Centre for Policy on Ageing



Decision-making in older adults with serious illness — barriers to the goals of care discussion
Author(s)	Rangaraj K Gopalraj, Laura J Grooms, Belinda K Setters
Journal title	Aging Health, vol 8, no 4, August 2012
Pages	pp 367-376
Source	http://www.futuremedicine.com/loi/ahe
Keywords	Chronic illness ; Dementia ; Dying ; Terminal care ; Management [care] ; Communication.
Annotation	Individualising the goals of care discussion is challenging, especially at the end of life. This article explores some difficulties with goals of care planning using a clinical scenario involving a cognitively impaired older African-American woman with advanced chronic lymphocytic leukaemia and dementia facing a life-threatening condition. Physicians should personalise divergent goals such as a cure, rehabilitation, life-prolonging care and comfort care after factoring in individual patient preferences and disease trajectories. This case illustrates the barriers to the goals of care discussion: lack of education about the disease progression, poor communication techniques, poor language choice, not having proper decision-makers present and lack of trust between the decision-maker and the healthcare team. Harnessing technology can cause breakthroughs in the future. (JL).
Accession Number	CPA-121026004 A
Classmark	CI: EA: CX: LV: QA: U
Data © Centre for Policy on Ageing

...from the Ageinfo database published by Centre for Policy on Ageing.