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Sponsor: Ascension Health
Conditions: End of Life Care
Interventions: Counseling (Care giver burden focus), Counseling (patient autonomy focus)
Countries: United States
People with life-limiting illness often receive more aggressive healthcare than desired including costly procedures that provide little medical benefit. Advance Directives (AD) can reduce this effect but various factors limit their adoption. A randomized trial will target hospitalized patients with a serious, life limiting illness to test if the behavioral economics principles of endowment (possessing something) and focusing (featuring something important to patients) can motivate AD completion. Investigators will examine if offering patients an AD by default, in combination with framing the rationale for AD completion (emphasizing patient control or caregiver burden) improves AD completion and family conversation compared to a no-intervention group. The study hypothesis is to determine if rates of AD completion and family conversations will be highest among patients receiving the intervention focused on reduced caregiver burden; and if the two intervention groups will have higher rates of both than the control group. The investigators suspect that a small change in how patient information is framed (endowment and focusing used in tandem) will potentially leverage large increases in AD completion and that targeting HHC patients allows AD discussions early in the disease trajectory when they can participate in care decisions.
Sex: ALL
Age: 50 Years to —
Healthy volunteers: No
Study type: INTERVENTIONAL
Inclusion Criteria: * 50 years or older * One or more of the following: * Chronic obstructive pulmonary disease * End stge renal disease * Peripheral vascular disease * NYHA class II or V heart failure * Cancer * Neuromuscular / movement disorder Exclusion Criteria: * Patient referred to palliative care * Patient has advance directive * Patient has impaired decision making ability * Patient previously enrolled in this study
- Grand Blanc, Michigan, United States