A Structured Tool for Communication and Care Planning in the Era of the COVID-19 Pandemic

J Am Med Dir Assoc. 2020 Jul;21(7):943-947. doi: 10.1016/j.jamda.2020.05.062. Epub 2020 Jun 4.

Abstract

Residents in long-term care settings are particularly vulnerable to COVID-19 infections and, compared to younger adults, are at higher risk of poor outcomes and death. Given the poor prognosis of resuscitation outcomes for COVID-19 in general, the specter of COVID-19 in long-term care residents should prompt revisiting goals of care. Visitor restriction policies enacted to reduce the risk of transmission of COVID-19 to long-term care residents requires advance care planning discussions to be conducted remotely. A structured approach can help guide discussions regarding the diagnosis, expected course, and care of individuals with COVID-19 in long-term care settings. Information should be shared in a transparent and comprehensive manner to allay the increased anxiety that families may feel during this time. To achieve this, we propose an evidence-based COVID-19 Communication and Care Planning Tool that allows for an informed consent process and shared decision making between the clinician, resident, and their family.

Keywords: Advance care planning; COVID-19; long-term care; skilled nursing facility.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Advance Care Planning / organization & administration
  • COVID-19
  • Coronavirus Infections / epidemiology
  • Coronavirus Infections / prevention & control*
  • Decision Making, Shared*
  • Female
  • Health Planning / organization & administration*
  • Humans
  • Infection Control / organization & administration
  • Interdisciplinary Communication
  • Long-Term Care / organization & administration*
  • Male
  • Middle Aged
  • Pandemics / prevention & control*
  • Pandemics / statistics & numerical data
  • Patient Care Team / organization & administration
  • Pneumonia, Viral / epidemiology
  • Pneumonia, Viral / prevention & control*
  • Program Development
  • Skilled Nursing Facilities / organization & administration*
  • Survival Analysis
  • United States