Doctors should discuss end of life with terminal patients and families, says Queen's expert
Doctors treating people with advanced terminal diseases should openly discuss their patients’ approaching death and help them make preparations with their families, says a Queen’s University expert in end-of-life care.
Daren Heyland, professor of Medicine at Queen’s and research director at the Clinical Evaluation Research Unit at Kingston General Hospital, heads a new study that shows patients who have this conversation are more satisfied with their care than those who don’t. They are also more likely to engage in other forms of advanced care planning and request a home death, the study revealed.
“Although such discussions are considered a key part of good end-of-life care, this doesn’t happen very often, thus denying patients and their families an opportunity to bring closure to life and put their affairs in order,” Dr. Heyland says. “Honest, timely and complete communication is a key determinant of overall satisfaction with care.”
One of the reasons doctors don’t discuss death with their patients is that they don’t want to destroy hope, he continues. “But our study shows for the first time that when the prognosis is discussed with seriously ill patients and their families, satisfaction with care may be greater, especially satisfaction with communication and decision-making.”
Published today in the international journal OPEN Medicine, the study surveyed a total of 440 patients with cancer or end-stage diseases and 160 family members at five Canadian hospitals. Only 18 per cent of patients and 30 per cent of families reported that they had had a discussion with their doctor about prognosis, even though these were very sick patients with more than 50 per cent probability of death within the next few months.
“The impact on patients and families of having these conversations cannot be understated,” says Dr. Heyland.
Funding for the study was provided by the National Health and Research Development Program of Canada. Also on the team are Deb Pichora from Queen’s Department of Medicine and researchers from the University of Victoria, Dalhousie, UBC and McMaster.
PLEASE NOTE: A copy of the study is available upon request.
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