GPST instructions Name and age of patient: Mrs Jones, 80 years old PMH: Breast cancer with bony mets, hypertension, osteoarthritis DH: Amlodipine, adcal D3, paracetamol, MST 20 mg BD, oramorph 5 to 10mls prn 6hourly for pain Mrs Jones has requested a home visit. Case notes- last few entries in records 2 weeks ago by GP partner: Home visit to see patient. Good insight into prognosis. Coping at home currently. End of life discussion; agreed to having DNACPR in place. Very clear wants to die at home. Main currently is back pain. I note from recent consultation with oncologist that there are known bony mets in the psine. Discussed increasing MST to 20mg BD. Declined anti-emetic. 3 weeks ago, letter from oncology consultant. I reviewed Mrs Jones in my clinic today. Unfortunately her breast cancer has progressed and there are bony mets in her hip and ribs. We have discussed that further treatment options are limited and supportive care is recommended. Examination findings Able to mobilise Pain in lumbar area No sensory loss. Power 4/5 in lower limbs. Reflexes normal. PR hard faeces in rectum –
GPST instructions Name and age of patient: Mrs Jones, 80 years old PMH: Breast cancer with bony mets, hypertension, osteoarthritis DH: Amlodipine, adcal D3, paracetamol, MST 20 mg BD, oramorph 5 to 10mls prn 6hourly for pain Mrs Jones has requested a home visit. Case notes- last few entries in records 2 weeks ago by GP partner: Home visit to see patient. Good insight into prognosis. Coping at home currently. End of life discussion; agreed to having DNACPR in place. Very clear wants to die at home. Main currently is back pain. I note from recent consultation with oncologist that there are known bony mets in the psine. Discussed increasing MST to 20mg BD. Declined anti-emetic. 3 weeks ago, letter from oncology consultant. I reviewed Mrs Jones in my clinic today. Unfortunately her breast cancer has progressed and there are bony mets in her hip and ribs. We have discussed that further treatment options are limited and supportive care is recommended. Examination findings Able to mobilise Pain in lumbar area No sensory loss. Power 4/5 in lower limbs. Reflexes normal. PR – hard faeces in rectum
CSA%20case%20-%20palliative%20care%20home%20visit.docx