Advance care planning in neurologic illness

Area of Science:

• Neurology
• Palliative Care
• Bioethics

Background:

• Advance care planning (ACP) is vital in neuropalliative care for acquired brain injuries and neurodegenerative diseases.
• Early recognition and timely ACP discussions maximize patient autonomy and capacity.
• Challenges arise due to cognitive decline impacting meaningful engagement in care discussions.

Purpose of the Study:

• To review advance care planning (ACP) in serious neurologic illness.
• To discuss approaches for clinicians engaging patients and families in ACP.
• To explore tools that enhance the ACP process for documented patient preferences.

Main Methods:

• Literature review of ACP in neurologic conditions.
• Discussion of clinical strategies for initiating and conducting ACP conversations.
• Exploration of evidence-based tools for patient preparation and aid in ACP.

Main Results:

• Early ACP in neurologic illness leads to more goal-concordant care.
• ACP affects end-of-life medical decision-making.
• Clinicians need familiarity with ACP significance and approaches for difficult discussions.

Conclusions:

• ACP is essential for ensuring patient values guide care in neurologic conditions.
• Clinicians should be equipped to approach ACP conversations effectively.
• Utilizing evidence-based tools can enhance the ACP process and documentation.