Goals of Care

Aligning patient priorities to provide person- and family-centred care.

Comfort Care

C2 (Comfort Care) Goals

  • Provide supportive care, symptom management and comfort measures within current location of care if possible.
  • Allow for natural death.
  • Patient-accepted transfer to emergency department for symptom control only.
  • No non-invasive positive pressure ventilation (NIPPV), intubation and/or vasopressors.

Resuscitation

  • No resuscitation in cardiac arrest.

C1 (Comfort Care) Goals

  • Provide supportive care, symptom management and comfort measures within current location of care if possible.
  • Allow for natural death.
  • Treatment which may prolong life to be decided in real time based on context and priorities.
  • Patient-accepted transfer to emergency department to be decided in real time based on context and priorities.
  • No non-invasive positive pressure ventilation (NIPPV), intubation and/or vasopressors.

Resuscitation

  • No resuscitation in cardiac arrest.

Selective Care

S2 (Selective Care) Goals

  • Provide medical treatment to cure or control symptoms and prolong life, excluding CPR. 
  • Allow for natural death.
  • Patient-accepted transfer to emergency department.
  • Non-invasive positive pressure ventilation (NIPPV) and/or vasopressors to be decided in real time, based on context and priorities.

Resuscitation

  • No resuscitation in cardiac arrest.

S1 (Selective Care) Goals

  • Provide medical treatment to cure or control symptoms and prolong life, excluding CPR. 
  • Allow for natural death.
  • Patient-accepted transfer to emergency department.
  • Provide care and treatment targeted to symptoms if possible.
  • Provide NIPPV and intubation (outside surgery) and/or vasopressors.

Resuscitation

  • No resuscitation in cardiac arrest.

Full Code

F (Full Code) Goals

  • Investigations, treatments and interventions should focus on cure or control of illness.
  • Prolonging life by all medically-effective means.
  • Provide treatment for reversible conditions.

Resuscitation

  • Full code/resuscitation including chest compressions, electrical cardioversion, intubation and assisted ventilation.

Guidance to LOI Designations

Please use the colour-coded guide below to help differentiate the different Levels of Intervention:

 

Please use this conversation guide to assist in discussing the different Levels of Intervention with patients and families:

Patient-centred priorities and Goals of Care: Understanding the Levels of Intervention on the Goals of Care Form

Nova Scotia Health, 2022