goals of care
Jump to navigation
Jump to search
Introduction
Patient's preferences or priorities for treatment of illness.
goals of care include longevity, function, & quality of life
Component of one of the 5 Ms of geriatrics
Clinical significance
- a 1st step in counseling a patient about treatment options & a care plan
- goals of care discussions with serious illness promote patient-centered outcomes at the end of life[1]
Complications
- goals of care are too frequently not transferred across care settings
Management
- as 'what is your understanding of where you are with your illness?'
- in the absence of established goals of care (advance directives) or an available surrogate decision maker, full resuscitation efforts are indicated[2]
Clinical trials
- a randomized clinical trial (electronic health record-based) to promote goals-of-care discussions had litte impact on occurrence of discussions[1]
More specific terms
Additional terms
References
- ↑ 1.0 1.1 1.2 Curtis JR et al. Intervention to promote communication about goals of care for hospitalized patients with serious illness: A randomized clinical trial. JAMA 2023 May 21; [e-pub]. PMID: https://pubmed.ncbi.nlm.nih.gov/37210665 https://jamanetwork.com/journals/jama/fullarticle/2805346
White DB, Andersen SK. Conversations on goals of care with hospitalized, seriously ill patients. JAMA 2023 May 21; [e-pub]. PMID: https://pubmed.ncbi.nlm.nih.gov/37210664 https://jamanetwork.com/journals/jama/fullarticle/2805347 - ↑ 2.0 2.1 NEJM Knowledge+
- ↑ Boyd C, Smith CD, Masoudi FA et al. Decision Making for Older Adults with Multiple Chronic Conditions: Executive Summary for the American Geriatrics Society Guiding Principles on the Care of Older Adults with Multimorbidity. J Am Geriatr Soc. 2019;67(4):665-673 PMID: https://pubmed.ncbi.nlm.nih.gov/30663782 https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.15809
- ↑ Bernacki RE, Block SD; American College of Physicians High Value Care Task Force. Communication about serious illness care goals: a review and synthesis of best practices. JAMA Intern Med. 2014 Dec;174(12):1994-2003 PMID: https://pubmed.ncbi.nlm.nih.gov/25330167 Review.
- ↑ Jacobsen J, Bernacki R, Paladino J. Shifting to Serious Illness Communication. JAMA. 2022 Jan 25;327(4):321-322. doi:http://dx.doi.org/ 10.1001/jama.2021.23695. PMID: https://pubmed.ncbi.nlm.nih.gov/34994773 No abstract available. https://jamanetwork.com/journals/jama/fullarticle/2788065
- ↑ Jain N, Bernacki RE. Goals of Care Conversations in Serious Illness: A Practical Guide. Med Clin North Am. 2020 May;104(3):375-389. PMID: https://pubmed.ncbi.nlm.nih.gov/32312404 Review.