What are the goals of care?

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Goals of care are the overarching aims, personal priorities, and expectations that guide a patient's medical treatment decisions based on their core values. They establish a shared understanding between the patient, their family, and the healthcare team about what matters most during serious illness.

You can learn more about how clinicians approach these talks through the UpToDate Discussion Guide. Additional formal context is also available in the PMC Literature Review on Goals of Care.

Core Components

  • Personal Values: What brings joy, meaning, and acceptable quality of life to the individual.
  • Medical Reality: A clear understanding of the diagnosis, prognosis, and treatment options.
  • Shared Decision-Making: Aligning medical interventions with the patient's explicit wishes.

Three General Approaches

  • Resuscitative Care: Using all appropriate medical and surgical interventions to prolong life and cure or control a condition.
  • Medical Care: Focusing on treating illness and extending life without relying on intensive or invasive life-support measures like an ICU.
  • Comfort Care: Prioritizing comfort and relief from symptoms rather than prolonging life (often part of palliative or end-of-life care).

What are some examples of goals of care?

Goals of care are broad medical directions or personal wishes that guide healthcare decisions based on a patient's values, preferences, and health status.

Common Categories of Goals of Care

  • Resuscitative Care: Aims to prolong life through intensive medical interventions, including cardiopulmonary resuscitation (CPR), intubation, mechanical ventilation, and intensive care unit (ICU) admission.
  • Medical Care (Life-Prolonging without Resuscitation): Aims to treat acute and chronic illnesses and prolong life, but explicitly excludes invasive measures like CPR or mechanical ventilation; often managed in a hospital or standard ward.
  • Comfort Care (Palliative/Hospice Focus): Focuses entirely on maximizing quality of life, relieving pain, and managing distressing symptoms rather than prolonging life or using life-sustaining procedures.

Specific Patient-Defined Examples

  • Functional Independence: Wanting to maintain the ability to live independently, feed oneself, or walk without assistance.
  • Milestone-Focused: Wishing to live long enough to attend a specific family event, such as a wedding, graduation, or a holiday.
  • Cognitive Engagement: Prioritizing treatments that allow a person to recognize loved ones, hold meaningful conversations, and stay mentally alert.
  • Environment Preference: Choosing to spend remaining time and pass away at home rather than in an ICU or clinical setting.

You can read more about planning these frameworks through Identifying Goals of Care or the UpToDate Discussion Guide.

What are the 7 core values of care?

The NHS Core Values and the wider health-and-social-care sector are most commonly defined by six core values (often paired with the 6 Cs of Care), though some frameworks blend principles to list seven values.

The Core Values of Care

  • Working together for patients: Putting patients and individuals first in all decisions and collaborating as a team.
  • Respect and dignity: Valuing every person as an individual, respecting their choices, and protecting their privacy.
  • Commitment to quality of care: Striving for best practices, safety, and continuous improvement.
  • Compassion: Responding to suffering with empathy, humanity, and kindness.
  • Improving lives: Striving to enhance overall health, well-being, and the quality of daily life.
  • Everyone counts: Ensuring fairness, maximizing resources, and making sure no one is left behind.
  • Courage (or Integrity): Often added as the seventh element (part of the 6 Cs or broader codes) to speak up and do the right thing for the safety of those in care.

What are the different goals of care?

Goals of care (GOC) categories classify a patient's overarching medical treatment plan and goals during an episode of care, particularly in the event of clinical deterioration.

Core Clinical Phases / Categories

In standard clinical frameworks (such as the Australian GOC framework), a patient's situation is commonly categorized into one of three primary phases of care based on treatment intent and prognosis:

  • Curative or Restorative: The primary aim is to cure, control, or reverse the disease process and restore the patient to their previous baseline health. This serves as the default position for admitted patients.
  • Palliative: The main focus shifts to maximizing comfort, maintaining quality of life, and managing symptoms when a chronic or serious illness is no longer curable.
  • Dying (Terminal): The condition is irreversible and death is imminent; all medical interventions are strictly focused on optimal comfort care and relieving suffering during the final stages of life.

Specific Treatment Designation Categories

Depending on local health policies (such as hospital Goals of Patient Care frameworks), these phases translate into actionable treatment ceilings or escalation limits:

  • All Life-Sustaining Treatment: Full active treatment, including intensive care unit (ICU) admission, mechanical ventilation, and resuscitation (CPR) if needed.
  • Life-Extended Intensive Treatment with Treatment Ceiling: Care within an ICU or high-dependency unit is considered, but specific interventions may be excluded based on patient values (e.g., no blood products or no CPR).
  • Active Ward-Based Treatment: Treatment is confined to standard hospital wards without transfer to an ICU, emphasizing comfort and life-extending measures that are non-burdensome.
  • Optimal Comfort Treatment: Exclusively focused on palliative and end-of-life comfort care, withholding life-prolonging interventions.

What are some good goals examples?

Good goals are specific, measurable, and tailored to different areas of your life like health, career, or personal growth.

Personal and Health Goals

  • Fitness Habit: Exercise for 30 minutes every day for the next month.
  • Sleep Routine: Sleep for 8 hours each night by following a fixed bedtime.
  • Hydration: Drink at least eight glasses of water every day.
  • Reading: Read 12 books over the next year (one book per month).

