End-of-life care–making decisions
Initiate discussion
• Establish supportive doctor-Pt relationship
• Designate surrogate decision maker
• Identify Pt's general preferences
Clarify prognosis
• Keep message clear, avoid misunderstanding
• Acknowledge prognostic limitations
Identify end of life goals
• Determine if preferences have changed
• Identify individual priorities
Develop treatment plan
• Help Pt understand treatment options
• Discuss resuscitation
• Discuss palliative care (RB Balaban, Harvard U, in Qual Life Matters 9,10/00)