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Medline ® Abstract for Reference 35

of 'Palliative care: Nursing home'

Goals of care toward the end of life: a structured literature review.
Kaldjian LC, Curtis AE, Shinkunas LA, Cannon KT
Am J Hosp Palliat Care. 2008 Dec;25(6):501-11.
Goals of care are often mentioned as an important component of end-of-life discussions, but there are diverse assessments regarding the type and number of goals that should be considered. To address this lack of consensus, we searched MEDLINE (1967-2007) for relevant articles and identified the number, phrasing, and type of goals they addressed. An iterative process of categorization resulted in a list of 6 practical, comprehensive goals: (1) be cured, (2) live longer, (3) improve or maintain function/quality of life/ independence, (4) be comfortable, (5) achieve life goals, and (6) provide support for family/caregiver. These goals can be used to articulate goal-oriented frameworks to guide decision making toward the end of life and thereby harmonize patients' treatment choices with their values and medical conditions.
Department of Internal Medicine, Division of General Internal Medicine, University of Iowa Carver College of Medicine, 500 Newton Road, Iowa City, IA 52242, USA. lauris-kaldjian@uiowa.edu