Initial Advanced Care Planning in Elderly Heart Failure Patients Admitted to Acute Care Hospitals

Abstract

[Purpose] To clarify the actual situation of Initial Advance Care Planning (ACP) used for elderly heart failure patients admitted to an acute care hospital and to obtain suggestions for future ACP methodology.

[Methods] A observational study on medical records of 17 elderly heart failure patients admitted to an acute care hospital. The patients were asked to discuss their ACP medical choices in case of future deterioration.

[Results] The mean age of the patients was 84 years, about 80% were first-time heart failure patients, and 70% were transported by ambulance. 16 patients defined their values, 11 patients described their preferred place of care, 13 patients decided on their future medical care, and 2 patients designated their advocate. Some of the stated values included, “I don’t want to live long,” and “I want to die in my sleep.” Among the 11 elderly first-time patients that discussed their future medical care, 7 indicated a preference for no invasive treatment.

[Conclusions] The results provided important suggestions for avoiding treatments and procedures that are not desired by elderly heart failure patients themselves. Even for elderly first-time heart failure patients having their initial ACP discussions, it is advisable to confirm the patient’s values and medical treatment preferences.