The Future of Advance Care Planning

Abstract

Seventy-six million baby boomers are poised to move into the ranks of the elderly and frail elderly in the next 20 to 30 years. The health care system will be challenged to provide appropriate and reasonable care at the end of life to a generation that has experienced unprecedented medical breakthroughs aimed at preserving and prolonging life. Advance care planning—thoughtful conversations between patients, families, and health care providers—will be key in ensuring that patients receive the care they want and the care that is most appropriate for them. To foster the best care, advance care planning must evolve from a document-based system of health care directives focused on specific treatment choices to an ongoing dialogue with the patient and family about health care outcomes. The baby boom generation will ask for and expect a holistic approach that takes into consideration not only treatment options but financial concerns and family needs.

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References

American Association of Retired Persons. (1999). Baby boomers envision their retirement. Retrieved December 18, 2001, from http://reaserch.aarp.org/econ/boomer_seg_toc.html

Government Accounting Office. (n.d.). Nursing workforce: Emerging nurse shortages due to multiple factors (GAO-01-944). Retrieved December 18, 2001, from www.gao.gov

Norlander, L., & McSteen, K. (2000). The kitchen table discussion: A creative way to talk about advance care planning. Home Healthcare Nurse, 18(8), 532-539.

Pearlman, R. A., Cole, W. G., Donald, P. L., Starks, H. E., & Cain, K. C. (1995). Advance care planning: Eliciting patient preferences for life-sustaining treatment. Patient Education and Counseling, 26, 353-361.

Pendergast, T. J. (2001). Advance care planning: Pitfalls, progress, promise. Critical Care Medicine, 29(Supp. 2), N34-N39.

Perkins, H. S. (2000). Time to move advance care planning beyond advance directives. Chest, 117(5), 1228-1231.

Project DECIDE: A roundtable report to the community. (1996). Minneapolis, MN: Allina Foundation.

Ratner, E., Norlander, L., & McSteen, K. (2001). Death at home following a targeted advance-care planning process at home: The kitchen table discussion. Journal of the American Geriatric Society, 49(6), 778-781.

Steinhauser, K., Clipp, E. C., McNeilly, M., Christakis, N. A., McIntyre, L. M., & Tulsky, J. A. (2000). In search of a good death: Observations of patient, families and providers. Annals of Internal Medicine, 132(10), 825-832.

10.

Twohig, J. (Ed.). (2001). New end of life benefits models in Blue Cross and Blue Shield plans. Vienna, VA: Barksdale Ballard.