Disaster Planning

Making Decisions in Advance for Very Sick Patients

Published in: Arizona Geriatrics Society Journal, v. 8, no. 1, 2003, p. 13-16

Posted on RAND.org on December 31, 2002

by Ilona Maria Kopits, Joanne Lynn

Advanced care planning to avoid unwanted care at the end of life remains a low priority in patient care. Only around 15-20% of sick or geriatric patients have such documents. In this article, the authors discuss the barriers to advanced care planning, citing three correctable problems that have been perpetuating the situation: (1) most physicians don't include such planning as an integral part of care, even for seriously ill patients; (2) even if plans are developed, they are not moved with the patient from one health care setting to another; (3) even if a care team is aware of an advanced care plan, the plan is sometimes not followed.

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