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Chaplains Effective in Facilitating Advance Care Planning

WEDNESDAY, Jan. 17, 2018 -- Offering patients a meeting with a chaplain can facilitate advance care planning (ACP) in medical practice, according to a research letter published online Jan. 16 in JAMA Internal Medicine.

Aoife C. Lee, from Rusk Oak Park Hospital in Illinois, and colleagues examined the feasibility of having a board-certified chaplain conduct ACP conversations with patients in the physician's office. Participants were age 70 years or older, decisional, and had no record of an advance directive (AD) in their electronic medical record. The chaplain identified patients who met the project criteria; physicians introduced the patients to the project and to the chaplain. Sixty patients were invited to meet the chaplain.

The researchers found that all patients agreed to meet the chaplain; the mean time of the consultation was 23 minutes. In association with these meetings, 80 percent of patients completed an AD or provided documentation of an existing AD for their medical record. The topics discussed with the chaplain included current life circumstances, family members and support system, experience with critical illness and end of life decisions, palliative care and hospice, and the role of faith in their lives and influence of belief on health care decision making.

"The project demonstrated that it is feasible and acceptable for a qualified chaplain to conduct ACP conversations in a medical office and that most of these conversations (80 percent) led to completion or documentation of ADs," the authors write.

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Posted: January 2018