Abstract

BackgroundOlder patients with multiple morbidities are a particularly vulnerable population that is likely to face complex medical decisions at some time in their lives. A patient-centered medical care fosters the inclusion of the patients’ perspectives, priorities, and complaints into clinical decision making.MethodsThis article presents a short and non-normative assessment tool to capture the priorities and problems of older patients. The so-called LAVA (“Life and Vitality Assessment”) tool was developed for practical use in seniors in the general population and for residents in nursing homes in order to gain more knowledge about the patients themselves as well as to facilitate access to the patients. The LAVA tool conceptualizes well-being from the perspectives of older individuals themselves rather than from the perspectives of outside individuals.ResultsThe LAVA tool is graphically presented and the assessment is explained in detail. Exemplarily, the outcomes of the assessments with the LAVA of three multimorbid older patients are presented and discussed. In each case, the assessment pointed out resources as well as at least one problem area, rated as very important by the patients themselves.ConclusionsThe LAVA tool is a short, non-normative, and useful approach that encapsulates the perspectives of well-being of multimorbid patients and gives insights into their resources and problem areas.

Highlights

  • Older patients with multiple morbidities are a vulnerable population that is likely to face complex medical decisions at some time in their lives

  • We present an assessment tool that is able to capture the priorities and problems of older patients that is based on a rather playful and nonnormative approach

  • It could be that the non-normative approach of the Life and Vitality Assessment (LAVA) tool – sorting a number of live aspects by using small plates to indicate satisfaction or dissatisfaction with life – made it easier for the patient to point out this problem area

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Summary

Introduction

A patient-centered medical care fosters the inclusion of the patients’ perspectives, priorities, and complaints into clinical decision making. Older patients with multiple morbidities are a vulnerable population that is likely to face complex medical decisions at some time in their lives. They differ from patients suffering from only one disease in a number of important aspects: (1) Irreversible disease burden. Person-centeredness has been advocated as an important dimension of the quality of health care

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