Centering Patient Autonomy in Hospital Care for Older Adults, with Valerie Louis

Hospitalized older adults are often not asked about their goals of care until a health crisis occurs—if at all. In the absence of documented preferences, the default is to initiate full resuscitative measures, which may not align with patient values or best interests.

Valerie Louis, a medical student at Northern Ontario School of Medicine University in Canada, is working on addressing this unmet need and empowering elderly patients in their care with the AKmeGOC (goals of care) study. She presented an overview of the study and the electronic tool she and her colleagues developed that documented elderly patients’ preferences and goals for their care before a health crisis at the American College of Physicians (ACP) Internal Medicine (IM) Meeting 2025, held April 3-5, in New Orleans, Louisiana.

HCPLive caught up with Louis during the meeting to learn more.

Louis and colleagues found that after using the tool and having conversations with elderly patients about their care, the proportion of patients who had no preferences documented in their charts dropped from 25% to 4% in the intervention group. Furthermore, the number of ICU days dropped by 30% for patients who got the conversation, and the number of ventilator days dropped by 60%.

“The 2 big things we’re working on are… letting patients have their own autonomy in decision making, it's their care, they should be the ones making the decisions; and reducing low value care, so reducing care that isn't actually beneficial for them. By scaling up this tool and expanding also to primary care offices or long-term care homes as well… are all things that we're working on expanding,” Louis told HCPLive during the meeting.

REFERENCE

Louis V. Assessment of Shared Decision-making Tool for Eliciting Informed Goals of Care in the Hospitalized Elderly: A Randomized Trial (ASKmeGOC Study). Presented at: ACP IM Meeting 2025; April 3-5; New Orleans, Louisiana.