Can We Talk? Yes, We Can!
F. Amos Bailey, MD Apr 14, 2020The importance of goal-concordant care is not new or even substantially different in the context of this pandemic, but the importance of providing goal-concordant care is now heightened in several ways. J. Randall Curtis et.al.
There is a push to have more discussions with more people about their values and goals. Particularly, as it relates to the use of Life-Sustaining-Treatments in the time of COVID-19. We will run out of hospital resources. We may run short of ventilators. And due to the nature of the illness if you get intubated you are likely to need MV support for not days but 2-3 weeks to give time for the lungs to heal and to be weaned off to oxygen. Then the long road to recovery begins.
It is important to have Goals and Values conversations with patients and families living with serious and life-limiting illness. In general people, living with serious illness or who older are thinking about these topics and are waiting for their providers to bring up this topic of discussion. Many people are stepping up to the plate. In the Netherlands, GP’s are calling their older patients to ask what their preference would be if they had COVID-19; come to the hospital or stay at home. Nursing homes and ALFs are stepping up their discussions of ACP as it relates to COVID. Geriatric and Palliative Care outpatient and home care programs are having these conversations.
You may feel uneasy but in general people are eager to have these kinds of conversation.
Please review CAPC COVID-19 Response and Resources which is open and free to all for helpful scripts to get you started with these conversations.
https://www.capc.org/toolkits/covid-19-response-resources/
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