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Decision Making About End of Life Care: Advance Directives, Durable Power of Attorney for Healthcare, and Talking with Patients with Heart Disease About Dying

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End-of-Life Care in Cardiovascular Disease

Abstract

Advancing technology has complicated decision making about end of life care. Advance directives arose as a legal response to concerns about patients receiving unwanted interventions near the end of life. Healthcare advance directives and durable power of attorney for healthcare held the promise of controlling medical care at the end of life. This promise has not been realized. All clinicians providing care to patients with heart failure or other life-limiting illnesses should develop a set of communication skills to discuss goals of care, resuscitation preferences and wishes for end of life care. Patient centered communication skills and empathetic response to emotion are the foundational tools for addressing these issues. Newer models of advance care planning are more based on communication between providers, patients and families than on legal documents The POLST paradigm represents an important innovation in allowing patients to document their preferences for care in a portable document which is a legal physician order.

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Authors and Affiliations

  1. General Medicine and Geriatrics, Portland VA Medical Center, 3710 SW US Veterans Hospital Rd (P3MED), Portland, OR, 97239, USA

    Craig Tanner MD

  2. Medicine Department, Oregon Health & Science University, Portland, OR, USA

    Craig Tanner MD

Authors
  1. Craig Tanner MD
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Correspondence to Craig Tanner MD .

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Editors and Affiliations

  1. Portland VA Medical Center,, Patient-Centered Education and Research, Salt Lake City, UT, USA, Portland, Oregon, USA

    Sarah J. Goodlin

  2. Washington University School of Medicine, St Louis, Missouri, USA

    Michael W. Rich

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© 2015 Springer-Verlag London

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Tanner, C. (2015). Decision Making About End of Life Care: Advance Directives, Durable Power of Attorney for Healthcare, and Talking with Patients with Heart Disease About Dying. In: Goodlin, S., Rich, M. (eds) End-of-Life Care in Cardiovascular Disease. Springer, London. https://doi.org/10.1007/978-1-4471-6521-7_2

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  • DOI: https://doi.org/10.1007/978-1-4471-6521-7_2

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  • Publisher Name: Springer, London

  • Print ISBN: 978-1-4471-6520-0

  • Online ISBN: 978-1-4471-6521-7

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