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And Lauren Ferrante has found in a study published in JAMA Internal Medicine that trajectories of disability in the year prior to ICU admission were highly predictive of disability post-ICU, on the same order of magnitude as mechanical ventilation. Julien: He basically had an end of lifecare discussion with this patient.
I think that those hospital modalities at VITAS were able to bring high-flow oxygen and other breathing modalities into the home. We’re able to provide IV treatments, and we’re even able to do home extubations with ventilator support. Fried: I think end-of-lifecare truly needs to be reimagined.
So when I was in my last year of pulmonary critical care fellowship, we had two week elective. Kate: And I kept saying, I want to do end of lifecare research with Scott Halpern and that’s what I did. Alex: So the proven trial was that the video in the nursinghomes? Kate: Yeah, the nursinghomes.
And typically, in the education around facilitating those conversations, we’re focused on eliciting goals and what are that individual’s goals of care and how does that direct the plan right now, knowing that some of those decisions, even if you make a choice now aren’t actually going to come into play for days, weeks, months.
A lot has changed, but what motivated the study was a recognition that most advanced care planning interventional research had been undertaken in nursinghomes. Eric 19:31 So it was interventions like feeding tubes, mechanical ventilation, dialysis at the very end of life. Wait, how is that actually defined?
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