Table 3.

Advance Care Planning

Sometimes patients are too sick to let their care team know their treatment preferences when they are hospitalized. Before surgery, what did you have in place to let your family know the type of care you would want if you became too sick to speak for yourself?
Previous advance care planning
Documentation of ACP	“I have a living will, everything is spelled out, signed legally, from a lawyer, so it’s all very clear.” -76YM
Transfer of responsibility to surrogate decision maker	“My daughter has all the rights to say yes or no. I took care of her when she was a child, she takes care of me now.” -84YF
During the treatment episode
No recollection of review of goals of care	“I mean I think I have a DNR, I have a health care proxy. But my husband said [these documents] really wasn’t discussed.” -65YF
Future advance care planning
Reflections on mortality	“So, it was emergency, you know it wasn’t planned, and it wasn’t uh it wasn’t welcomed except that it kept me from dying so that’s a really good thing [laughs]. When you reach our age, you know you bury parents, you frequently bury you know sibling, you you’ve you know you’ve buried friends, you’ve experienced medical crisis among your relative and friend circles. These are conversations that my generation has, I think.” -69YF
Avoidance of future	“Oh god I don’t even want to contemplate the possibility. I have no idea.” -83YF “I don’t want to think about it. I’ve had three surgeries, believe me I don’t think I would survive another one, but hopefully I won’t need one.” -85YF