When end-of-life goals change, what is a recommended approach?

• A. Ignore changes and keep initial goals.
• B. Reassess, involve family, respect goals, and update documentation.
• C. Only document changes if asked by medical team.
• D. Discuss goals only at diagnosis.

Answer: (B)

When end-of-life goals change, the important idea is to actively reassess and align care with the patient’s current values and medical reality. Revisit the goals, have open conversations with the patient (if possible) and with family or designated surrogates, and update the care plan accordingly. This approach honors autonomy, clarifies what matters most now, and helps everyone understand how decisions should be made as circumstances evolve. Involving the family supports shared decision-making and ensures the chosen path reflects known preferences, while updating documentation—such as advance directives, code status, and goals-of-care orders—provides clear, actionable guidance for the care team and reduces the risk of conflicting or unwanted interventions. Goals of care should be reviewed and updated whenever the situation changes, not only at diagnosis or at others’ prompting.