Doctors encouraged to talk about end-of-life care
The American College of Physicians (ACP) has recognized communication about care goals as a low-risk, high value intervention for patients with serious and life-threatening illnesses. While neither the physician nor the patient may be comfortable with such a conversation, the ACP reports that early discussions with a seriously ill patient can improve end-of-life outcomes including longer survival rates and better quality of life.
“Discussions about end-of-life care, especially early in the course of a life-limiting illness, are associated with care more consistent with patient goals and improved patient outcomes, including longer survival rates and better quality of life,” said Dr. David Fleming, president, ACP, in a release. “This approach is also associated with improved bereavement outcomes for family members.”
Effective communication involves sharing prognostic information, discussing trade-offs in care, learning patient priorities and decision-making preferences, and understanding fears/anxieties and the desired level of family involvement.
“It is important for physicians, patients, and their families to know that the evidence does not support the commonly-held belief that communication about end-of-life issues increases depression, anxiety, or loss of hope among patients,” Dr. Fleming said.
“I would concur with Dr. Fleming,” says Rev. Dr. Karrie Oertli, vice-president of mission and spiritual care at Advocate BroMenn Medical Center in Normal, Ill. “When the patient, family members, and the health care team can have open, frank conversations about end of life matters, I have observed that there is actually a release of tension, a greater sense of ease, and clear direction for all involved. This kind of communication is in itself a kind of healing experience.”
About the Author
Lynn Hutley, health enews contributor, is coordinator of public affairs and marketing at Advocate BroMenn Medical Center and Advocate Eureka Hospital in central Illinois. Having grown up in a family-owned drug store, it is no surprise that Lynn has spent almost 18 years working in the health care industry. She has a degree in human resources management from Illinois State University and is always ready to tackle Trivia Night.