Elderly Septic Diabetic Foot Debridement with Dementia

You are a consultant anaesthetist at a metropolitan tertiary hospital. On the day's emergency list is an 82-year-old man for the debridement of his right forefoot. He is a current inpatient having been admitted from home, unwell with sepsis, the previous day. From the intern admission note you see that he has a significant past medical history including: - Hypertension - CCF - medically managed - Chronic renal impairment - eGFR 42 mL/min/1.73m2 - Aortic stenosis managed by TAVI in 2019 and complicated by CVA with mild residual dysphasia - Dual antiplatelet therapy - Progressive dementia - still lives at home with support from his family and aged care service providers who visit daily You go to the ward to pre-operatively assess him. He is the patriarch of a large family and his son (who has medical power of attorney) is in attendance.