Advance care planning (ACP) is a vital process that allows patients to express healthcare desires before they are unable to make decisions on their own behalf. Despite its guidance in end-of-life care, nearly 30% of patients die without having clearly articulated their goals, leading to uncertain decision-making and potential unwanted medical interventions. ACP incorporates documents such as living wills, medical power of attorneys (POAs), and physician orders for life-sustaining treatment (POLST). These forms provide a structured format for patients, mainly those with chronic illness or aging, to ensure their values and treatment preferences are upheld. This case highlights a geriatric patient with a complex medical history who outlined his wishes before his condition was compromised. By initiating these conversations prior to medical decline, healthcare workers can respect the patient's wishes and reduce the emotional burden on family members. They were able to appoint a medical POA and develop a living will. Effective ACP not only reduces unnecessary interventions and hospitalizations but also improves the patient's psychological well-being and quality of life moving forward. The context of this patient brings an interesting perspective on ACP, especially since the patient was admitted to the hospital for his hallucinations but ended up deceasing during that same hospital stay from respiratory failure. Without proper education about ACP, this patient could have received undesired interventional treatment during his stay. This case reinforces the value of individualized end-of-life care that incorporates ACP as a preventative and forward-thinking strategy as opposed to last-minute responses in geriatric management.
Portnell et al. (Tue,) studied this question.