The investigator will measure quantitatively and qualitatively whether patients found this intervention acceptable and provided suggestions for its improvement.

The investigators will ask the emergency department clinicians who administered the intervention to report the intervention acceptability using a Likert scale survey.

The clinicians administrating the intervention are part of the research team and are not subjects of the clinical trial per NIH definition because they are not prospectively assigned to an intervention (they are the intervention itself), and the outcomes assessed from them were not health-related. The mean acceptability using a Likert scale (0 not acceptable, 1-4 somewhat unacceptable, 6-9 somewhat acceptable, and 10 completely acceptable).

The investigators will measure patient's quality of life using a validated survey measure (Quality of life at the end of life, QUAL-E, Steinhauser et al. 2004) at baseline and after the intervention. QUAL-E consists of 25-items and measures 4 domains (symptom impact, relationship with the healthcare provider, preparation for the end of life, and life completion). Each item is in a 5-point Likert scale ranging from (1 Not at all to 5 Completely), and lower scores indicate better outcomes for all domains except for the preparation for the end of life domain and life completion domain where higher scores indicate better outcomes. The mean composite score is compared between baseline and 1 month after the intervention.

Patients found this survey too long to complete when they just left the emergency department after acute health decline. Further, the questions were making patients think more about the end of life, which may skew our aim. Therefore, we decided to stop collecting this outcome after the first 9 patients. Only 3 out of those 9 participants completed their 1-month QUAL-E assessment.

The investigators will measure patient's behaviors and actions for completing advance care planning using a validated survey measure (advance care planning engagement survey, Sudore et al 2017) at baseline and after the intervention. The measure is a 4-item survey measuring actions and behaviors of advance care planning. The additive composite score is calculated and ranges from 1 (least engagement) to 5 (most engagement).

The investigators will measure patient empowerment by using a validated survey measure (Patient Activation Measure, PAM™) at baseline and after the intervention.

We did not collect this outcome as the "advance care planning engagement survey" was felt to be better suited for this study.

The investigators will measure patient anxiety/distress regarding a particular event (in this case, our intervention) by using a validated survey measure (Impact of Event Scale - Revised, IES-R, Weiss 1996) within a week after the intervention. IES-R is a 22-item, 5-point Likert scale measure (ranging from 0 Not at all to 4 Extremely).

Results consist of the mean rating for the total score and raw scores for three subscales:

The Avoidance Scale, Intrusion Scale, and the Hyperarousal Scale.

The scores give an indication of the level of impairment from post traumatic stress, where: 0 = No symptoms 1 = Few symptoms 2 = Moderate symptoms 3 = A High level of symptoms 4 = An Extremely high level of symptoms

We stopped collecting this outcome after the first 8 patients because patients did not express any clinically meaningful anxiety/distress due to our intervention. Furthermore, a much more traumatic event for these patients seemed to be the recent emergency department visit or hospitalization, which made this scale not appliable.