ABSTRACT
Patients, family members, and providers face many challenges when managing serious illness. Those challenges arise at the point of diagnosis, continue through the application of curative treatments, and endure on through a turn to palliative and end-of-life (EOL) care. Across the continuum of the illness experience, two critical tasks are effective communication and informed decision-making. This chapter highlights evidence-based interventions designed to promote both. Several standardized protocols have been developed to guide clinicians through the disclosure of sensitive information and the communication of health-related material to their patients and care partners. In addition, resources have been developed for patients and family members, such as coaching interventions and question prompt lists, all designed to empower patients and care partners to obtain the information they need and to express their preferences for care. Complementary interventions include tools to help patients weigh options when they are faced with complicated medical scenarios and make decisions that are consistent with their values. These tools are designed to enhance comprehension of complex medical information by clarifying benefits and risks so that decisions are well informed. Despite advances in communication and decision science, many interventions have not been extensively evaluated, and questions remain about their generalizability to different patient populations, racial/ethnic groups, and across regions. Nonetheless, these interventions hold promise to enhance person-centered care across the illness trajectory.
