The goals of care conversation: a tool to improve patient care in the nursing home at the end of life.

Patients residing in nursing homes may undergo burdensome transitions in care during the final months of life. They may get care they do not want and are unlikely to benefit from. Patients and families may not understand prognosis or the potential benefits of treatment. A "goals of care" conversation can be the critical first step in identifying a patient's wishes and then developing a plan of care that honors those wishes. When the goal of care is to focus on comfort, hospice can be accessed. Hospice can help ensure that the patient's final time is spent in comfort and that the family's needs are attended to both before and after the patient dies.