How to Accommodate the Emotional Dimensions of Advance Care Planning Using Motivational Interviewing and Conditional Medical Orders.

Palliative care discussions offer a unique opportunity for helping patients choose end-of-life (EOL) treatments. These are among the most difficult decisions in later life, and protecting patients\u27 ability to make these choices is one of healthcare\u27s strongest ethical mandates. Yet, traditional approaches to advance care planning (ACP) have only been moderately successful in helping patients make decisions that lead to treatments concordant with their values. In particular, neglect of attention to the emotions that occur during consideration of the end of one\u27s life contributes to patients\u27 difficulty with engaging in the process and following through on decisions. To improve ACP outcomes, providers can address the patient\u27s emotional experiences, and can use motivational interviewing as a way attend to elicit them and incorporate them into care planning. Applying personalizing emotion-attuned protocols like Conditional Medical Orders (CMO) also promotes this end