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Do not resuscitate discussions in a hospital-based home care program
D Havlir1, L Brown, G K Rousseau
1Department of Internal Medicine, San Francisco Veterans Administration Hospital, California.
Journal of the American Geriatrics Society
|January 1, 1989
Summary
Discussing patient code status at home increased participation for chronically ill individuals. In this study, many chose not to be resuscitated, showing benefits for patients, families, and healthcare providers.
Area of Science:
- Medical Ethics
- Palliative Care
- Patient Autonomy
Background:
- Discussions regarding patient code status typically occur in inpatient settings.
- Critically ill patients often cannot participate in these crucial decisions.
- This limits patient autonomy and family involvement in end-of-life care planning.
Purpose of the Study:
- To explore the feasibility and benefits of discussing patient code status in the home setting.
- To increase patient and family participation in advance care planning.
- To assess the impact of outpatient code status discussions on patient, family, and healthcare provider experiences.
Main Methods:
- Conducted code status discussions in the homes of 37 chronically ill patients.
- Patients were enrolled in a hospital-based home care program.
- Documented patient and family preferences regarding resuscitation in case of cardiac arrest.
Main Results:
- Twenty patients or their conservators opted against resuscitation.
- The study involved a small, select group of chronically ill patients.
- Outpatient code status discussions were found to be beneficial.
Conclusions:
- Home-based code status discussions can enhance patient participation in end-of-life care decisions.
- This approach supports patient autonomy and informed decision-making.
- Benefits were observed for patients, their families, and healthcare providers involved in the home care program.