Please select the eligibility criteria that correspond to the clinical trial below.
Title: Palliative Care to Improve Quality of Life in CHF and COPD
Brief Summary: Chronic heart failure (CHF), chronic obstructive pulmonary disease (COPD), and interstitial lung disease (i.e., pulmonary fibrosis) are common serious illnesses. Despite disease-specific medical care, people with these illnesses often left with poor quality of life (i.e., burdensome symptoms, impaired function). Furthermore, while these illnesses are leading causes of hospitalization and mortality, few people with these illnesses engage in advance care planning, the process of considering and communicating healthcare values and goals. The investigators are conducting a randomized clinical trial to study a symptom management, psychosocial care and advance care planning intervention to improve quality of life. The study is important because it aims to improve quality of life and provision of care according to peoples' goals and preferences in common, burdensome illnesses. Furthermore, this study will generate information that supports the broader dissemination and implementation of the intervention and informs the development of future palliative care and team-based interventions in the VA.


Options:
A: Inclusion Criteria:

* At high risk for impending death in the next 12 months

Exclusion Criteria:

* Patient not having decision-making capacity
B: Inclusion Criteria:

Patient participant:

* Patients must be 21 years old or older and must be diagnosed with advanced heart failure (New York Heart Association Class III and IV). Patients must be aware of their diagnosis
* Caregiver/Decision-maker participant: Subject must be 21 years old or older Participant must be either

  * appointed substitute decision maker or
  * most likely to be substitute decision maker for patient (if patient were to lose decision-making capacity)

Exclusion Criteria:

* Patient participant: Patients must not have any psychiatric or cognitive disorders
* Caregiver/Decision-maker participant: Cannot be a maid or foreign domestic worker
C: Inclusion criteria:

1. Diagnosis of HF from either systolic or diastolic dysfunction, with an ejection fraction of ≤ 40%
2. Completion of an outpatient HF visit within the past 6 months
3. Ability to read, write, and speak in English

Exclusion criteria:

1. Short BLESSED cognitive score \> 10 to rule out significant cognitive impairment;82
2. Diagnosis of any additional terminal illness with life expectancy of ≤ 1 year not related to heart disease
3. Psychiatric illness that required hospitalization in the past year; and (4) age less than 18 years
D: Inclusion Criteria:

* Veterans enrolled in VA Eastern Colorado Health Care System or VA Puget - Sound Health Care System
* Diagnosis of CHF, pulmonary fibrosis, or COPD in 2 years prior to enrollment
* High risk for hospitalization and death
* Poor quality of life
* Symptomatic
* Primary care or other provider who is willing to facilitate intervention medical recommendations
* Able to read and understand English
* Consistent access to and able to use a standard telephone

Exclusion Criteria:

* Previous diagnosis of dementia
* Active substance abuse
* Comorbid metastatic cancer
* Nursing home resident
* Heart or lung transplant or left ventricular assist device (LVAD)
* Currently receiving hospice, palliative or home-based primary care
* Currently pregnant
* Currently a prisoner

Answer: D