Addressing end‐of‐life care in the chronically ill: Conversations in the emergency department

Journal of the American College of Emergency Physicians Open

卷:2

Elizabeth P. Clayborne¹  Mohamad Moussa²  Heidi C. Knowles³  Eileen F. Baker⁴  Rebecca R. Goett⁵  Katarina Hughes⁶  Samantha Achauer⁶ 

[1] Department of Emergency Medicine University of Maryland School of Medicine Baltimore Maryland USA;

[2] Emergency Medicine University of Toledo College of Medicine and Life Sciences Toledo Ohio USA;

[3] John Peter Smith Health Network Fort Worth Texas USA;

[4] Riverwood Emergency Services, Inc. Perrysburg Ohio USA;

[5] Rutgers New Jersey Medical School Newark New Jersey USA;

[6] University of Toledo College of Medicine and Life Sciences Toledo Ohio USA;

关键词: advance directives;    brief negotiated interview;    do not resuscitate orders;    durable power of attorney;    end‐of‐life;    illness trajectories;   

DOI  :  10.1002/emp2.12569

来源: DOAJ

【 摘 要 】

Abstract Patients present to the emergency department in various stages of chronic illness. Advance directives (ADs) aid emergency physicians in making treatment decisions, but only a minority of Americans have completed an AD, and the percentage of those who have discussed their end‐of‐life wishes may be even lower. This article addresses the use of common ADs and roadblocks to their use from the perspectives of families, patients, and physicians. Cases to examine new approaches to optimizing end‐of‐life conversations in patients who are chronically ill, such as the Improving Palliative Care in Emergency Medicine Project, a decision‐making framework that opens discussion for patients to gain understanding and determine preferences, and the Brief Negotiated Interview, a 7‐minute, scripted, motivational interview that determines willingness for behavior change and initiates care planning, are used.

【 授权许可】

Unknown