Doctor Palliative Care Goals of Care Note
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Create a goals of care conversation documentation framework for palliative situations.

Clinical context (placeholders):
- Setting: [inpatient/outpatient/home]
- Clinical situation: [serious illness/end of life/uncertain prognosis]
- Participants: [patient/family/surrogate]
- Prior advance directive: [yes/no/unknown]

IMPORTANT: Goals of care conversations require skilled clinicians — this is a documentation framework only.

GOALS OF CARE CONVERSATION FRAMEWORK

1. PREPARATION
   - Review medical history and prognosis
   - Know the patient's prior expressed wishes
   - Identify decision maker if patient lacks capacity
   - Choose appropriate setting: [private/quiet/seated]
   - Allow adequate time: [no rushing]
   - Bring support person if available

2. CONVERSATION STRUCTURE

   OPENING
   "I want to talk with you about what is most important to you
   as we think about your care going forward.
   I want to make sure we understand your wishes."

   ASSESS UNDERSTANDING
   "What is your understanding of where things stand
   with your illness right now?"

   EXPLORE VALUES
   "What matters most to you in your daily life?"
   "What are you hoping for?"
   "What are you worried about?"
   "Are there any health states that would be
   unacceptable to you?"

   DISCUSS PROGNOSIS (if appropriate)
   "I want to share with you what we know about
   what to expect..."
   Use: "We hope for the best while preparing for the worst"

   EXPLORE TREATMENT PREFERENCES
   "Given what you have shared, how does that affect
   what you would want if your condition worsened?"
   Discuss CPR, mechanical ventilation, artificial nutrition
   in context of their values — not as isolated decisions

3. DOCUMENTATION
   - Participants present: []
   - Patient capacity: [intact/lacking — surrogate]
   - Key statements from patient/family: [quote]
   - Goals identified: [comfort/function/life prolongation]
   - Specific decisions made: []
   - Code status: [full/DNR/DNI]
   - Advance directive: [present/to be completed]
   - Follow-up plan: []

Note: Palliative care conversations require specialized training — consider palliative care consultation

Source: https://promptzyo.com/prompt/doctor-palliative-care-goals-of-care-note