Abstract
Advance care planning (ACP) is the process of eliciting a person’s goals and values for future medical care, including at the end of life (EOL) and communicating these goals and values to caregivers and clinicians. Advance directives (AD) are written summaries of ACP conversations. There are many benefits and barriers to ACP for people with hematologic malignancies (HM). HMs affect a relatively younger population compared to solid tumors, and the prognosis is variable, ranging from cure to death. These factors make ACP challenging but extremely important because people with HMs may lose decisional capacity at some point in their illness trajectory. ACP can occur from diagnosis to the end of life (EOL), and topics explored will depend on where a person is on the disease trajectory. Clinicians can use open, honest communication to help their patients hope for the best while planning for other possibilities. Communicating prognostic uncertainty and normalizing the ACP conversation can prevent mistrust and anxiety. Resuscitation status conversations should occur in the context of a person’s overall disease trajectory and prognosis. Clinicians should make balanced recommendations based on a patient’s values and the medical reality to help patients with HMs receive the future medical care they value.
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Rao, V., Guyer, D. (2023). Advance Care Planning in Hematologic Malignancies and Other Serious Blood Disorders. In: Ullrich, C.K., Roeland, E.J. (eds) Palliative Care in Hematologic Malignancies and Serious Blood Disorders. Springer, Cham. https://doi.org/10.1007/978-3-031-38058-7_11
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