End-of-Life Care Issues

End-of-Life Care Issues Wednesday, December 18, 2013

Seriously ill or very elderly patients often cannot express their wishes because of limited mental or physical capabilities, leading to health care decisions that may be inconsistent with their wishes. Although advance care planning—a shared decisionmaking process about future health care choices—can help, many patients fail to engage in such planning; this may be true more often in minority populations. In addition, State policies can either facilitate or hinder the provision of effective, compassionate end-of-life care.

The featured Innovations describe three programs that aimed to increase rates of advance care planning. The programs include one that provided education and trained nonphysician facilitators to guide patients and their families in advance care planning; another in which a State-mandated council focused on end-of-life policy issues; and third in which care coordinators used a culturally sensitive, tailored approach to discuss advance care directives with seniors.

The featured QualityTools include a program and a Web site that offer resources to help people make informed decisions about end-of-life care and services, as well as a program that offers health care professionals the tools, training, and technical assistance necessary to start successful palliative care programs.

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