We know that many older patients with serious illness want to maintain quality of life rather than prolong it. However, the use of aggressive life-sustaining technologies in this vulnerable population is common. Instead of having a peaceful end-of-life experience, they are receiving invasive medical treatments during the last days of their lives. A national, multi-year study involving seriously ill, older Canadians revealed that even though 28% of the participants stated a preference for “comfort care” (no curative treatments), this was documented in only 4% of charts.
iCAN-ACP is a new 3-year national study that aims to improve this situation by introducing and evaluating advance care planning tools that we hope will result in more, earlier and better conversations between older adults, families and the health care team. Advance care planning involves thinking about and communicating your preferences for care in a way that expresses your values. It also includes choosing someone to be your Substitute Decision Maker, someone who could speak for you and make decisions if you couldn’t speak for yourself.
The iCAN-ACP study, funded by the Canadian Frailty Network, is being conducted in long-term care homes, family doctor’s offices and hospitals across Canada, bringing together a team of 32 investigators from 16 universities, five international collaborators and 42 partner organizations. Team members will be working with elderly Canadians living with frailty and their families to evaluating and tailor ACP tools in all of these settings, while paying particular attention to the needs of marginalized groups in this demographic.
John You, MD, MSc, FRCPC — McMaster University (Project Leader)
Michelle Howard, PhD, MSc — McMaster University (Deputy Project Leader)
Doris Barwich, MD, CCFP — University of British Columbia
Gloria Gutman, PhD, FCAHS, OBC, LLD(Hon.) — Simon Fraser University
Dev Jayaraman, MD, MPH – McGill University
Sharon Kaasalainen, RN, BScN, MSc, PhD — McMaster University
Daniel Kobewka, MD FRCPC MSc — University of Ottawa
Jessica Simon, MBChB, FRCPC — University of Calgary
Amy Tan, MD, MSc, CCFP(PC), FCFP — University of Calgary
Tamara Sussman, MSW, PhD — McGill University
Robin Urquhart, PhD — Dalhousie University
This research is funded by Canadian Frailty Network (known previously as Technology Evaluation in the Elderly Network, TVN), supported by Government of Canada through Networks of Centres of Excellence (NCE) Program.