We hope you have added to your knowledge skills and attitudes about End-of-Life care and Symptom Management in the Older ED Patient. Caring for patients at or nearing the end of life is a challenge in the ED. A busy chaotic environment is a difficult place to have sensitive discussions about life’s most important issues! Our ability to provide excellent care to vulnerable patients and families can be increased by using our knowledge of disease trajectories and prognosis. Patient care can be improved by moving beyond “do you want to be resuscitated” to a more complex discussion of goals of care. And we can practice so that we can be the doctor we would want to have if we were in pain.
As part of your regular practice, it is important to encourage patients to have the discussion with their family or substitute decision maker about their values as it relates to their goals of care. In addition to this allowing for the patient’s wishes to be known and respected, substitute decision makers may feel less conflicted when trying to determine what their loved ones would want as they near the end of their life.
Review the Learning Objectives before proceeding to the Knowledge Check.
At the end of this module the learner should be able to:
- Describe disease trajectories, recognizing their link to prognosis and end-of-life decision making.
- Use disease trajectories to inform discussion of goals of care and advance care planning in the ED.
- Name the key components of an effective goals of care discussion.
- Describe ED-appropriate management for pain, nausea, constipation, dyspnea, and anxiety.