Patient Self-Defined Goals: Essentials of Person-Centered Care for Serious Illness

• DOI: 10.1177/1049909117699600
• Publication Date: 2017-11-06T12:57:18Z
• Authors: Sandra Ellen Sche...; Eric Worden Anderson; Monica Schmitz Fr...; Cindy Lynn Cain
• Keywords: Specialty; Advance Care Planning

This research, a descriptive qualitative analysis of self-defined serious illness goals, expands the knowledge what goals are important beyond physical-making existing disease-specific guidelines more holistic. Integration care discussions and documentation is standard for quality palliative but not consistently executed into general specialty practice. Over 14 months, lay health-care workers (care guides) provided monthly supportive visits 160 patients with advanced heart failure, cancer, dementia expected to die in 2 3 years. Care guides explored was most documented their on medical record flow sheet. Using definitions an expanded set whole-person domains adapted from National Consensus Project (NCP) Clinical Practice Guidelines Quality Palliative Care, 999 associated plans were deductively coded examined. Four themes identified-medical, nonmedical, multiple, global. Forty percent domain; 40% nonmedical domains-social (9%), ethical (7%), family (6%), financial/legal (5%), psychological housing (3%), legacy/bereavement spiritual (1%), end-of-life (1%). Sixteen complex reflected mix domains, "multiple" goals. The remaining (4%) too global attribute NCP domain. Self-defined express experiences physical health extend all aspects whole person. It feasible elicit approach can support meaningful person-centered care, decision-making, planning that accords individual preferences late life.