An Approach of Advance Care Planning in Emergency and Intensive Care

Abstract

In Japan's hyper-aged society, many elderly people in the final stages of life are transported to emergency and intensive care facilities. However, many of them have not done Advance Care Planning（ACP）, and emergency/intensive care physicians need to perform “emergency ACP”. In the United States, there is a large body of evidence that communication skills training for intensive care providers enables better ACP. The authors have developed a Japanese version of Vital Talk, a well-known training method. This paper illustrates the communication skills advocated by the Japanese version of Vital Talk, and describes a method for emergency/intensive care providers to better communicate “bad news” to patients and their families, including frail elderly patients in the final stages of life, and to provide “emergency ACP” that respects the patient's sense of values.