Please select the eligibility criteria that correspond to the clinical trial below.
Title: Advance Care Planning: A Way to Improve End-of-life Care
Brief Summary: Communication about end-of-life issues is often suboptimal. A way to improve the quality of end-of-life care is Advance Care Planning (ACP). ACP is a discussion between an incurable ill patient and the health professionals about preferences for end-of-life care. In Denmark, there is no tradition of systematic communication with patients about end-of-life care. The aim is to investigate how ACP can be beneficial among incurable ill patients treated in an outpatient context and if the concept is feasible in a Danish context. The study is designed as a prospective randomised controlled trial. Patients from relevant departments will be included and randomised in two groups: one receiving usual care and the other receiving usual care and ACP. Data will be collected from Electronic Patient Files and from questionnaires. If ACP is effective, it will improve the quality of end-of-life care for patients and their families and reduce the psychological distress in the bereaved relatives.


Options:
A: Inclusion Criteria:

* Adult patients who have advanced heart failure and are being evaluated for DT LVAD
* Caregivers of patients who are being evaluated for DT LVAD

Exclusion Criteria:

* Under 18 years of age
* Non-English Speaking
* Unable to consent
* Prisoner
* Already implanted with DT LVAD
B: Inclusion Criteria:

1. A diagnosis of advanced heart failure as defined by ALL THREE of the following:

   • New York Heart Association Class III or IV (NYHA III or IV) (III: marked limitation in activity due to symptoms, even during less-than-ordinary activity; IV: severe limitations, experiences symptoms while at rest).

   AND
   * Hospitalization for heart failure within the last six months. AND
   * Age greater than or equal to 65.
2. Additionally ONE of the following must be met:

   * According to the attending physician's best judgment the patient's survival is limited to 2 years but may very well be less than 1 year (i.e. the physician would not be surprised if the patient died within one year from any cause) OR
   * Three heart failure hospitalizations in the last year OR
   * One of the following:

     * Two Systolic Blood Pressures \< 90 within the last 6 months in the ambulatory setting
     * Na \< 130 within the last 6 months
     * NTproBNP \> 3,000
     * EGFR \< 35
     * High diuretic use (160 mg po Lasix or 100 mg po torsemide or equivalent total daily dose)

Exclusion Criteria:

* New patient
* A transplant or mechanical circulatory support candidate
* Major psychiatric illness as determined by the attending that would make this study inappropriate.
* Any patient that has been excluded for transplant or mechanical circulatory support due to psychological or psychiatric co-morbidities.
C: Inclusion Criteria:

* Eligible patients from the departments of oncology, cardiology and respiratory medicine at Aarhus University Hospital
* the patient is over 18
* acceptable Danish language skills

Exclusion Criteria:

* cognitive impairment
* expected to dy within the next month
* has no relatives
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: C