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- Title
Harnessing the Chaplain's Capacity to Identify Unmet Palliative Needs of Vulnerable Older Adults in the Emergency Department.
- Authors
Howard, Elizabeth Hamill; Schwartz, Rachel; Feldstein, Bruce; Grudzen, Marita; Klein, Lori; Piderman, Katherine M.; Wang, David
- Abstract
Objective: To explore chaplains' ability to identify unmet palliative care (PC) needs in older emergency department (ED) patients. Methods: A palliative chaplain-fellow conducted a retrospective chart review evaluating 580 ED patients, age >80 using the Palliative Care and Rapid Emergency Screening (P-CaRES) tool. An emergency medicine physician and chaplain-fellow screened 10% of these charts to provide a clinical assessment. One year post-study, charts were re-examined to identify which patients received PC consultation (PCC) or died, providing an objective metric for comparing predicted needs with services received. Results: Within one year of ED presentation, 31% of the patient sub-sample received PCC; 17% died. Forty percent of deceased patients did not receive PCC. Of this 40%, chaplain screening for P-CaRES eligibility correctly identified 75% of the deceased as needing PCC. Conclusion: Establishing chaplain-led PC screenings as standard practice in the ED setting may improve end-of-life care for older patients.
- Subjects
PALLIATIVE treatment; TERMINAL care; MEDICAL decision making; QUALITY of life; COVID-19 pandemic
- Publication
Journal of Palliative Care, 2022, Vol 37, Issue 4, p480
- ISSN
0825-8597
- Publication type
Article
- DOI
10.1177/08258597211003359