Patient Understanding of End of Life Care

Assessing Patient Understanding and Factors That Govern Advanced Directives and End of Life Discussion

This study aims at assessing factors that affect patient choices for end of life care. 300 patients would be assigned either to a control arm (questionnaire alone) or intervention arm (standardized explanation+ questionnaire). Our intervention is a standardized explanation which explains what code status, advance directive and end of life care mean. Based on patient responses, factors that affect choices of code status would be analyzed. We will also evaluate if a standardized explanation improves patient understanding of end of life issues. This would be determined by generating a composite score of correct responses to a subset of objective questions in the questionnaire

Patients in both arms were administered a questionnaire, that assessed demographics, subjective questions as well as a set of objective questions designed to assess patient understanding of code status. The responses to the objective questions were scored and the composite score of correct responses was used as a marker of patient understanding. Patients in the control arm were administered the questionnaire alone. Patients in the intervention arm first received our standard explanation, and were then administered the questionnaire

Patients interviewed within 48 hours of admission, questionnaire adminsitered at the time of interview

Compare differences in demographic, medical, social and associated factors on patient choice of code status

Patients interviewed within 48 hours of admission, questionnaire adminsitered at the time of interview

Inclusion Criteria: Age >18 years Admitted to regular nursing floor Exclusion Criteria: altered mental status admitted in ICU positive screening for depression terminal illness defined as life expectancy< 100 days inability to consent