Advance Care Planning: Preferences for Care at the End of Life

Advance Care Planning
Preferences for Care at the End of Life
Research in Action, Issue 12
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Research can help physicians and other health care professionals guide patient decisionmaking for care at the end of life. Findings resulting from research funded by the Agency for Healthcare Research and Quality (AHRQ) are discussed. This research can help providers offer end-of-life care based on preferences held by the majority of patients under similar circumstances.

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Introduction / Discussion of Research Findings / Patient Preferences for Treatment / For More Information / References
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By Barbara L. Kass-Bartelmes, M.P.H., C.H.E.S., and Ronda Hughes, Ph.D.

Introduction
Patient Preferences Are Often Not Known
Predicting what treatments patients will want at the end of life is complicated by:

* The patient's age.
** The nature of the illness.
*** The ability of medicine to sustain life.
**** The emotions families endure when their loved ones are sick and possibly dying.
***** When seriously ill patients are nearing the end of life, they and their families sometimes find it difficult to decide on whether to continue medical treatment and, if so, how much treatment is wanted and for how long. In these instances, patients rely on their physicians or other trusted health professionals for guidance.

In the best of circumstances, the patient, the family, and the physician have held discussions about treatment options, including the length and invasiveness of treatment, chance of success, overall prognosis, and the patient's quality of life during and after the treatment. Ideally, these discussions would continue as the patient's condition changed. Frequently, however, such discussions are not held. If the patient becomes incapacitated due to illness, the patient's family and physician must make decisions based on what they think the patient would want.

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Advance Care Planning: Preferences for Care at the End of Life