hypoactive delirium, dehydration, hypernatraemia, abnormal liver function, and multiple hepatic metastases. Despite IV fluids and antibiotics, her condition deteriorated with hypoxia and hypotension. Palliative care was involved on 12 June, and goals of care discussions occurred with family and carers who supported transition to comfort care. She died on 13 June 2024. This case illustrates appropriate end-of-life care decision-making in a patient with advanced malignancy, with timely palliative involvement and family engagement in shared decision-making.
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Specialties
palliative caregeneral medicineoncology
Clinical conditions
metastatic breast cancerhepatic metastaseshypoactive deliriumdehydrationhypernatraemiahypoxiahypotensionDandy-Walker syndromeintellectual disability
Contributing factors
advanced metastatic disease with hepatic metastases
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