Eliciting Informed Goals of Care in Elderly Patients

Launched by ROYAL VICTORIA HOSPITAL, CANADA · Aug 14, 2023

Keywords

ClinConnect Summary

This clinical trial, titled "Eliciting Informed Goals of Care in Elderly Patients," is focused on improving how healthcare providers discuss and understand the treatment preferences of elderly patients, particularly regarding end-of-life care. The study aims to create a better way for doctors and patients to communicate about what kind of medical care patients want if they face serious health issues. The researchers have developed a new tool to help guide these important conversations, and they want to see if this tool is more effective than standard practices in making sure patients’ wishes are known and respected.

To participate in this trial, patients need to be at least 80 years old and currently hospitalized for a medical or surgical issue. They should have previously indicated that they do not want life-sustaining treatments. Eligible patients must be able to communicate in English or have a translator available and should be competent to make their own decisions or have someone to make decisions for them. Throughout the study, participants can expect to engage in discussions about their treatment options with the help of this new tool, which has already shown promise in earlier small-scale tests. Overall, this trial aims to ensure that elderly patients receive care that aligns with their personal goals and values, especially during critical times.

Gender

ALL

Eligibility criteria

• Inclusion Criteria:
• • Hospitalized patients ≥ 80 years old with an acute medical or surgical condition admitted to any hospital ward
• • Previously or currently documented CODE STATUS preferences do not include any life sustaining therapies
• • Duration of admission ≥ 24 hours
• • English speaking, or translator present
• • Competent patient or substitute decision maker
• Exclusion Criteria:
• • Treating physician, patient, or substitute decision maker declines
• • Documented resuscitation preferences for comfort or supportive care
• • New diagnosis of life-limiting illness on this hospital admission, for example, new diagnosis of metastatic cancer
• • Clinically unstable, admitted to an intensive care unit, or currently receiving acute life support treatment (mechanical ventilation, acute dialysis, or inotropic/vasopressor support)
• • Readmission after index hospitalization
• • Pre-existing need for chronic mechanical ventilation (invasive mechanical ventilation via tracheostomy \> 90 days) or maintenance dialysis (peritoneal or hemodialysis \> 90 days)