Friday, October 2, 2009

Barriers and Benefits of End-of-Life Discussions with Doctors (Video 1:56 mins.)

Unless we are sure we will never experience physical death, we should all take advantage of preparing for the inevitable long before illness even comes. Not having productive discussions about end-of-life options hinders opportunities to make informed choices, including the choice of hospice care. However, patients’ reluctance to discuss end-of-life options is not the only barrier to their receiving hospice care. As this research shows, doctors can play an important role in delaying hospice discussions that provide benefits to patients and their families:

In a two-year experiment involving interviews with 215 elderly, terminally ill patients, Yale University Medical School researchers determined that factors most strongly associated with hospice discussions were clinicians' estimate of and certainty about patient life expectancy. Unfortunately, clinicians were unable to anticipate the deaths of a considerable portion of patients (40%). Results concluded that, ultimately, “patients' use of hospice, relies largely on clinician estimates of patient life expectancy and the predictability of disease course.” This is another reason why patients should finalize their end-of-life care wishes in writing well in advance. You can read more here about this research on determining hospice discussion.

What are benefits of having end-of life discussions with doctors? This video, which refers to a study at Boston’s Dana-Farber Cancer Institute, shows how these conversations with doctors promote dignified death journeys that help patients and their families.

Frances Shani Parker, Author
"Becoming Dead Right: A Hospice Volunteer in Urban Nursing Homes”
“Hospice and Nursing Homes Blog”

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