Website helps patients with advance care planning

Content focuses on defining values, communication
Tools

A new website called PREPARE uses audio and video content to walk patients through the steps of making complex medical decisions. It was developed at the San Francisco VA Medical Center and the Veterans Health Research Institute by researchers who recently published a study on advance care planning in the Journal of Pain and Symptom Management.

"There are few resources which can adequately prepare patients and their families to face serious illness or a medical crisis--situations which often involve complex decisions over time," lead study author Rebecca Sudore, a geriatrician and palliative medicine physician at the VA hospital and associate professor medicine at the University of California-San Francisco School of Medicine, says in an announcement.

Advance directives are just one piece of the puzzle, according to Sudore. The website, she says, is designed to help families identify what is most important in life, communicate that with family and friends and doctors, and make informed medical decisions.

The study points out factors key to successful advance care planning, including selecting a surrogate, determining the surrogate's role and communicating with the surrogate as well as other family members and doctors. The website is written at a fifth-grade reading level, has voice-overs and captioning for the hearing impaired, as well as a large font for the visually impaired.

While the Meaningful Use Stage 3 requirements bring a focus on patient engagement, there's still a gap when it comes to including the content of advance directives.

Most patients' end-of-life wishes differ from the care they actually receive, according to a California HealthCare Foundation survey published last February. Almost 80 percent of respondents said they wanted to talk with their doctor about end-of-life care, yet only 7 percent have had that discussion, the survey found. Moreover, 82 percent said it's important to put end-of-life wishes in writing, while only 23 percent have done so, according to the survey released this week.

With the number of young doctors going into the specialty of palliative care on the rise, generational differences can arise, adding to the importance of making patients' final wishes clear.

To learn more:
- here's the UCSF announcement
- check out the PREPARE website
- read the abstract

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