Professional and Career Goals

  • Public Speaking: Join a local group like Toastmasters International and present at one internal meeting by year-end.
  • Time Management: Use a digital planner daily and try the Pomodoro Technique to stay focused.
  • Networking: Grab coffee with one new colleague or industry contact each month.

Financial Goals

  • Debt Payoff: Pay off personal credit card debt within the next six months.
  • Emergency Fund: Save three months of living expenses in a high-yield savings account this year.

Goals of Care Designations

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What is the goal of care?

The goal of care is to align medical treatments and healthcare decisions with a patient's personal values, preferences, and priorities during serious or chronic illness.

Core Approaches to Care

  • Resuscitative care: Aims to prolong life using intensive medical, surgical, or ICU interventions (including intubation and chest compressions) to cure or control a condition.
  • Medical care: Aims to prolong life and treat a condition using active medical interventions, but excludes high-intensity measures like intensive care unit (ICU) admission or cardiopulmonary resuscitation.
  • Comfort care: Focuses primarily on maximizing comfort, relieving pain, and managing symptoms when life-prolonging treatments are no longer desired or effective.

Why Goals of Care Matter

  • Promotes autonomy: Ensures patients receive the care they actually want and avoid unwanted, burdensome interventions.
  • Guides clinical teams: Provides clear direction for doctors and nurses making acute or long-term treatment choices.
  • Reduces distress: Lowers anxiety and improves satisfaction for both patients and their families by establishing clear expectations.

Organizations like the Goals of Care Coalition of New Jersey provide helpful resources and frameworks to guide these essential discussions.

What are the five principles of care?

The five core values of general care practice are safety, dignity, independence, privacy, and communication.

The Five Core Principles of Care

  • Safety: Prevent injuries, infections, and harm by keeping environments secure and practicing clean habits like handwashing.
  • Dignity: Treat every person with respect, protect their self-esteem, and honor their personal worth as an adult.
  • Independence: Encourage individuals to do as much as possible for themselves to maintain their skills and health.
  • Privacy: Keep personal details confidential and protect a person's modesty and private space.
  • Communication: Talk and listen every day, making sure the individual stays involved in choices about their daily routine and medical support.

(Note: Depending on your specific training or region, "five principles of care" can also refer to the Health and Social Care Standards—which focus on dignity and respect, compassion, inclusion, responsive care, and wellbeing—or the legal rules of the Mental Capacity Act.)

What are 7 basic care needs?

The seven basic care needs typically refer to the core Activities of Daily Living (ADLs) used in healthcare to measure a person's ability to care for themselves.

The 7 Essential Activities of Daily Living

  • Bathing and showering: Cleaning the body and maintaining personal hygiene.
  • Dressing: Selecting appropriate clothes and putting them on.
  • Eating and drinking: Consuming and processing adequate nutrition and hydration.
  • Continence: Managing bladder and bowel control.
  • Toileting: Using the toilet safely and cleaning up afterward.
  • Mobility: Walking or moving around inside and outside the home.
  • Transferring: Moving safely between different positions, such as from a bed to a chair.

What are the three values of care?

While health and social care frameworks typically use a broader set of principles (such as the 6 Cs of Care which include care, compassion, competence, communication, courage, and commitment), informal caregiving discussions often focus on the foundational 3 Cs of caregiving: compassion, communication, and commitment.

The 3 Cs of Caregiving

  • Compassion: Caring with empathy, respect, and dignity, treating the individual the way you would want to be treated.
  • Communication: Listening actively and sharing clear information so the person receiving care stays actively involved in their own choices.
  • Commitment: Showing up consistently and responsibly every day to keep the care steady and reliable.

How to discuss goals of care?

A goals of care discussion is a conversation between a patient, their family, and their healthcare team to align medical treatments with the patient's personal values, wishes, and priorities.

You can follow a step-by-step framework like the VitalTalk REMAP Guide to structure the conversation effectively:

Preparation and Setting

  • Choose a quiet space: Find a private, comfortable place where everyone can sit down unhurried and face-to-face.
  • Involve support: Invite key family members, loved ones, or a trusted surrogate decision-maker to join.
  • Review the medical facts: Know the current diagnosis, recent changes in health, and realistic treatment options before you start.

Step-by-Step Approach (REMAP)

  • R – Reframe the situation: Highlight changes in health or the limits of current treatments so everyone understands the clinical context is shifting.
  • E – Expect and explore emotion: Listen closely, watch for emotional reactions, validate feelings, and use comforting silence to let the news sink in.
  • M – Map out values and goals: Ask open-ended questions about what matters most to the patient (e.g., spending time at home, maintaining alertness, or avoiding heavy machinery).
  • A – Align with the patient: Connect the medical choices directly to the values the patient shared. State clearly that the care plan will respect their personal priorities.
  • P – Propose a plan: Recommend a medical treatment plan that fits those goals, and agree to revisit the discussion as health needs change.

For deeper clinical insights and guidance on these conversations, you can review the medical recommendations on UpToDate or explore the best practices outlined by ACP Decisions.