The old adage that a picture is worth a thousand words appears to ring true for critically ill patients.

A study of people with advanced heart failure shows that those who watched a short video depicting different levels of end-of-life care are more likely to choose comfort care over invasive care that could prolong their life.

These patients were more knowledgeable about care levels and more likely to discuss end-of-life care with their doctor, the researchers report.

In the study, 246 advanced heart failure patients (average age 81) from 7 US hospitals were given a verbal description of 3 levels of care they could receive at the end of their life:

  • life-prolonging care, including CPR, intubation and being placed on a ventilator;
  • limited care, including intravenous therapy and hospitalisation, but not CPR or ventilation; and
  • comfort care, typically delivered at home with a focus on quality of life, but including hospitalisation if required for symptom relief.

Half of the participants were then randomly assigned to watch an advance care planning video.

The researchers found the video watchers were more informed, more likely to select a focus on comfort and less likely to want CPR /intubation compared with patients receiving verbal information only.

“In this study, the video tool improved patients’ understanding of their options, influenced their preferences and served as a catalyst to actually having the conversation with their clinician,”  write the researchers in Circulation.

They conclude that advance care planning videos could have wide application.

Last Reviewed: 30/06/2016

Reproduced with kind permission from


Randomized, Controlled Trial of an Advance Care Planning Video Decision Support Tool for Patients With Advanced Heart Failure.