In patients with life-limiting illnesses, effective communication techniques should be used to determine what the patient and family know about the condition and to clarify their goals of care.
The patient’s goals of care and previously expressed wishes, not the prognosis, should always guide treatment focus.
An advance directive is a general term for any documentation provided by a patient that lays out future medical decisions and preferences to be used in the event a patient is unable to communicate.
The POLST (physician orders for life-sustaining treatment) and MOLST (medical orders for life-sustaining treatment) are specific medical orders signed by a physician after a conversation with a patient or his surrogate. www.oregonpolst.org
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Steinhauser KE, Christakis NA, Clipp EC, et al. Factors considered important at the end of life by patients, family, physicians, and other care providers. JAMA. 2000;284(19):2476- 2482. (Cross-sectional survey; 1122 patients/families/providers) DOI: http://doi.org/10.1001/jama.284.19.2476
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