As patients near the end of their lives, they are often unable to understand and engage in complex medical decision-making. Advance care planning (ACP) is designed to allow patients to maintain a locus of control at the end of their lives. Although there has been recent controversy about the benefits of ACP, prior work has shown that engagement in ACP is associated with a higher likelihood of dying in a preferred location, superior hope at the end of life, less anxiety surrounding death for patients, and decreased decisional anxiety for caregivers. Despite the acknowledged importance of ACP, data consistently show that ACP often occurs late in the course of a patient’s disease or not at all. This research shows that nurse-led primary palliative care is a promising approach to improve ACP among patients with advanced cancer, particularly for those without access to specialty palliative care.
Links: Journal of the National Comprehensive Cancer Network (4/2023)