Communication Key to Eliciting Patient Goals for End-of-Life Care

​Communication with patients and their families is essential to establishing goals for palliative, hospice, and other "comfort care" in the hospital, according to a review article in the December 24, 2015, New England Journal of Medicine. Defining comfort care as "meticulous palliation of troubling symptoms and offering of skilled psychosocial and spiritual support," the authors emphasize that comfort care is not equivalent to a do-not-resuscitate order and that the patient's wishes should be reflected explicitly in orders in the patient's record. If possible, discussions of the patient's goals should occur early in the progression of the illness, beginning with an assessment of the patient's and family's understanding of the illness, prognosis, and diagnostic and therapeutic options.