Problem
MA is an 85-year-old female living in a long-term care facility. She has significant cognitive decline, and her physician has even said that death is near with her other health issues including renal failure and CHF. She has been on blood thinners for years due to a valve replacement 20 years ago. She cries in agony with each fingerpick and can barely tolerate the lab draws if needed to check her INR. Is continual monitoring of the INR needed given her terminal status?