Eliciting Informed Goals of Care in Elderly Patients (ASKMEGOC)
Goals of Care, Patient Preference, End of Life
About this trial
This is an interventional health services research trial for Goals of Care
Eligibility Criteria
Inclusion Criteria: Hospitalized patients ≥ 80 years old with an acute medical or surgical condition admitted to any hospital ward Duration of admission ≥ 24 hours English speaking, or translator present Competent patient or substitute decision maker Exclusion Criteria: Treating physician, patient, or substitute decision maker declines Documented resuscitation preferences for comfort or supportive care New diagnosis of life-limiting illness on this hospital admission, for example, new diagnosis of metastatic cancer Clinically unstable, admitted to an intensive care unit, or currently receiving acute life support treatment (mechanical ventilation, acute dialysis, or inotropic/vasopressor support) Readmission after index hospitalization Pre-existing need for chronic mechanical ventilation (invasive mechanical ventilation via tracheostomy > 90 days) or maintenance dialysis (peritoneal or hemodialysis > 90 days)
Sites / Locations
Arms of the Study
Arm 1
Arm 2
Experimental
Active Comparator
GOCD Tool
usual care
Intensive care unit-facilitated goals-of-care discussion using web-based shared-decision making software tool
Usual discussions conducted by attending physician with patient