Feasibility of Discussing End-of-Life Care Goals with Inpatients Using a Structured, Conversational Approach: The Go Wish Card Game

Lankarani‐Fard, Azadeh; Knapp, Herschel; Lorenz, Karl; Golden, Joya F.; Taylor, Anne; Feld, Jamie; Shugarman, Lisa R.; Malloy, Demetria; Menkin, Elizabeth S.; Asch, Steven M.

doi:10.1016/j.jpainsymman.2009.08.011

Cited by 48 publications

(58 citation statements)

References 19 publications

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“…Using simple tools, Lankarani‐Fard et al (2010) found that a card‐sorting game can be effective in identifying individuals’ values and priorities for end‐of‐life care.…”

Section: Resultsmentioning

confidence: 99%

Person‐directed care planning in nursing homes: A scoping review

Lepore

Scales

Anderson

et al. 2018

Int J Older People Nursing

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AimFederal regulations require nursing homes in the United States to support residents in directing their own care rather than having their care plans developed for them without their engagement, but knowledge of person‐directed approaches to care planning in nursing homes is limited. The purpose of this study was to advance understanding of person‐directed care planning (PDCP).MethodsA multidisciplinary research team conducted a scoping review on individual and family involvement in care planning, including literature from a variety of care contexts. Search results were systematically screened to identify literature that addressed individual or family involvement in care planning as a primary concern, and then analysed using thematic content analysis.ResultsSeveral themes were identified, including definitions of the concept of PDCP, essential elements of PDCP, barriers, facilitators and outcomes. The concept of PDCP is informed by multiple disciplines, including humanist philosophy, disability rights and end‐of‐life care. Essential elements of PDCP include knowing the person, integrating the person's goals in care planning and updating care plans as individuals’ needs or preferences change. Limited time for care planning in nursing homes hinders PDCP. Facilitators include regulatory mandates and humanist social trends. Outcomes of PDCP were found to be positive (e.g., increased independence), but were inconsistently assessed across studies.ConclusionThis study offers pragmatic information that can support PDCP within nursing homes and insights for policy reform that may more effectively support PDCP.Implications for practiceThese findings can be used to guide implementation of PDCP.

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“…Using simple tools, Lankarani‐Fard et al (2010) found that a card‐sorting game can be effective in identifying individuals’ values and priorities for end‐of‐life care.…”

Section: Resultsmentioning

confidence: 99%

Person‐directed care planning in nursing homes: A scoping review

Lepore

Scales

Anderson

et al. 2018

Int J Older People Nursing

View full text Add to dashboard Cite

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“…Recent studies elaborate on other efforts to further support patients in light of the common issues experienced during end of life scenarios in non-confrontational settings. For example, different approaches can be utilized in conjunction with the go wish card game (Lankarani-Fard et al 2010 ).…”

Section: Discussionmentioning

confidence: 99%

The utility of standardized advance directives: the general practitioners’ perspective

Otte

Elger

Jung

et al. 2016

Med Health Care and Philos

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Advance directives (AD) are written documents that give patients the opportunity to communicate their preferences regarding treatments they do or do not want to receive in case they become unable to make decisions. Commonly used pre-printed forms have different formats. Some offer space for patients to (a) appoint a surrogate decision maker, and/or (b) to determine future medical treatments and/or (c) give a statement of personal values. So far it is unknown which forms GPs preferably use and why they decide to do so. 23 semi-structured interviews with GPs were analysed using content analysis. Interviewees mainly use short templates (to appoint surrogate decision makers) and medium length templates with checkboxes to indicate patients’ preferences in regards to life prolonging measures. Especially when patients faced the progression of a disease, participants use the latter version. Only then, the interviewees remarked, patients are capable to rate concrete situations reliably. GPs also realize the importance of the verbal assessment of patients’ preferences; however they rarely keep a written form of the conversation. Some GPs hand out one or more templates and ask their patients to read and think about them at home with the option to talk to them about it later on, while others prefer their patients to fill them out alone at home. Regardless of template usage, most GPs emphasize that ADs require regular updates. GPs tend to see standardized advance directives mainly as a tool to start a conversation with their patients and to identify their real preferences and values. When the patient is still not facing the progression of an already existing disease it could be sufficient to only appoint a surrogate decision maker instead of creating a full AD. However, in all other situations, appointing a surrogate decision maker should be backed up by a written statement of a patient’s general values. Patients and their relatives should always have the opportunity to ask their GP for medical advice when drafting an AD. It is crucial to regularly verify and update existing ADs within the course of a disease.

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“…The Go Wish Card© game was a structured, conversational game to explore EOL wishes in a nonthreatening manner ( Potthoff, 2015 ). The Go Wish Card© game was previously used in inpatient and community settings ( Lankarani-Fard et al, 2010 ; Menkin, 2007 ). The game contains 36 cards, each representing items recognized as important at the EOL.…”

Section: Methodsmentioning

confidence: 99%

What Matters Most at the End-of-Life for Chinese Americans?

Lee

Hinderer

Alexander

2018

Gerontology and Geriatric Medicine

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Background: To provide optimal end-of-life (EOL) care in the Chinese American population, we need to have a better understanding of what matters most at EOL from their perspective. Experiencing a “good death” at the EOL is the optimal goal of palliative care. Studies show that the meaning and description of good death varies across cultures in different populations. In the United States, Chinese Americans comprise the largest Asian demographic. Aim: To describe EOL wishes, which define a good death for Chinese Americans. Method: Qualitative study using focus groups. A convenience sample of 60 Chinese Americans was recruited from a community organization in Maryland. Ten focus group discussion sessions were conducted. Results: Wishes at the EOL that defined a good death for the participants in this study included being pain-free, not being a burden to family, being with family, having a trusted physician, maintaining dignity, and prayer. Conclusion: A good death is a complex concept. What matters most to patients at the EOL differs depending on their cultural background. When caring for Chinese Americans, a comprehensive EOL care plan should include cultural considerations in addition to physical, psychosocial, and spiritual needs.

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Feasibility of Discussing End-of-Life Care Goals with Inpatients Using a Structured, Conversational Approach: The Go Wish Card Game

Cited by 48 publications

References 19 publications

Person‐directed care planning in nursing homes: A scoping review

Person‐directed care planning in nursing homes: A scoping review

The utility of standardized advance directives: the general practitioners’ perspective

What Matters Most at the End-of-Life for Chinese Americans?

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