KEYPOINTS
Seaman, J.B. (2013). Improving Care at End of Life in the ICU: A Proposal for Early
Discussion of Goals of Care. Journal of Gerontological Nursing, 39(8), 52-58.
1 Critically ill older adults in the intensive care unit (ICU) face high
likelihood of mortality or significant functional impairment and
are at risk for receiving care that is inconsistent with their values
and preferences.
2Multiple factors contribute to this problem, including prevailing
technological and research imperatives that dominate ICU culture,
a lack of explicit informed consent for ongoing treatment,
and knowledge deficits related to the role of decisional surrogates.
3 Early discussion of goals of care, specifically discussion within
48 hours after ICU admission, is proposed as a solution to this
problem.
4 Critical care nurses play a critical role in implementation and facilitation
of this solution.