While most individuals don’t consider advance care planning (ACP) until they become quite ill, it shouldn’t take a serious illness to begin thinking about future care and preferred treatment options. Planning ahead and having crucial conversations with family, friends, and caregivers may expand options when a medical emergency arises.
Chronic Obstructive Pulmonary Disease (COPD) is a common progressive disease characterized by airflow limitations and persistent respiratory symptoms, including cough and sputum production. The disease is unpredictable and incurable, and for individuals with advanced forms of COPD, the final years of life are often combined with functional decline, frequent visits to the emergency department, and a general poor quality of life. Among individuals with COPD, common comorbidities range from cardiovascular disease to depression and anxiety.
The liver has many important jobs that are vital to the sustainability of life. It processes what is ingested into energy and nutrients that the body can use. It also removes harmful substances from the blood. Because of its role in keeping the body running, the liver may be damaged by long-term diseases and as it is repeatedly injured, it produces scar tissue known as cirrhosis. Cirrhosis is unpredictable with stretches of stability and periods of decompensation that may result in a rapid health decline. It also can be tricky to diagnose as many with the condition have no symptoms in the early stages.
In 2015, the worldwide prevalence of heart failure (HF) was estimated to be approximately 40 million people. Although the clinical condition of heart failure is sometimes stable for a long time, it may change suddenly. When a person's heart condition worsens, in many cases, they require urgent and intensive care management. In this situation, people with HF and their families might not be able to contemplate treatment and care options that take into account the person's values and care preferences.
Advance care planning, goals-of-care conversations, clarification of medical prospects, expression of preferences for current and future treatment, promotion of patient autonomy and self-determination – all of these are essential outcomes for palliative care. Palliative care is a multidisciplinary medical specialty that focuses on relieving symptoms of serious illness, reducing stress, enhancing coping, and improving quality of life for the patient and for loved ones. But it all starts with talking about goals of care.
While stroke has been moved from the third to the fifth-leading cause of death in the United States, thanks to recent advances in prevention and treatment, according to the American Heart Association (AHA), stroke survivors still face increased rates of post-stroke illness. The AHA states that a high rate of stroke recurrence is an important factor in post-stroke death and disability: one-quarter of the nearly 800,000 Americans who suffer from stroke each year are survivors of a previous stroke. What’s more, the AHA notes that people who survive a stroke have twice the risk of developing dementia after the first stroke and one in three develop dementia following a recurrent stroke.
September is Healthy Aging Month, which gives focus on the positive aspects of growing older. Experts believe the number of older adults in the U.S. will reach nearly 71 million by 2030, By 2060, 1 in 4 Americans will be age 65 or older. According to data compiled by AARP, this expanding older adult population will significantly affect the nation’s public health system and increase the demand for aging-related services, which means efforts to help older adults stay healthy are a huge priority.
Dementia is an irreversible progressive brain disorder with neurodegenerative symptoms including decline in memory, reasoning and communication skills, and a gradual loss of skills needed to carry out daily living activities. It is estimated that there are an estimated 5.8 million older adults in the United States with dementia. That number is expected to grow as the number of individuals entering older age increases. By 2050, the number of individuals aged 65 and older with dementia is expected to climb to 14 million. Alzheimer’s disease, the most common cause of dementia, is the sixth-leading cause of death among all adults and the fifth-leading cause of death for individuals age 65 and older.
Race, language, ethnicity and sociodemographics are leading barriers impacting Advance Care Planning (ACP) utilization in the United States. Recent studies have shown that minority populations have low rates of documented advance directives (AD) with key barriers to AD completion having been identified as language, poor physician-patient communication, cultural values and health literacy.
In 1990 Congress passed the Patient Self-Determination Act with the goal of giving people an opportunity to express in advance their values and preferences for medical treatments in a future medical crisis. Healthcare providers were tasked with informing patients about their rights under their state’s law to make such decisions about future medical care.