Elderly patients with organ failure undergoing heroic medical measures may be intubated and require dialysis, preventing hospice transfer and leading to death in the ICU.

“Maybe someone had a an aortic dissection or a ruptured abdominal aortic aneurysm. They're old. They already have organ failure. You go ahead and do it. But this is a person who was cognitively completely intact when they came in. 3 weeks later, they're intubated. they're on dialysis, you can't transfer that person to hospice, right? I mean, because the moment you turn off because you can't have the ventilator, you can't have the diialysis. The moment you turn those things off, the person expires. So, they're going to expire in an ICU. Never what they wanted probably.”