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Discussing treatment limitations in frail older COVID-19 patients: A Framework Analysis.
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  • Sophie Lochtenberg,
  • Elise Pel,
  • Roeline Pasman,
  • Peter Noordzij
Sophie Lochtenberg
VU University Medical Centre Amsterdam

Corresponding Author:[email protected]

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Elise Pel
Erasmus Medical Center
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Roeline Pasman
Amsterdam UMC Location AMC
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Peter Noordzij
Sint Antonius Ziekenhuis
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Aims and objectives: The COVID-19 pandemic caused an increase in hospitalizations for frail older people and required healthcare professional to make difficult ethical and medical decisions regarding intensive care unit admission and treatment. This study investigates the experiences of healthcare professionals with the use of a decision support tool when discussing treatment limitations with older patients with COVID-19. Methods: A qualitative approach was chosen to obtain further in-depth information on the experiences of the healthcare professionals with the conversations about treatment limitation and on the contribution of a decision support tool for frail older adults with COVID-19. The framework method was used for the data analysis. Results: The following themes illustrate the analyzed concepts for the subject conversations about treatment limitation: careful consideration, the conversation is a part of the job, the burden of the conversation, scheduling conversation and acquiring skills to perform the conversation. The concepts of the theme AGE-ICU evaluation are included in the following themes: considered and comprehensible overview, confirmation of own assessment, every decision is context and person dependent, contributes to considered decision and tool not needed because of own expertise. Conclusion: A decision support tool for older patients with COVID-19 may help the healthcare professional to objectify the patients’ health status and functioning and discuss risk factors for adverse outcomes. Besides this, the tool helps to initiate the difficult conversation with the patient and their family. Finally, the AGE-ICU contributes to shared-decision making because it helps patients to understand the suggested decision and patients are more involved in the decision-making process.