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Cross-sectional study
Goals of care are important for older adults with severe illness and their families, and are infrequently addressed by health professionals
  1. Rony Dev
  1. University of Texas MD Anderson Cancer Center, Houston, Texas, USA
  1. Correspondence to : Dr Rony Dev, University of Texas MD Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 1414, Houston, TX 77030, USA; rdev{at}mdanderson.org

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Commentary on: You JJ, Dodek P, Lamontagne F, et al, ACCEPT Study Team and the Canadian Researchers at the End of Life Network (CARENET). What really matters in end-of-life discussions? Perspectives of patients in hospital with serious illness and their families. CMAJ 2014;186:E679–87.

Implications for practice and research

  • Patients and families identify goals of care discussions as being essential and include preferences for care at the end-of-life, eliciting patient's values, disclosing prognosis, allowing expression of fears or concerns and questions about goals of care.

  • Healthcare providers often do not address guideline recommended elements of goals of care discussion, but when undertaken, patient satisfaction can improve.

  • Future research should examine the benefits of automatic triggers, variations of timing along the disease trajectory and interventions to improve the quality of end-of-life discussions …

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