Eliciting Informed Goals of Care in Elderly Patients
This research is testing a new way to help elderly hospital patients and their healthcare teams have important conversations about future medical care, particularly when considering end-of-life decisions. Often, these discussions don't happen well, leading to care that isn't what the patient wanted. Doctors have created a special tool to guide these conversations, aiming to make sure patients' wishes are clearly understood, written down, and respected. The study will compare this new tool to standard care to see how well it works. The main goal is to improve communication, so patients receive care that truly matches their preferences, helping them and their families avoid unnecessary distress.
At a glance
What is this study about?
When you're in the hospital, especially as you get older, it's really important for your healthcare team to understand what matters most to you regarding your health and future care. This is often called 'goals of care'. It means making sure that any medical decisions match your personal wishes and values. These conversations are particularly important when thinking about serious illnesses or end-of-life care, as they help ensure you get the right kind of support and treatment.
Sometimes, these important conversations don't happen as clearly or as often as they should. This can unfortunately lead to situations where patients might receive medical care they didn't want, causing distress for them and their families. To address this, doctors have developed a new tool designed to make these difficult conversations easier and more effective for both patients and healthcare providers.
This study wants to see how well this new tool works compared to the usual way of doing things. Researchers will look at whether it helps make sure patients' wishes about their treatment are clearly identified, recorded, and ultimately lead to care that truly reflects what they want. They will also look at whether it improves how satisfied patients are with these discussions and how well communication happens.
Key takeaways
- This study helps older hospital patients talk about their future medical wishes.
- It tests a new tool to make 'goals of care' discussions clearer and more effective.
- The aim is to ensure patients receive care that truly matches their preferences.
- Participation involves observation of care discussions, not new treatments or medications.
- You can withdraw from the study at any time without affecting your medical care.
Who may be eligible?
This study is looking for older patients who are currently in the hospital. You would generally need to be 80 years or older and admitted for a medical or surgical reason. You should also be able to speak English, or have a translator available, and be able to make your own decisions, or have someone who can make decisions for you.
Some things might mean you can't join the study. For example, if you or your doctor doesn't want to take part, or if your current medical notes already say you only want comfort care. Also, if you've just been diagnosed with a life-limiting illness during this hospital stay, or if you're very unstable and in intensive care on life support (like breathing machines or dialysis), you wouldn't be able to join.
Other reasons not to be included are if you're being readmitted shortly after a previous hospital stay, or if you already rely on long-term breathing support or regular dialysis at home.
Could this study suit you?
Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.
- Are you 80 years old or older and currently in the hospital?
- Were you admitted for a medical or surgical condition?
- Can you speak English, or is there a translator available?
- Are you able to make your own medical decisions, or do you have someone who can?
- Is your existing care plan open to discussing life-sustaining treatments?
What does participation involve?
If you join this study, you'll be placed into one of two groups by chance, like flipping a coin. One group will experience the new 'goals of care' tool being tested, where a healthcare provider will use a specific guide to help you discuss your preferences for future medical care. The other group will receive the usual care, meaning these conversations will happen as they normally would in the hospital. The study will mainly involve observing how these discussions happen and their outcomes during your hospital stay and for up to 12 months afterwards. There are no extra visits or new medications involved, just an assessment of how well your preferences are understood and put into practice.
Potential risks and benefits
Locations (1)
- Royal Victoria Regional Health CentreVerified postcodeBarrie, Canada· Recruiting
Common questions
What does 'goals of care' mean?
It means talking about your wishes, values, and what's most important to you when making decisions about your future medical treatment and well-being.
Will I have to take any new medicines?
No, this study is about improving conversations about your care, not about trying new medications or treatments.
How long will I be involved in the study?
The study will look at your care during your hospital stay and then monitor outcomes for up to 12 months after you leave the hospital, or until death.
Can I change my mind about taking part?
Yes, you can decide to stop being part of the study at any time without it affecting the medical care you receive.
What happens if I'm in the 'usual care' group?
You will receive the standard excellent care and conversations about your treatment that normally happen in the hospital, but without using the specific new tool being tested.
How to find out more
Giulio DiDiodato, MD PhD
Always speak to your GP or specialist before deciding to take part in a study.
Interested in taking part?
Discussion
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