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Advance Care Planning for Patients with Current and Future Medical Complexity

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Integrated Care for Complex Patients

Abstract

The author traces the courses of two aging patients from physical health to death. She highlights the process of creating an advance care directive and Physician Orders for Life-Sustaining Treatment (POLST). These documents provide guides for patients’ physicians in the event that lifesaving measures become necessary. Discussions needed to guide a patient through medical requirements as the end-of-life approaches are also illustrated.

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Recommended Resources for Facilitating Conversations in Advance Care Planning and End-of-Life Care Choices

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  • Advance care planning and conversation resources for patients and clinicians are available at many online locations including the Coalition for Compassionate Care of California (CoalitionCCC.org), the website for the National POLST Paradigm (POLST.org), the National Hospice and Palliative Care Organization (NHPCO.org).

Suggested Additional Reading

  • Butler K. Knocking on Heaven’s door: the path to a better way of death. Scribner reprint ed; 2014.

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  • Gawande A. Being mortal: medicine and what matters in the end. New York: Metropolitan Books; 2014.

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  • Kalanitihi P. When breath becomes air. New York: Random House; 2016.

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  • Volandes A. The conversation: a revolutionary plan for end of life care. Paperback ed. New York: Bloomsbury; 2016.

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  • Zitter, JN. Extreme Measures. Finding a Better Path to the End of Life. 2017 Avery, 1st Ed. ISBN-13: 978-1101982556

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Author information

Authors and Affiliations

  1. Internal Medicine, Coalition for Compassionate Care of California, Sacramento, CA, USA

    Lael Duncan MD

Authors
  1. Lael Duncan MD
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Corresponding author

Correspondence to Lael Duncan MD .

Editor information

Editors and Affiliations

  1. Department of Psychiatry, University of California School of Medicine, San Francisco, California, USA

    Steven A. Frankel

  2. Department of Psychiatry, Baylor Scott & White Health Central Texas Division, Temple, Texas, USA

    James A. Bourgeois

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Duncan, L. (2018). Advance Care Planning for Patients with Current and Future Medical Complexity. In: Frankel, S., Bourgeois, J. (eds) Integrated Care for Complex Patients. Springer, Cham. https://doi.org/10.1007/978-3-319-61214-0_23

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  • DOI: https://doi.org/10.1007/978-3-319-61214-0_23

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-61212-6

  • Online ISBN: 978-3-319-61214-0

  • eBook Packages: MedicineMedicine (R0)

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