Taking the next steps in goal ascertainment: A prospective study of patient, team, and family perspectives using a comprehensive standardized menu in a geriatric assessment and treatment unit

OBJECTIVES: To examine the performance of an expanded menu of goals in a geriatric rehabilitation setting incorporating patient, family, and team perspectives. DESIGN: Prospective comparative study. SETTING: Inpatient geriatric rehabilitation unit. PARTICIPANTS: Nineteen consecutive eligible inpatients and their family members and seven unit team members. MEASUREMENTS: Each participant independently reviewed a standardized menu of medical, functional, psychosocial, spiritual, and future planning goals, which were compared with the goals set by the healthcare team. RESULTS: On average, patients and their family members agreed on goals about half the time; family members tended to have more goals than patients. Agreement between the team and patients and families was poor (kappas=-0.11-0.33). The team was less likely to identify functional, psychosocial, spiritual, and future planning goals. CONCLUSION: Patients and families have a broad range of goals that are not always identified by the healthcare team. A comprehensive standardized menu is feasible and may be helpful in setting goals in a geriatric rehabilitation setting.