{"id":1031,"date":"2024-04-15T09:26:14","date_gmt":"2024-04-15T13:26:14","guid":{"rendered":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/?post_type=chapter&#038;p=1031"},"modified":"2024-04-15T18:18:44","modified_gmt":"2024-04-15T22:18:44","slug":"2-7-3","status":"publish","type":"chapter","link":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/chapter\/2-7-3\/","title":{"raw":"2.7.4 Goals of Care Conversations in a Palliative Context","rendered":"2.7.4 Goals of Care Conversations in a Palliative Context"},"content":{"raw":"Goals of Care (GOC) conversations:\r\n<ul>\r\n \t<li>Are different from ACP conversations<\/li>\r\n \t<li>\u00a0Should be resident centered and should be aligned with their previously expressed values and wishes<\/li>\r\n \t<li>GOC conversations help put previously expressed wishes (ACP discussions) into current clinical context leading to identification of specific medical decisions<\/li>\r\n \t<li>GOC conversation is usually initiated based on patient\u2019s risk of mortality\r\n<ul>\r\n \t<li>Low risk of death<\/li>\r\n \t<li>Intermediate risk of death<\/li>\r\n \t<li>High risk for imminent death[footnote]Jain &amp; Bernacki, 2020[\/footnote][footnote]Canadian Researchers at the End of Life Network (CARENET), 2014[\/footnote]<\/li>\r\n<\/ul>\r\n<\/li>\r\n<\/ul>\r\n&nbsp;\r\n\r\nACP and GOC conversations can provoke strong emotional response from residents and\/or care partners.\u00a0 They may also present with subtle clues through body language suggestive of processing information they were not expecting.\u00a0It is important to not provide false reassurance out of your own discomfort and align resident\/care partner\u2019s hope with the poor prognosis by using the following statement, \u201cI wish things were different\u201d.[footnote]Quill et al., 2001[\/footnote]\r\n<div class=\"textbox textbox--exercises\"><header class=\"textbox__header\">\r\n<p class=\"textbox__title\">Recommended Reading<\/p>\r\n\r\n<\/header>\r\n<div class=\"textbox__content\">\r\n<ol>\r\n \t<li>Serious Illness Care:\u00a0 <a href=\"https:\/\/www.ariadnelabs.org\/areas-of-work\/serious-illness-care\/\">SERIOUS ILLNESS CARE - Ariadne Labs<\/a><\/li>\r\n<\/ol>\r\n<\/div>\r\n<\/div>\r\n&nbsp;\r\n\r\n&nbsp;","rendered":"<p>Goals of Care (GOC) conversations:<\/p>\n<ul>\n<li>Are different from ACP conversations<\/li>\n<li>\u00a0Should be resident centered and should be aligned with their previously expressed values and wishes<\/li>\n<li>GOC conversations help put previously expressed wishes (ACP discussions) into current clinical context leading to identification of specific medical decisions<\/li>\n<li>GOC conversation is usually initiated based on patient\u2019s risk of mortality\n<ul>\n<li>Low risk of death<\/li>\n<li>Intermediate risk of death<\/li>\n<li>High risk for imminent death<a class=\"footnote\" title=\"Jain &amp; Bernacki, 2020\" id=\"return-footnote-1031-1\" href=\"#footnote-1031-1\" aria-label=\"Footnote 1\"><sup class=\"footnote\">[1]<\/sup><\/a><a class=\"footnote\" title=\"Canadian Researchers at the End of Life Network (CARENET), 2014\" id=\"return-footnote-1031-2\" href=\"#footnote-1031-2\" aria-label=\"Footnote 2\"><sup class=\"footnote\">[2]<\/sup><\/a><\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<p>ACP and GOC conversations can provoke strong emotional response from residents and\/or care partners.\u00a0 They may also present with subtle clues through body language suggestive of processing information they were not expecting.\u00a0It is important to not provide false reassurance out of your own discomfort and align resident\/care partner\u2019s hope with the poor prognosis by using the following statement, \u201cI wish things were different\u201d.<a class=\"footnote\" title=\"Quill et al., 2001\" id=\"return-footnote-1031-3\" href=\"#footnote-1031-3\" aria-label=\"Footnote 3\"><sup class=\"footnote\">[3]<\/sup><\/a><\/p>\n<div class=\"textbox textbox--exercises\">\n<header class=\"textbox__header\">\n<p class=\"textbox__title\">Recommended Reading<\/p>\n<\/header>\n<div class=\"textbox__content\">\n<ol>\n<li>Serious Illness Care:\u00a0 <a href=\"https:\/\/www.ariadnelabs.org\/areas-of-work\/serious-illness-care\/\">SERIOUS ILLNESS CARE &#8211; Ariadne Labs<\/a><\/li>\n<\/ol>\n<\/div>\n<\/div>\n<p>&nbsp;<\/p>\n<p>&nbsp;<\/p>\n<hr class=\"before-footnotes clear\" \/><div class=\"footnotes\"><ol><li id=\"footnote-1031-1\">Jain &amp; Bernacki, 2020 <a href=\"#return-footnote-1031-1\" class=\"return-footnote\" aria-label=\"Return to footnote 1\">&crarr;<\/a><\/li><li id=\"footnote-1031-2\">Canadian Researchers at the End of Life Network (CARENET), 2014 <a href=\"#return-footnote-1031-2\" class=\"return-footnote\" aria-label=\"Return to footnote 2\">&crarr;<\/a><\/li><li id=\"footnote-1031-3\">Quill et al., 2001 <a href=\"#return-footnote-1031-3\" class=\"return-footnote\" aria-label=\"Return to footnote 3\">&crarr;<\/a><\/li><\/ol><\/div>","protected":false},"author":517,"menu_order":58,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-1031","chapter","type-chapter","status-publish","hentry"],"part":3,"_links":{"self":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1031","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/users\/517"}],"version-history":[{"count":2,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1031\/revisions"}],"predecessor-version":[{"id":1050,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1031\/revisions\/1050"}],"part":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/parts\/3"}],"metadata":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapters\/1031\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/media?parent=1031"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/pressbooks\/v2\/chapter-type?post=1031"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/contributor?post=1031"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/pressbooks.library.torontomu.ca\/npltc\/wp-json\/wp\/v2\/license?post=1031"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}