Palliative/End of Life

Advanced care planning: Accounting for changing perspectives

GeriPal is rethinking advanced care planning (ACP).

Rather than focusing on making prespecified decisions, ACP should help patients and their families make the best possible in-the-moment decisions.

GeriPal’s inspiration comes from a recent article by Rebecca Sudore and Terri Fried.

Patients’ goals and preferences change as their health and circumstances change. For example, many healthy elders would say that living with disability is unacceptable to them. However, once they become disabled, they adapt. and their view of quality of life and treatment preferences change to reflect their new perspective.

The bottom line?

The article contains many suggestion for helping patients prepare for in-the-moment decisions. GeriPal lists and expands on a few of them.

  • Help motivate patients to prepare.
  • Help clarify values.
  • Clarify whether values have changed.
  • Establish whether the patient wants to give the surrogate leeway in decision-making.

9/21/10 11:17 JR

Hi, I’m JR

John Russo, Jr., PharmD, is president of The MedCom Resource, Inc. Previously, he was senior vice president of medical communications at, a complementary and alternative medicine website.