title: Last moments of life: can telemedicine play a role?
abstract: BACKGROUND
  We describe the experience of managing the dying moments of a nursing home patient via telemedicine.
  
  
  METHODS
  Ms. C was a 92-year-old frail woman with multiple medical problems, living in a nursing home. She spent her final days in the nursing home, choosing not to be transferred to an acute hospital should she turn ill. On the last day of her life, she complained of acute-onset breathlessness and agreed to a teleconsultation with the hospital physicians involved in acute care.
  
  
  RESULTS
  During the telemedicine consultations (tele-consultation) process, Ms. C's condition deteriorated rapidly as she entered the dying phase of life. She died peacefully soon after, in the presence of the nurse, the pastoral care worker, and the physician who was conducting the tele-consultation session 30 km away. The family was not present at the patient's bedside when she died. They were, however, relieved to know and were appreciative of the fact that a physician had been "present" during the patient's death.
  
  
  CONCLUSIONS
  Telemedicine could act as an effective communication tool in end-of-life care, between the patient and carers, up to the last moment of life.
authors: Department of Geriatric Medicine and Palliative Care, Khoo Teck Puat Hospital, Singapore.
authors: James A
authors: JA
authors: Low
authors: St Joseph's Nursing Home, Singapore.
authors: Gillian
authors: G
authors: Beins
authors: Department of Geriatric Medicine and Palliative Care, Khoo Teck Puat Hospital, Singapore.
authors: Kok Keng
authors: KK
authors: Lee
authors: Department of Geriatric Medicine and Palliative Care, Khoo Teck Puat Hospital, Singapore.
authors: Ethel
authors: E
authors: Koh
mesh_terms: D000369:Aged, 80 and over; D003142:Communication; D003422:Critical Care / Q000379:methods*; D017809:Fatal Outcome; D005260:Female; D017051:Hospice Care / Q000379:methods*; D006801:Humans; D009735:Nursing Homes; D017216:Telemedicine; D013727:Terminal Care / Q000379:methods*