Can palliative care help older ICU patients and their families?

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Patient Inclusion Criteria 1. Admitted to a participating study ICU 2. Age greater than or equal to 60 years 3. Meets one or more of the following acute or chronic triggers for PC consultation Acute: * Cardiac or respiratory arrest with coma * Ischemic or hemorrhagic stroke requiring mechanical ventilation * ICU admission after hospital stay of greater than or equal to 10 days or ICU readmission within 30 days * Age greater than or equal to 80 and 1 or more forms of organ support * Multiorgan system failure * CCM physician judgment of greater than or equal to 50% risk of in-hospital death or new severe long term functional impairment Chronic: * Admission from a SNF or LTACH with progressive functional decline * Metastatic (stage IV) cancer or advanced cancer without curative treatment * End stage cardiorespiratory disease * End stage liver disease * Advanced dementia or other end-stage neurologic disease * Age greater than or equal to 80 with two or more major comorbidities * Moderate-severe frailty (excluding stable intellectual or physical disability 1. Pittsburgh Cardiac Arrest Category (PCAC) greater than or equal to 2 2. Organ support: RRT, invasive or non-invasive mechanical ventilation, vasopressors 3. Sequential Organ Failure Assessment (SOFA) score greater than or equal to 10 4. Model for End-Stage Liver Disease (MELD) greater than or equal to 30 5. Major comorbidities defined by Charlson Co-morbidity Index (CCI) 6. Clinical Frailty Scale (CFS) score greater than or equal to 6 Patient Exclusion * No surrogate decision maker * Already received (or refused) a Palliative Care consultation during the same hospitalization * Determined to be imminently dying (within hours) by CCM physician * Within 1 year of receiving organ transplant, or actively undergoing work-up for organ transplant * Non-English speaking Surrogate Inclusion * Primary surrogate, as determined by the patient's advance directive or by the hierarchy codified in state law * Up to 3 additional surrogates Surrogate Exclusion * Age \<18 * Cannot read or understand English * Cannot complete surveys due to physical or cognitive limitations Clinician Inclusion •Patient's primary attending (or their designee)