What is important to palliative care patients, beyond physical concerns?
Patient self-defined goals: Essentials of person-centered care for serious illness
In this project (part of a larger US study of an upstream community-based palliative care approach) lay health care workers provided monthly supportive visits for 160 patients with advanced heart failure, cancer or dementia, and expected to die within two to three years. As part of the project, the care guides explored what was most important to the patients and documented their self-defined goals.
Four key themes were identified from the responses – medical, non-medical, multiple and global and these were distributed as follows:
The authors concluded that it is feasible to elicit and record serious illness goals in this patient population. They noted that the diverse range of goals that were identified related to global aspirations and many facets of the whole person, which presents an opportunity to individualise assessments and care planning processes and assist decision-making that more fully reflects current health status and psychosocial and spiritual aspects of patients’ lives.
Sandra Ellen Schellinger, Eric Worden Anderson, Monica Schmitz Fraser and Cindy Lynn Cain, Patient Self-Defined Goals: Essentials of Person-Centered Care for Serious IIlness, American Journal of Hospice and Palliative Medicine, published online 23 March 2017, doi:10.1177/1049909117699600.
Reflecting on my own practice, it’s easier to concentrate on physical issues and it’s a timely reminder of the importance of non physical issues for holistic patient care.
Thanks to the PCV newsletter for the heads up….