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Advance care planning (ACP) involves a process of eliciting patients’ values and life goals over time and then translating those values into appropriate medical care plans.
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ACP can help individuals receive medical care that is aligned with their values and improve patient-reported outcomes.
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ACP should be initiated early in the disease trajectory for patients with cardiovascular disease, even at the time of diagnosis, and account for how other chronic conditions impact their prognosis, personal
Advance Care Planning and Goals of Care Communication in Older Adults with Cardiovascular Disease and Multi-Morbidity
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Key points
Summary
Clinicians who care for older adults with cardiovascular disease and multi-morbidity can engage older adults in ACP through multiple brief discussions over time. ACP emphasizes choosing a surrogate decision-maker, identifying personal values, communicating values with surrogates and clinicians, translating preferences into specific medical treatment plans, and documenting preferences for future medical care. Although patients and clinicians face specific challenges related to ACP,
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Case discussion: The critically ill older adult in spiritual distress
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2020, Physician Assistant ClinicsCitation Excerpt :It not always is evident to patients and families when illness becomes serious or when end of life is near. Understanding prognosis, the prediction of an illness outcome, and time frame is a challenge for everyone involved.8,11 Some providers find prognostication difficult and, therefore, a barrier to ACP.11
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Disclosure: The authors do not have commercial or financial conflicts of interest to disclose. This work was supported in by part by a Junior Faculty Career Development Award from the National Palliative Care Research Center (NPCRC).