Do Hispanics Prefer to be Full Code at the End of Life? The Impact of Palliative Care Consults in Clarifying Code Status Preferences in Spanish-Speaking Patients (S750)

Abstract

identify at risk inpatients who may benefit from earlier palliative care interventions. Research Objectives. To identify the prevalence of risk factors for geriatric oncology patients associated with increased length of stay, readmission rates, and morbidity. Methods. A protocol was initiated to trigger palliative care consults on patients ages 65 or older admitted to the oncology unit. Patients screened positive if they triggeredwithat least one responseonanine-questionworksheet. 101 geriatric oncology inpatients were screened over a two-year period at our 496 bed, tertiary care, academic, city hospital through the Trigger Program. Results. 98 of 101 patients screened positive and received a palliative care consult. 70 patients (71.4%) did not have an advanced directive, 45 patients (45.9%) did not have a healthcare proxy, 37 patients (37.7%) reported uncontrolled pain, and 33 patients (33.7%) lived alone. 22 of the 33 patients (66.67%) that lived alone did not have a healthcare proxy. The mean number of triggers was 3.25 per patient. Conclusions. Our program elucidated the proportion of geriatric oncology patients without advanced directives and healthcare proxies in our hospital and identified a concern for inadequate treatment of pain in this vulnerable population. We also found that most patients who live alone have not identified a surrogate decision maker. Implications for Research, Policy, or Practice. The extant literature shows that lack of an advanced directive is associated with increased hospital deaths, higher costs, and fewer hospice enrollments. We need to focus our attention on discussing advanced directives in these patients as early as possible to improve outcomes and patient experience. We hope that by triggering consults earlier in their hospital course, we can effectively target this population to improve their symptoms and outcomes.