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October 2004, Volume 34 Number 10 , p 66 - 66





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    My patient, a 61-year-old native of China, has been hospitalized with a stroke. Although stable, she's unresponsive and her prognosis for recovery is poor. She has no advance directives and no one to speak for her except her granddaughter, a young woman going to college in our town. The rest of the patient's family is in China .

    As her caregivers, we anticipate some difficult treatment decisions ahead. The granddaughter tells us that these decisions would normally be made by family consensus, but no one from the family can afford to make the long trip from China. She's terrified of making a “wrong” decision and doesn't want to accept the responsibility. To complicate matters, she's the only person in the family who speaks English well .

    It can take several months to get a court-appointed guardian in this state, and we need help now. What do you suggest? —M.C., NEB.

    Figure. ...

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